Non-specialised admitted patient mental health care

Service provision

Non-specialised admitted patient mental health care takes place outside a designated psychiatric unit but for which the principal diagnosis is considered to be mental health-related. A list of mental health related principal diagnoses is available in the technical information section. Data for public acute and public psychiatric hospitals are combined in this section as there were very few separations without specialised psychiatric care in public psychiatric hospitals in 2015–16.

States and territories

In 2015–16, the national rate of public hospital mental health-related separations without specialised psychiatric care was 33.4 per 10,000 population. South Australia had the highest rate (46.8 per 10,000 population) while Tasmania had the lowest (21.6).  

The rate of mental health-related separations without specialised psychiatric care in private hospitals for the Australian Capital Territory, Tasmania, and the Northern Territory are not published for confidentiality reasons. In all other reported jurisdictions, the rates were less than 6 separations per 10,000 population (Figure ON.5). 

Figure ON.5: Overnight mental health-related separations without specialised psychiatric care, states and territories, by hospital type, 2015–16

Vertical bar chart showing the rate (per 10,000 population) of overnight admitted mental health-related separations without specialised psychiatric care for all states and territories. The aggregate rate for all public hospitals was 33.4 and private hospitals 3.7. Public hospitals by state or territory: NSW 37.1; Vic 29.2; Qld 29.0; WA 33.9; SA 46.8; Tas 21.6; ACT 29.8; NT 42.5. Refer to Table ON.12

Notes:

1. The Northern Territory and Australian Capital Territory do not have any public psychiatric hospitals.

2. Private hospital figures for the Australian Capital Territory, Tasmania and the Northern Territory are not published for confidentiality reasons.

Source: National Hospital Morbidity Database.

Source data: Overnight admitted mental health-related care Table ON.12 (690KB XLS).

For public hospitals in 2015–16, the majority (85.6%) of overnight mental health-related separations without specialised psychiatric care had a funding source of Public patient (e.g. health service budget or reciprocal health care agreement). This ranged from 96.0% for the Northern Territory to 75.2% for Tasmania. For private hospitals, the majority (81.7%) of these separations had a funding source of Private health insurance. Among the jurisdictions for which private hospital figures are published, this ranged from 87.4% for Victoria to 79.2% for both Queensland and Western Australia.

In 2015–16 the most common mode of separations for overnight mental health-related separations without specialised psychiatric care in both public (68.0%) and private (86.5%) hospitals was discharge to ‘home’, which includes discharge to usual residence/own accommodation/welfare institution (including prisons, hostels and group homes providing primarily welfare services). For public hospitals this ranged from 76.4% for the Northern Territory to 61.8% for South Australia. For private hospitals, among the jurisdictions for which private hospital figures are published, this ranged from 90.8% for New South Wales to 69.0% for Western Australia.

Patient characteristics

Patient demographics

In 2015–16, the highest rate of overnight mental health-related separations without specialised psychiatric care was for patients aged 65 and older (8.76.6 per 10,000 population) and the lowest for those aged under 15 (12.5) (Figure ON.6). The separation rate was higher for females than males (38.0 and 36.2 per 10,000 population respectively).

Figure ON.6: Overnight mental health-related separations without specialised psychiatric care, by sex and age, 2015–16

Vertical bar chart showing the rate (per 10,000 population) of overnight admitted mental health-related separations without specialised psychiatric care by age-group and sex. In aggregate terms, females (38.0) had a slightly higher rate than males (36.2). Persons by age group: <15 years 12.5; 15-24 years 27.7; 25-34 years 34.3; 35-44 years 40.0; 45-54 years 33.6; 55-64 years 27.0; 65 years and older 86.6. Refer to Table ON.3.

Source: National Hospital Morbidity Database.  

Source data: Overnight admitted mental health-related care Table ON.3 (690KB XLS).

Aboriginal and Torres Strait Islander people had a rate of overnight mental health-related separations without specialised psychiatric care that was more than 3 times that of other Australians (112.4 and 33.0 per 10,000 population respectively).

Those living in Remote and very remote areas (65.4 per 10,000 population) had a higher rate of overnight mental health-related separations without specialised psychiatric care in 2015–16 than those in Major cities (34.3 per 10,000 population).

Those living in the most disadvantaged socioeconomic quintile (46.0 per 10,000 population) had a higher rate of overnight mental health-related separations without specialised psychiatric care than those living in the least disadvantaged quintile (28.9).

Principal diagnosis

In 2015–16, the most frequently reported principal diagnosis for overnight mental health-related separations without specialised psychiatric care were Mental and behavioural disorders due to use of alcohol (ICD-10-AM code F10) (21.2% in public hospitals and 20.1% in private hospitals), followed by Other organic mental disorders (16.9% in public and 15.7% in private hospitals) (Figure AD.7).

Figure ON.7: Overnight mental health-related separations without specialised psychiatric care (per cent), by the 5 most frequently reported principal diagnoses, 2015–16

Horizontal bar chart showing the percent of overnight admitted mental health-related separations without specialised psychiatric care for the 5 most frequently reported principal diagnoses. The 5 most common principal diagnoses for all hospital types: Mental and behavioural disorders due to use of alcohol (F10) 21.1%25; Other organic mental disorders (F04-09) 16.8%25; Mental and behavioural disorders due to other psychoactive substance use (F11-19) 8.9%25; Dementia (F00-03) 8.3%25; Depressive episode (F32) 7.2%25. Refer to Table ON.14.

Source: National Hospital Morbidity Database.

Source data: Overnight admitted mental health-related care Table ON.14 (690KB XLS).

Procedures

About 3 in 5 (63.3%) of overnight mental health-related separations without specialised psychiatric care recorded at least 1 procedure in 2015–16. The most frequently reported procedure block was Generalised allied health intervention, which was recorded for almost half (46.2%) of separations without specialised psychiatric care. Allied health interventions were most frequently for Social work (22.8% of allied health procedures), followed by Physiotherapy (22.5%) and Occupational therapy (16.8%).

The next most frequently reported procedure block was Alcohol and drug rehabilitation and detoxification, which was recorded for 10.1% of overnight separations without specialised psychiatric care.

Regional reporting

Information on overnight mental health-related separations can be reported at smaller geographic areas than state and territory boundaries. Sub-jurisdictional reporting provides the opportunity to consider differences within the jurisdictions boundary. For the analysis presented here, the geographical area is based on the usual residence of the patient rather than the geographical location of the hospital. There are two types of geographical areas which are reported here:

  • Primary Health Network (PHN) areas – 31 geographic areas covering Australia, with boundaries defined by the Australian Government Department of Health.
  • Statistical Areas Level 3 (SA3s) – 333 geographic areas covering Australia, with boundaries defined by the Australian Bureau of Statistics.

In 2015–16 the national rate of mental health-related separations both with and without specialised psychiatric care was 102 per 10,000 population. At the PHN level, Country SA had the highest rate (135 per 10,000 population) and Australian Capital Territory the lowest (73). At the SA3 level, Adelaide City (SA) had the highest rate (224 per 10,000 population) and Litchfield (NT) the lowest (43).   

It is important to note that variability in hospitalisation rates between geographical areas may be due to one or more of a range of factors including the proportion of the population in an area with a diagnosable mental illness who are admitted to hospital, availability of community-based services and variability in approaches to planning and delivering services across and within states and territories.

This analysis was originally published on the AIHW’s My Healthy Communities website.