Mental health services in Australia

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 2016–17.

States and territories

In 2016–17, the national rate of public hospital mental health-related separations without specialised psychiatric care was 35.4 per 10,000 population. Northern Territory had the highest rate (53.3 per 10,000 population) while Tasmania had the lowest (25.9) (Figure ON.5).

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 Alternative text - Source data: Overnight admitted mental health-related care Table ON.12 (911KB XLS).

For public hospitals in 2016–17, the majority (84.0%) 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 96.5% for the Northern Territory to 78.9% for New South Wales. For private hospitals, the majority (83.2%) of these separations had a funding source of Private health insurance. Among the jurisdictions for which private hospital figures are published, this ranged from 91.4% for South Australia to 75.7% for Western Australia.

In 2016–17 the most common mode of separations for overnight mental health-related separations without specialised psychiatric care in both public (67.1%) and private (85.7%) 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 74.8% for the Australian Capital Territory to 61.1% for South Australia. For private hospitals, among the jurisdictions for which private hospital figures are published, this ranged from 90.6% for New South Wales and Queensland to 67.4% for Western Australia.

Patient characteristics

Patient demographics

In 2016–17, the highest rate of overnight mental health-related separations without specialised psychiatric care was for patients aged 65 and older (92.1 per 10,000 population) and the lowest for those aged under 15 (12.3). The separation rate was slightly higher for females than males (39.0 and 38.2 per 10,000 population respectively) (Figure ON.6).

Figure ON.6 Alternative text - Source data: Overnight admitted mental health-related care Table ON.13 (911KB 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 (126.0 and 34.2 per 10,000 population respectively).

Those living in Remote and Very remote areas (74.1 per 10,000 population) had a higher rate of overnight mental health-related separations without specialised psychiatric care in 2016–17 than those in Major cities (36.1 per 10,000 population).

Those living in the most disadvantaged socioeconomic quintile (47.8 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 (30.4).

Principal diagnosis

In 2016–17, 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) (21.1% in public hospitals and 20.9% in private hospitals), followed by Other organic mental disorders (18.0% in public and 17.2% in private hospitals) (Figure ON.7).

Figure ON.7 Alternative text - Source data: Overnight admitted mental health-related care Table ON.14 (911KB XLS).

Procedures

Almost two-thirds (63.8%) of overnight mental health-related separations without specialised psychiatric care recorded at least 1 procedure in 2016–17. The most frequently reported procedure block was Generalised allied health intervention, which was recorded for almost half (48.3%) of separations without specialised psychiatric care. Allied health interventions were most frequently for Social work (23.2% of allied health procedures), followed by Physiotherapy (22.0%) and Occupational therapy (16.9%).

The next most frequently reported procedure block was Alcohol and drug rehabilitation and detoxification, which was recorded for 9.6% of overnight separations without specialised psychiatric care.

Regional reporting

Information on overnight mental health-related separations is reportable 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 2016–17, the national rate of mental health-related separations both with and without specialised psychiatric care was 107 per 10,000 population. At the PHN level, North Coast (NSW) had the highest rate (132 per 10,000 population) and Gippsland (Vic) the lowest (73 per 10,000 population). At the SA3 level, Fyshwick - Pialligo - Hume (ACT) had the highest rate (413 per 10,000 population) and Cotter - Namadgi (ACT) the lowest (24).  

The observed variability in hospitalisation 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 are admitted to hospital, availability of community-based services and variability in approaches to planning and delivering mental health support services across and within states and territories.