Specialised mental health services expenditure

Recurrent expenditure

Around $6.5 billion was spent on state and territory specialised mental health services in 2018–19. The largest proportion of this recurrent expenditure was spent on public hospital services for admitted patients ($2.8 billion), comprising of public acute hospitals with a specialist psychiatric unit or ward ($2.2 billion) and public psychiatric hospitals (almost $0.6 billion). This was closely followed by expenditure on community mental health care services totalling $2.4 billion.

Per capita expenditure on specialised mental health services ranged from $241 per person in Queensland to $325 per person in Western Australia, compared to a national average of $257 per person during 2018–19.

Per capita expenditure on state and territory specialised mental health services, adjusted for inflation, increased by an average annual rate of 1.5% between 2014–15 and 2018–19. This equates to an increase of about $16 per person, from about $241 in 2014–15 to about $257 in 2018–19.

Detailed expenditure data are available covering more than 25 years to 2018–19. Figure EXP.1 shows the changes in state and territory spending patterns, for example, increased investment in community mental health care services, reflecting changes to the state and territory specialised mental health service profile mix over this time. Further information can be found in the Specialised mental health care facilities section.

 

Figure EXP.1: Recurrent expenditure ($) per capita on state and territory specialised mental health services, constant prices, 1992-93 to 2018-19

Stacked line chart showing the per capita spending on specialised mental health services from 1992–93 to 2018–19. Public psychiatric hospital spending has decreased over the period. Spending increased for specialised psychiatric units of wards in public hospitals, community mental health care services, residential mental health services, grants to non-government-organisations and other indirect expenditure. Refer to Table EXP.4.

Visualisation not available for printing

Source data: Expenditure on mental health-related services 2018–19 tables (506KB XLSX)

Funding

The majority (96.7% or $6.2 billion of the $6.5 billion total cost) of funding for state and territory specialised mental health services was provided by state or territory governments in 2018–19. However, this estimate does not take into account the Australian Government payments to states/territories for the running of public hospital services which includes the community-based clinical services managed by public hospitals. Refer to the data source section for technical information regarding Australian Government expenditure.

Public sector specialised mental health hospital services

The $2.8 billion of recurrent expenditure for public sector specialised mental health hospital services during 2018–19 equates to an average cost per patient day of $1,254. The Northern Territory ($1,679) had the highest average cost per patient day, while the average cost in Queensland ($1,080) was the lowest.

Recurrent expenditure on public sector specialised mental health hospital services can be further described using target population (General, Child and adolescent, Youth, Older person and Forensic target groups), program type (acute and non-acute) or a combination of these.

Target population and program type

Mental health services classified as having a General target population ($2.1 billion or 72.5%) accounted for the majority of recurrent expenditure for public sector specialised mental health hospital services during 2018–19. Child and adolescent services ($2,366 per patient day) had the highest costs per patient day, continuing a long term trend of these services costing more to run than services with General target population ($1,229 per patient day), Older person ($1,101 per patient day) and Forensic ($1,304 per patient day) services.

There was an average annual increase in expenditure per patient day for General (2.3%), Child and adolescent (2.0%), Older person services (4.6%), and Forensic services (3.0%) between 2014–15 and 2018–19, adjusted for inflation.

Average patient day costs for acute public sector specialised mental health hospital services at the national level were higher than those for non-acute services for all target population categories in 2018–19.

Community mental health care services

Community mental health care services accounted for $2.4 billion of recurrent expenditure on mental health services during 2018–19, representing 37.9% of total state/territory expenditure.

Residential mental health services

Of the $404 million spent on residential mental health services during 2018–19, the majority was spent on 24-hour staffed services ($363 million or 89.9%). General services ($289 million) accounted for more than two thirds (71.4%) of the total residential expenditure.

The average national cost per patient day for residential mental health services was $522 per day in 2018–19. Average costs varied between states and territories, ranging from $353 per patient day in Western Australia to $680 per patient day in the Northern Territory.

Expenditure by target population

Recurrent expenditure for public sector specialised mental health hospital, community and residential services can be combined and presented by target population. Expenditure on General services ($252 per person) was the highest of the 5 target populations during 2018–19, reflecting that many jurisdictions do not have the other specialised target population hospital services which contribute substantial costs to the overall expenditure profile. Adjusted for inflation, General, Child and adolescent and Forensic services have had moderate per capita expenditure increases between 2014–15 and 2018–19 while per capita expenditure on Youth services increased by an average of 9.0% per year. Over this time period, per capita expenditure on Older person services decreased by an average of 0.5% per year, which reflects the fact that Older persons services have not increased to the same extent as the increases in the size of the Older persons population. For example, while the adjusted expenditure on Older person services had an annual average increase of 2.8% to $618 million between 2014–15 and 2018–19, the Older person population (65 years and over) increased by 13.7% to 4.0 million people over the same period.

Private hospital specialised mental health services

Total revenue for specialised mental health private hospital services was $791 million in 2018–19, and the non-Commonwealth sourced component of this revenue was $584 million. Adjusted for inflation, these represent annual average increases from 2014–15 of 6.5% and 6.9% per year respectively. Expenditure on specialised mental health services in private hospitals has not been available since 2017–18 due to changes in how the data is collected (see below), however historically this has been about 80% of revenue (averaged over 25 years), and was about 78% in 2016–17.

In previous years, estimates of expenditure on specialised mental health services in private hospitals were derived from the annual Private Health Establishment Collection (PHEC) undertaken annually by the Australian Bureau of Statistics. PHEC was discontinued after 2016–17. Commencing 2017–18, estimates of private psychiatric hospital care are based on the Private Psychiatric Hospitals Data Reporting and Analysis Service (PPHDRAS), a collection jointly funded by the Australian Private Hospitals Association and the Australian Government Department of Health. See the Data Source section further information.