Mental health services in Australia

This section presents information on specialist disability support services, provided under the National Disability Agreement (NDA) to service users with a Psychiatric disability either as their Primary disability or as an Other significant disability. Unless otherwise stated, service users with a psychiatric disability include all service users with a psychiatric disability, regardless of whether it is considered a primary or other significant disability. The progressive transition of service users from the NDA to the National Disability Insurance Scheme (NDIS) has reduced the collection of data under the NDA. For this reason, comparisons of data between years should be undertaken with caution.

While some specialist disability support services provided under the NDA have been rolled into the NDIS, other services (such as Disability Employment Services) will continue once the NDIS is fully rolled out. Further information can be found in Disability support services: services provided under the National Disability Agreement 2018–19 (AIHW 2020).

The information presented in this section has been extracted from the 2018–19 Disability Services National Minimum Data Set (Disability Services NMDS); comprising national administrative data on disability support services. The data source section provides further information on coverage, data quality and other aspects of the Disability Services NMDS.

The NDIS began operating at trial sites in July 2013. From July 2016, it began transitioning to the full scheme and the roll-out is nearing completion. Most, but not all, existing NDA service users are expected to move to the NDIS over time (AIHW 2020). This section also includes data from the Disability Services NMDS on the number of NDA service users who transitioned to the NDIS in the period 2014–15 to 2018–19.

As at 30 June 2019, there were 25,192 people with a primary psychosocial disability, that may arise from a mental health issue, who were active participants with an approved plan (a document outlining a participant’s needs and goals) under the NDIS (NDIA 2019). The data source section provides further information on the NDIS.

The National Disability Insurance Agency (NDIA) is an independent statutory agency whose role is to implement the NDIS. The NDIA collects data pertaining to the NDIS and publishes online quarterly reports (NDIA 2019). More information about the NDIS can be found on the NDIS website.

Data downloads:

Psychiatric disability support services 2018–19 tables (258kB XLSX)

Psychiatric disability support services 2018–19 section (507kB PDF)

This section data was last updated in July 2020.

Key points

Service users with a psychiatric disability

Across Australia, 229,752 people made use of specialist disability support services provided under the NDA during 2018–19 (AIHW 2020). There were 106,401 service users with a psychiatric disability, and of these, 70,791 had a primary psychiatric disability.

In 2018–19, there were 422.6 users of psychiatric disability support services per 100,000 population nationally (Figure DIS.1). South Australia had the highest rate of service users (606.4), followed by Queensland (490.0) and Victoria (477.9). Note that the Australian Capital Territory Government did not collect Disability Services NMDS data in 2015–16 and 2016–17, and was not required to collect data under the NDA during 2017–18 and 2018–19 as the transition of clients to the NDIS was completed in 2016–17. Consequently, ACT data only includes users of Australian Government administered services.

Source data: Psychiatric disability support services 2018–19 tables (258KB XLSX).

Over the 5 years to 2018–19, the rate of service users per 100,000 population with a psychiatric disability increased an average of 0.7% annually, from 407.1 in 2014–15 to 422.6 in 2018–19 (Figure DIS.2). Note that data from 2013–14 onwards are affected by the progressive introduction of the NDIS—as a result, analysing trends in Disability Services NMDS data over time is complex, but a decrease in the number of NDA clients is expected as the roll-out of the NDIS progresses. More information can be found in the data source section.

Source data: Psychiatric disability support services 2018–19 tables (258KB XLSX).

Nationally, there were 253.5 service users per 100,000 population with a primary psychiatric disability in Australian Government funded services (Figure DIS.3). South Australia had the highest rate (394.9), followed by Tasmania (310.4) and Queensland (304.0).

Source data: Psychiatric disability support services 2018–19 tables (258KB XLSX).

NDA service users who transitioned to the NDIS

During the period 2014–15 to 2018–19; 13,675 NDA service users with a psychiatric disability transitioned to the NDIS, and of these, 4,635 (33.9%) transitioned during 2018–19. There was a small decrease in the number of service users with a psychiatric disability who transitioned to the NDIS in 2018–19 compared with the previous year. A similar pattern was observed for all NDA service users, with over one-third (40,018) of the 107,325 NDA service users who transitioned to the NDIS during the period 2014–15 to 2018–19 having done so in 2017–18 (AIHW 2020). This pattern reflects the commencement of the full NDIS roll-out from 1 July 2016.

Most service users with a psychiatric disability who transitioned to the NDIS in 2018–19 were aged 35–64 years (3,260 or 70.3%). There were 3,095 (66.8%) service users who lived in a private residence, 3,181 (68.6%) reported the Disability Support Pension as their main source of income, and 1,859 (40.1%) were not in the labour force.

