Mental health services in Australia

Services

There were 12.4 million Medicare-subsidised mental health-specific services provided to 2.7 million Australians in 2019–20. Further details of the characteristics of these services are described below. Victoria (542.6 services per 1,000 population) had the highest rate of services, and Northern Territory (164.3) had the lowest, considerably lower than the national rate (486.1) (Figure MBS.4).

Source data: Medicare-subsidised mental health-specific services 2019–20 tables (740KB XLSX)

In 2019–20, Australians aged 18–24 years had the highest rate of Medicare-subsidised mental health-specific service use (69.6 services per 100 people aged 18–24 years), and people aged 0–4 years had the lowest usage rate (2.6 services per 100 people aged 0–4 years). Females had a higher rate of service usage than males (60.8 and 36.2 services per 100 females and males, respectively). People living in Major cities had the highest rate of service use (52.5 services per 100 people living in Major cities), with rates decreasing with increasing remoteness to 9.4 for Very remote (Figure MBS.5).

Source data:  Medicare-subsidised mental health-specific services 2019–20 tables (740KB XLSX)

Average number of services per patient

In 2019–20, patients in Victoria had the highest average number of Medicare-subsidised mental health-specific services per patient (4.8), compared to the national average of 4.5 services per patient. The Northern Territory had the lowest number of services per patient at 2.9. The average number of services per patient for all other states and territories ranged between 4.2 and 4.6 services per patient. For the age groups analysed, people aged 55–64 had the highest average number of services per patient (4.8) and patients aged 0–4 years had the lowest (2.6). Females had more services per patient than males (4.7 and 4.2, respectively).

Over time

The total number of Medicare-subsidised mental health-specific services increased from 7.0 million in 2009–10 to 12.4 million in 2019–20; increasing from 319.6 services per 1,000 population in 2009–10 to 486.1 in 2019–20 (Figure MBS.6). The increase in the rate of services was mostly due to increases in services provided by GPs (increase of 2.0 million from 2009–10 to 2019–20), followed by Psychological Therapy Services provided by clinical psychologists (1.5 million), and other psychological services provided by clinical psychologists and other psychologists (1.2 million). There was a relatively small increase in the rate of Medicare-subsidised mental health-specific services delivered by psychiatrists (average annual change of 0.9% from 2009–10 to 2019–20). In 2006–07 new items were added through the Better Access initiative. In 2019–20, further Better Access items were added, as well as additional mental health-related items in response to the COVID-19 pandemic (next section). Refer to DOH 2020 reference for further information about Better Access.

Source data: Medicare-subsidised mental health-specific services 2019–20 tables (740KB XLSX)

Services provided via telehealth during the COVID-19 pandemic

During the course of the COVID-19 pandemic, the Australian Government introduced a wide range of additions to the MBS to support provision of care via telehealth, to help reduce the risk of community transmission of COVID-19 and provide protection for both patients and health care providers. These items include mental health services provided by GPs, psychiatrists, psychologists and allied health workers.

Nearly 1.5 million (11.8%) services were provided via telehealth (phone or video) in 2019–20. Psychiatrists and clinical psychologists provided a higher proportion of Medicare-subsidised mental health-specific services via telehealth than other types of providers (14.6% and 14.4% respectively), and GPs provided the lowest proportion of mental health MBS services via telehealth (8.2%). For more detail about the use of telehealth services during the pandemic, more information can be found in the Mental health impact of COVID-19 section.

Use of services during the beginning of the COVID-19 pandemic

New analyses of the Medicare-subsidised mental health-specific services by quarter have been included to show seasonal variations in service use, and provide more insight into the impact of events such as the COVID-19 pandemic. These include service and person counts disaggregated by provider type, age group and sex (Tables MBS.24–MBS.27).

From 2015–16 to 2018–19 the number of people receiving Medicare-subsidised mental health-specific services and the number of services being delivered was consistently highest in the April–June period and lowest in the October–December period. Note that reduced service usage is typical during public holidays and particularly the Christmas/New Year period.

In 2019–20, an unseasonably low number of people used services in April–June, likely due to movement restrictions during lockdown periods. However, a relatively high number of services were still used, meaning more services were used per person in April–June (2.1) than in other quarters (1.8–1.9).

Providers show different patterns of activity over the year. Psychiatrists provide services to a relatively stable number of patients, while GPs and psychologists show more seasonal variations. The number of patients accessing GP provided mental health services typically peak in the January–March period, while the number of patients accessing psychologist provided services typically peak in the April–June period. However this pattern was not observed in 2019–20; it is too early to tell if this is a one-off change driven by lockdown restrictions.