Patient demographics
In 2018–19, there was a higher proportion of mental health-related presentations among patients aged 18–54 (70.6%) compared with all emergency department presentations (44.6%). By contrast, there was a lower proportion of mental health-related presentations among patients aged less than 18 (10.3%) compared with all emergency department presentations (24.2%). Of all patient age groups, those aged 25–34 represented the highest proportion of both mental health-related (20.7%) and all (13.6%) ED presentations. The highest population rate of all ED presentations occurred among patients aged 85 years and over (8,033.5 per 10,000 population), whereas the highest rate of mental health-related presentations occurred among patients aged 18–24 (205.1 per 10,000 population). This is likely to be influenced by the typical age of onset of many mental disorders (WHO 2019).
Males had a higher number of mental-health related ED presentations than females in 2018–19 (representing 52.3% and 47.7% respectively), but were more equally represented in all ED presentations (49.9% and 50.1% respectively). The population-rate of mental health-related ED presentations for males was higher than the rate for females (127.1 and 113.9 per 10,000 population respectively).
Aboriginal and Torres Strait Islander people, who represent about 3.3% of the Australian population (ABS 2018), accounted for 11.2% of mental health-related ED presentations, compared with 7.1% of all ED presentations. The rate of mental health-related ED presentations for Indigenous Australians was more than 4 times that of non-Indigenous Australians (449.4 and 108.0 per 10,000 population respectively).
People living in areas classified as having the lowest socioeconomic status (SEIFA Quintile 1) had the highest population-rate of mental health-related ED presentations (149.6 per 10,000 population), with the rate decreasing with increasing socioeconomic status, to 79.8 per 10,000 population for people in the least disadvantaged area (Quintile 5) (Figure ED.2).
People living in Major cities accounted for almost two-thirds (64.7%) of mental health-related ED presentations, and those in Remote and Very remote areas accounted for 3.4% of presentations in 2018–19. The rate per 10,000 population of mental health-related ED presentations for patients living in Major cities was the lowest (104.1) while that for patients in Remote and Very remote areas was the highest (202.6).
Detailed ED data for mental health-related presentations by Primary Health Network (PHN) show variation in the number and rate of presentations within PHN groups at the Statistical Area 3 (SA3) region level. In 2018–19, the highest mental health-related ED presentation rate occurred among patients living in the Tumut-Tumbarumba SA3 region (1,520.8 per 10,000 population) in New South Wales, followed by Barkly (585.4) and Alice Springs (540.5) in the Northern Territory. Note that some areas do not have EDs in scope for provision to the National Non-Admitted Patient Emergency Department Care Database (NNAPEDCD). Further information on NNAPEDCD coverage is available in the data source section. The observed variability in emergency department presentation rates between geographical areas may be due to a range of factors including the proportion of the population in an area with a diagnosable mental illness who present to the emergency department, availability of community-based services and variability in approaches to planning and delivering mental health support services across and within states and territories.