Mental health-related prescriptions

Mental health-related prescriptions 2019–20 section (766KB PDF)This section presents Pharmaceutical Benefits Scheme (PBS) information on prescriptions for mental health-related medications; both subsidised prescriptions and under co-payment prescriptions (that is, prescriptions that cost less than the threshold for subsidy under the PBS). Mental health‑related medications reported in this section comprise Psycholeptics, Antipsychotics, Anxiolytics, Hypnotics and sedatives, Psychoanaleptics, Antidepressants, and Psychostimulants, agents used for Attention-deficit hyperactivity disorder (ADHD) and nootropics prescribed by all medical practitioners.

For further information on the PBS and Repatriation Pharmaceutical Benefits Scheme (RPBS) and the medications covered by these schemes, refer to the data source section. Related data on expenditure on medications subsidised under the PBS and RPBS are presented in the Expenditure section.

From February 2020, a range of restrictions on travel, business, social interaction and border control were introduced to prevent and reduce the spread of SARS-CoV-2, the virus that causes COVID-19. While this report explores the impact on mental health‑related prescriptions, the AIHW has published a report on the Impacts of COVID‑19 on Medicare Benefits Scheme and Pharmaceutical Benefits Scheme service use more broadly.

Data downloads:

Mental health-related prescriptions 2019–20 tables (1.2MB XLSX)

Mental health-related prescriptions 2019–20 section (766KB PDF)

Mental health-related prescriptions interactive data

Data source and key concepts related to this section.

Data coverage includes the time period 2005–06 to 2019–20. Data in this section were last updated in May 2021.

Key points

  • 40.7 million mental health-related medications (subsidised and under co-payment) were dispensed in 2019–20.

  • 4.4 million patients (17.2% of the Australian population) filled a prescription for a mental health-related medication in 2019–20, with an average of 9.2 prescriptions per patient.

  • 61.7% of mental health-related prescriptions filled were subsidised by the PBS/RPBS in 2019–20.

  • 82.7% of mental health-related prescriptions filled were prescribed by GPs; 7.3% prescribed by psychiatrists; 4.6% prescribed by non-psychiatrist specialists in 2019–20.

  • 72.1% of mental health-related prescriptions filled were for Antidepressant medications in 2019–20.

Overview

There were 40.7 million prescriptions filled for mental health-related medications (subsidised and under co-payment)  in Australia in 2019–20. This is equivalent to 1,596.5 mental health-related prescriptions per 1,000 population. These medications were dispensed to 4.4 million patients, which equates to 17.2% of Australians. There was an average of 9.2 prescriptions filled per patient in 2019–20.

Of the 40.7 million mental health related prescriptions, 25.1 million were subsidised under the PBS/RPBS and filled by 2.5 million patients; an average of 10 subsidised prescriptions per patient in 2019–20.

Patient characteristics

More than 1 in 6 Australians (17.2% of the Australian population) filled a mental health-related prescription in 2019–20. Tasmania had the highest proportion of people (22.6% of the population) dispensed with mental health-related medications (subsidised or under co-payment), while New South Wales (16.1%) had the lowest (excluding the Northern Territory – refer to the Note accompanying Figure PBS.1). Victoria (16.4%) and the Australian Capital Territory (16.5%) had similar rates to New South Wales.

Figure PBS.1: People (per cent of the population) dispensed with mental health-related prescriptions, states and territories, 2019-20.

Bar chart showing the per cent of patients filling mental health-related prescriptions (subsidised and subsidised and under co-payment) by states and territories in 2019–20. New South Wales had 9.3% of the population filling subsidised prescriptions, Vic (9.1%), Qld (10.8%), WA (9.6%), SA (11.6%), Tas (14.2%), ACT (7.0%), NT (4.7%), Australian total (9.7%). When considering subsidised and under co-payment prescriptions: NSW (16.1%), Vic (16.4%), Qld (19.0%), WA (17.9%), SA (19.0%), Tas (22.6%), ACT (16.5%), NT (10.0%), Australia total (17.2%). Refer to Table PBS.2.

Source data: Mental health-related prescriptions 2019–20 tables (1.2MB XLSX).

The proportion of people filling mental health-related subsidised and under co-payment prescriptions in 2019–20 was lowest for the youngest age groups (0.2% of people aged 0–4 years, 4.3% of people aged 5–11 years and 8.2% of people aged 12–17 years), increasing by age group to 42.1% for people aged 85 years and over (Figure PBS.2). A higher proportion of females filled mental health-related prescriptions than males (20.4% and 14.0% of the respective populations). A greater proportion of people living in Inner regional areas were dispensed with mental health-related medications (21.1% of the Inner regional population), followed by people living in Outer regional areas (18.9%), Major cities (16.4%), Remote (13.5%) and Very remote (7.9%) areas.

Figure PBS.2: People (per cent of the population) dispensed with mental health-related prescription (subsidised and under co-payments), by patient demographics.

