Overnight admitted mental health-related care

Some people’s mental health care needs may require care in a hospital setting such as a hospital ward, an emergency department or an outpatient clinic. A patient may be admitted to the hospital just for the day, a single overnight stay, or for a number of days. Care that lasts more than one day is referred to as, overnight admitted patient care.

When admitted to a hospital, patients can receive specialised psychiatric care in a psychiatric hospital or in a hospital’s psychiatric unit. Patients with mental illness may also be admitted overnight to other areas of the hospital where health care workers may not be specifically trained to care for the mentally ill, such as a drug and alcohol treatment unit. These overnight admissions are classified as being without specialised psychiatric care.

This section presents information on overnight admitted patient mental health-related separations from Australian hospitals. Data are sourced from the National Hospital Morbidity Database (NHMD); a collation of data on admitted patient care in Australian hospitals defined by the Admitted Patient Care National Minimum Data Set (APC NMDS). It is possible for patients to have multiple separations in any given reference period. Further information can be found in the data source section. The statistical measures presented are derived based on episodes of care that ended within a collection period.

Data downloads:

Overnight admitted mental health-related care tables 2017–18 (272KB XLS)

Overnight admitted mental health-related care section 2017–18 (906KB)

Data coverage includes the time period 2006–07 to 2017–18. This section was last updated in October 2019.

Key points

  • 260,250 overnight admitted mental health-related hospital separations occurred in 2017–18, of which 63.6% included specialised psychiatric care.
  • About a third (36.3%) of overnight mental health separations with specialised psychiatric care were involuntary admissions.
  • Depressive episode (14.8%) and Schizophrenia (14.1%) were the most common diagnoses for overnight mental health separations with specialised psychiatric care.
  • Aboriginal and Torres Strait Islander people rates of overnight mental health separations with and without specialised care were about 151 and 117 per 10,000 population respectively, which are respectively about 2.4 and 3.4 times the rates for other patients.
  • Over the past decade, the population rate of overnight mental health related hospital separations increased by 1.7% per year on average.
  • For females aged 12–17, the population rate of overnight separations with specialised care has doubled between 2006–07 and 2017–18.
  • For those aged 85+, the population rate of overnight mental health separations without specialised care has increased by 75.5%, from 2006–07 to 2017–18.
  • For 12–17 year old females, the population rate of overnight mental health separations has consistently been about 2 to 3 times the rate for males, throughout 2006–07 to 2017–18.

There were about 4.4 million overnight hospital separations in 2017–18, across the public and private hospital sectors. Of these 260,250 were mental health-related, representing about 1 in 17 (5.9%) of all overnight hospital separations. Almost two thirds of overnight mental health related separations involved specialised psychiatric care (165,452 or 63.6%). About 4 in 5 overnight mental health-related separations occurred in public hospitals (79.0%).

The number of overnight mental health separations increased by 0.8% from the previous year, similarly to non-mental health overnight separations at 0.9%. However across longer time frames, mental health separations have increased more rapidly, with an annual average of 5.1% from 2013–14 to 2017–18, and an annual average of 3.4% across the decade from 2007–08 to 2017–18. In comparison, non-mental health overnight separations increased by annual averages of 2.3% and 2.4% respectively over the same periods.

While the number of overnight mental health separations increased year-on-year, the associated number of patient days declined -21.4% from 4,492,549 to 3,530,189. This decline was attributable to a -28.2% decline in the public hospital sector. In contrast, the private hospital sector saw a 5.1% year-on-year increase in patient days associated with mental health separations. Furthermore, patient days associated with non-mental health separations did not change substantially year-on-year.

The large decline in patient days associated with public hospital mental health related separations from 2016–17 to 2017–18 followed large increases from 2014–15 to 2015–16 and 2015–16 to 2016–17. These fluctuations are likely to be related to the introduction of the Mental health care type from 1 July 2015. For example, to change the care type of patients receiving mental health care, Queensland (in 2015–16) and New South Wales (in 2016–17) discharged and readmitted patients, causing the rise in separations and patient days counted in those years. The rise in patient days is substantially impacted by long stay mental health patients, who can individually account for hundreds or thousands of days. The subsequent decline in patient days seen in 2017–18 is impacted by days accrued before the change in care type being counted in an earlier year.

Over the past decade (2007–08 to 2017–18) the number of mental health related patient days has increased by an average of 1.6% per year, which compares to an average of 0.9% per year for non-mental health related patient days. Over the past decade the number of procedures associated with overnight mental health separations increased by 8.7% per year on average, which compares to 3.2% for procedures associates with non-mental health separations. 

The average length of stay for overnight mental health related separations was 13.6 days in 2017–18, which contrasts with 4.8 days for non-mental health related separations. Despite recent fluctuations, the average length of stay for overnight mental health separations has consistently been around 3 times that of non-mental health separations across the time span from 2006–07 to 2017–18.