Services accessed by users with a psychiatric disability

The disability support services accessed by people with a psychiatric disability may be either Residential support services or Non-residential support services or both, depending on availability and their individual needs. Non-residential services are provided either by State or territory administered services or Australian Government funded services. Residential services are provided by state or territory administered services.

Non-residential support services include Accommodation support, Community support, Community access, Respite services, and Employment services.

Residential Service types include Large residential facilities/institutions, Small residential facilities/institutions, Hostels and Group homes.

Non-residential services are provided at a much higher rate than residential services. In 2018–19, there were 421.4 users per 100,000 population with a psychiatric disability who accessed non-residential services whilst 3.3 users per 100,000 accessed residential services (Figure DIS.4). South Australia had the highest population-rate for non-residential service usage (606.4 users per 100,000) while Queensland had the highest population-rate for residential service usage (7.7 users per 100,000) of those jurisdictions who collected data in 2018–19.

Source data: Psychiatric disability support services 2018–19 tables (258KB XLSX).

Non-residential disability support services

Over the 5 years to 2018–19, the rate of non-residential service users with a psychiatric disability increased on average by 0.8% annually, from 405.0 users per 100,000 population in 2014–15 to 421.4 in 2018–19 (Figure DIS.5).

Source data: Psychiatric disability support 2018–19 services (258KB XLSX).

Non-residential service users with a psychiatric disability in 2018–19 accessed Employment services at a higher rate than other non-residential service types. Nationally, Employment services were accessed at a rate of 388.7 users per 100,000 population, and South Australia had the highest rate at 606.4. Other non-residential services accessed were Community support (25.0 users per 100,000 nationally), Respite services (8.2 nationally), Accommodation support (7.8 nationally) and Community access (5.4 nationally). Victoria had the highest population rate for Accommodation support, Respite and Community support service usage (17.4, 27.0 and 79.4 users per 100,000, respectively).

Residential disability support services

Residential service users represented just 0.8% of NDA service users with a psychiatric disability in 2018–19. Over the 5 years to 2018–19, the rate of residential service users with a psychiatric disability has decreased by an average of 26.5% annually, from 15.6 users per 100,000 population in 2014–15 to 3.3 in 2018–19 (Figure DIS.5). Disability Services NMDS data from 2013–14 onwards are affected by the progressive introduction of the NDIS. Service users leave the data collection from the date at which they get an approved NDIS plan, even if their plan doesn’t cover all support. As such, a decrease in the number of NDA clients is expected as the roll-out of the NDIS progresses. In addition to the transition of NDA residential support service users to the NDIS, jurisdictions are moving away from the provision of institutional style accommodations, which are included in the residential service type. These factors are likely to have contributed to the decrease in the rate of residential service users over the period.

Nationally, Group homes were the most common residential service type for users with a psychiatric disability (2.8 service users per 100,000 population).

Client characteristics

For clients with a psychiatric disability using non-residential services (106,107), 66.6% (70,715) had a primary psychiatric disability. The most frequently reported primary disability for residential service users with a psychiatric disability (842) was intellectual disability (529 or 62.8%).

Non-residential service users

There were more male (51.4%) than female (48.6%) users with a psychiatric disability accessing non-residential disability support services in 2018–19. Almost two-thirds (63.2%) of service users were aged 35–64, and 4 in 5 (79.7%) were born in Australia.

In 2018–19, 6.2% of non-residential service users with a psychiatric disability were Aboriginal and Torres Strait Islander people. However, the rate of service use for Indigenous Australians was almost 2 times that for other Australians (796.3 and 409.3 service users per 100,000 population, respectively).

People living in Major cities accounted for 67.3% of non-residential service users with a psychiatric disability. The rate of service use for people living in Inner regional and Outer regional areas (538.4 and 482.2 users per 100,000 population, respectively) was higher than that for Major cities (396.6).

The majority of non-residential service users in 2018–19 lived in a private residence (82.4%), and reported either living alone (46.1%), living with others (32.8%) or living with family (14.1%). The most common source of income was the Disability support pension (20.1%), or other pension or benefit (55.1%), and 7.1% of users reported paid employment as their main income source.

Residential service users

There were more male (62.1%) residential service users with a psychiatric disability than female (37.9%) in 2018–19. The majority of service users were born in Australia (91.0%), lived in Major cities (78.3%) and were aged 45 years and over (65.1%).

In 2018–19, 5.1% of residential service users with a psychiatric disability were Aboriginal and Torres Strait Islander people. The rate of service use for Indigenous Australians was more than 1.5 times that for other Australians (5.2 and 3.3 service users per 100,000 population, respectively).

Residential service users with a psychiatric disability most commonly reported living with others (82.1%), residing in a domestic-scale supported living facility (45.0%), and receiving the disability support pension as their main source of income (88.2%).