Horizontal bar chart showing the per cent of people filling mental health-related prescriptions (subsidised and under co-payment), by patient demographics for 2019–20. Rates were lowest for people aged 0–4 years (0.2% age specific population) gradually increasing to the highest rate for those 85 years and over (42.1%). The proportion of females (20.4%) filling prescriptions was higher than males (14.0%). Rates varied among patient area of usual residence: Major cities (16.4% of the Major City population), Inner regional (21.1%), Outer regional (18.9%), Remote (13.5%) and Very remote (7.9%). Refer to Table PBS. 4.

Source data: Mental health-related prescriptions 2019–20 tables (1.2MB XLSX)

The population rate for females aged 85 and over filling mental health‑related prescriptions (subsidised and under co‑payment), was higher than all other age groups for all drug types, except for Psychostimulants, agents used for ADHD and nootropics where those aged 12–17 had the highest population rate. A similar pattern was seen in males except the highest population rate for Psychostimulants, agents used for ADHD and nootropics was for those aged 5–11. When comparing males and females, a higher proportion of males were dispensed Psychostimulants, agents used for ADHD and nootropics, while a higher proportion of females were dispensed Anxiolytics, hypnotics and sedatives, and Antidepressants. The rates for Antipsychotics were the same for males and females.

Over time

The proportion of the population filling PBS and RPBS subsidised and under co-payment mental health-related prescriptions has risen from 16.6% in 2015–16 to 17.2% in 2019–20. The proportion of people filling subsidised mental health-related prescriptions has declined by an average of 0.9% per year over the same period, from 10.1% in 2015–16 to 9.7% in 2019–20 (Figure PBS.3). 

Figure PBS.3: People (per cent of population) dispensed with mental health-related prescriptions, 2007-08 to  2019-20.

Line chart showing the rate (per cent of the population) of filled mental health-related subsidised prescriptions, and subsidised and co-payment prescriptions, by year. Rates of subsidised prescriptions have fluctuated from a high of 11.2% (in 2007–08) and a low of 9.6 in 2018–19. Rates for total prescriptions filled (subsidised and under co-payment) are only available from 2012–13 and have been steadily increasing from 15.9% in 2012–13 to 17.2% in 2019–20. Refer to Table PBS.3.

Source data:Mental health-related prescriptions 2019–20 tables (1.2MB XLSX)

Prescriptions

States and territories

The Australian Capital Territory (684.9 subsidised prescriptions per 1,000 population) had the lowest rate of mental health-related prescriptions filled for subsidised prescriptions, while New South Wales (1,456.8 subsidised and under co-payment prescriptions per 1,000 population) had the lowest rate of subsidised and under co-payment prescriptions filled in 2019–20 (with the exception of the Northern Territory; see Figure PBS.4, and the associated note). Tasmania had the highest rate of prescriptions filled (1,449.9 subsidised and 2,169.3 subsidised and under co-payment prescriptions per 1,000 population). These patterns were similar to the patient rates (see Figure PBS.1).

Figure PBS.4: Mental health-related prescriptions (per 1,000 population), by states and territories 2019-20.

Bar chart showing rate of mental health-related prescriptions filled (subsidised and under co-payment) per 1,000 population by jurisdiction in 2019–20. Subsidised prescription rates: NSW (916.5), Vic (931.5), Qld (1,086.6), WA (946.1), SA (1,177.9), Tas (1,449.9), ACT (684.9), NT (422.6), National total (985.3). Subsidised and under co-payment prescription rates: NSW (1,456.8), Vic (1,531.2), Qld (1,756.7), WA (1,621.0), SA (1,777.5), Tas (2,169.3), ACT (1,479.4), and NT (809.3), National total (1,596.5). Refer to Table PBS.11.

Source data: Mental health-related prescriptions 2019–20 tables (1.2MB XLSX)

Prescription characteristics

Of the 40.7 million mental health-related medications (subsidised and under co-payment) dispensed in 2019–20, the majority (82.7%) were prescribed by general practitioners (GPs), with another 7.3% prescribed by psychiatrists and 4.6% by non-psychiatrist specialists. These proportions were similar for subsidised prescriptions.

The majority of subsidised and under co-payment mental health-related prescriptions filled were for Antidepressants (72.1%, or 29.4 million) in 2019–20, followed by Antipsychotics (10.4%), Anxiolytics (8.4%), Hypnotics and sedatives (5.0%) and Psychostimulants, agents used for ADHD and nootropics (4.1%) (Figure PBS.5). Among the categories of medications, the majority of prescriptions were issued by GPs, except for Psychostimulants, agents used for ADHD and nootropics. Similar patterns were observed for subsidised prescriptions.

Figure PBS.5: Mental health-related prescriptions (subsidised and under co-payment), by type of medication and prescribing medical practitioner, 2019-20.

horizontal bar chart showing the number of mental health-related prescriptions filled (subsidised & under co-payment), by ATC group of medication and prescribing medical practitioner, 2019–20. Antidepressants were prescribed by: GPs (25.8 million), non-psychiatrist specialists (0.8), psychiatrists (1.6). Antipsychotics: 2.8, 0.1, 0.7. Anxiolytics: 3.0, 0.1, 0.2. Hypnotics and sedatives: 1.8, 0.1, 0.05 Psychostimulants, agents used for ADHD and nootropics: 0.3, 0.9, 0.5. Refer to Table PBS.11.

Source data: Mental health-related prescriptions 2019–20 tables (1.2MB XLSX)

Antidepressants and Antipsychotics had the highest average number of subsidised and under co-payment prescriptions filled per patient (8.8 and 8.7, respectively) in 2019–20. Psychostimulants, agents used for ADHD and nootropics had the least number of prescriptions filled, but had the third highest rate of prescriptions filled per patient (7.1). A similar pattern was observed for subsidised prescriptions.

Females had a higher rate of subsidised and under co-payment mental health-related prescriptions filled (1,901.0 per 1,000 population) than males (1,262.9) in 2019–20. However males and females filled a similar number of scripts per patient, averaging 9.0 for males and 9.3 for females.

Over time

For the period 2015–16 to 2019–20, the rate (per 1,000 population) of subsidised and under co-payment mental health-related prescriptions being filled increased from 1,487.7 to 1,596.5, an average annual increase of 1.8%. In contrast, the rate of PBS and RPBS subsidised prescriptions being filled decreased over the same period from 1,001.6 to 985.3 per 1,000 population, an average annual decrease of 0.4% (Figure PBS.6). The same pattern in seen for patients filling mental health-related prescriptions. This is partly due to price reductions on medications no longer under patent. More information about this is available in the Expenditure on mental health-related services section.

Figure PBS.6: Rate (per 1,000 population) of  mental health-related prescriptions 2004-05 to 2019-20.

Line chart showing the rate of mental health-related prescriptions filled (subsidised and subsidised and co-payment per 1,000 population between 2006–07 and 2019–20. Rates of subsidised prescriptions: 988.8 for 2006–07, 984.3 for 2008–09, 1,036.7 for 2010–11, 1,045.9 for 2012–13, 1,018.8 for 2014–15, 982.6 for 2016–17, 971.9 for 2018–19 and 985.3 for 2019–20. Rates for subsidised and co-payment prescriptions: 1,378.5 for 2012–13, 1,424.6 for 2013–14, 1,456.3 for 2014–15, 1,487.7 for 2015–16, 1,506.1 for 2016–17, 1,524.0 for 2017–18, 1,548.9 for 2018–19 and 1,596.5 for 2019–20. Refer to Table PBS.12.

Source data: Mental health-related prescriptions 2019–20 tables (1.2MB XLSX)

Between 2015–16 and 2019–20, the rate (per 1,000 population) of mental health-related subsidised and under co-payment prescriptions filled decreased from 156.6 to 133.6 for Anxiolytics and from 103.2 to 79.6 for Hypnotics and sedatives, an average annual decrease of 3.9% and 6.3% respectively. Conversely, the prescription rates have increased over the same period of time from 163.1 to 166.1 for Antipsychotics; from 1020.9 to 1151.4 for Antidepressants; and from 44.0 to 65.8 for Psychostimulants, agents used for ADHD and nootropics, an average annual increase of 0.5%, 3.1% and 10.6% respectively.

Prescriptions during COVID-19 pandemic

Analyses of prescriptions for mental health‑related medications by quarter have been included to show seasonal variations in medication dispensed, and provide more insight into the impact of events such as the COVID-19 pandemic. These include service and person counts disaggregated by medication type, age group and sex (Tables PBS.8–9, PBS.18–19).

Between 2018–19 and 2019–20, the January to March quarter had the highest percentage increase in both the total prescriptions filled and the patients dispensed one or more subsidised and under co-payment mental health-related medications. This is consistent with the general trend seen across the PBS, with a 23.1% increase in the number of medications dispensed in March 2020 compared with March 2019 (AIHW, 2020).

Regional reporting

Information on subsidised and under co-payment mental health-related prescriptions can also be reported at the sub-jurisdictional level, within state and territory boundaries.

Sub-jurisdictional data for 2019–20 are included with the data downloads for this section (Table PBS.20, Table PBS.21, Table PBS.22 and Table PBS.23). This data shows variation in the number and rate of prescriptions and patients across Australia’s 31 Primary Health Network (PHN) areas, as well as at the Statistical Area 3 (SA3) region level. For the analysis presented here, geographical area is based on the patient's residential address, or, if the patient’s address is unknown, the location of the supplying pharmacy is used.

The Tasmanian Central Highlands SA3 region had the highest rate of subsidised and under co-payment mental health-related medications dispensed in 2019–20 (2,765.3 per 1,000 of the population), followed by the North West Hobart SA3 region (2,673.7), while Christmas Island and East Arnhem had the lowest rate of medications dispensed (240.9 and 281.3 of the respective populations).

The Tasmanian Central Highlands SA3 region had the highest rate of patients filling subsidised and under co-payment mental health-related prescriptions in 2019–20 (28.3% of the population), followed by the Tasmanian South East Coast and North West Hobart SA3 regions in Tasmania (26.8% and 26.2% of the respective populations), while East Arnhem and Christmas Island had the lowest rates of patients filling prescriptions (3.6% and 4.0% of the respective populations).