Same day admitted mental health care—public hospitals

This section presents information on same day admitted patient mental health-related separations in Australian public 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). The information describes separations. It is possible for individuals to have multiple separations in any given reference period. Further information can be found in the data source.

There were a total of 3.5 million same day separations from public acute and public psychiatric hospitals in 2016–17. There were 64,692 same day admitted mental health-related separations in 2016–17, accounting for 1 in 50 (1.8%) of all same day public hospital separations. Of these, 22,182 (34.3%) separations involved specialised psychiatric care and 42,510 (65.7%) did not.

Due to the relatively small number of same day admitted patient mental health-related separations from public psychiatric hospitals, these separations have been combined with the public acute hospitals separations for reporting purposes in this section. Where possible, a distinction is made between separations with and without specialised psychiatric care.

Specialised same day admitted patient mental health care—public hospitals

Service provision

Specialised same day public admitted mental health care takes place within a designated psychiatric ward/unit, which is staffed by health professionals with specialist mental health qualifications or training and have as their principal function the treatment and care of patients affected by mental illness. It may also be referred to as specialised psychiatric care.

States and territories

In 2016–17, there were 22,182 same day public admitted mental health-related separations with specialised psychiatric care; equivalent to a national rate of 9.1 per 10,000 population.

The rate of same day public mental health-related separations with specialised psychiatric care in 2016–17 was highest for Queensland (23.0 per 10,000 population) and lowest for the Northern Territory (1.1) (Figure SD.1).

The principal source of funding for a separation is collected as part of the APC NMDS. However, it should be noted that a separation may be funded by more than one funding source and information on additional funding sources is not available. For public hospitals in 2016–17, more than three-quarters (79.0%) of same day public mental health-related separations with specialised psychiatric care were public patients (e.g. the health service budget or reciprocal health care agreement). This ranged from 99.3% for the South Australia to 49.0% for New South Wales.

The mode of separation is also collected and provides information on how each separation ended, and for some separations, the place to which the patient was discharged or transferred to. In 2016–17, the most common mode of separation for same day public mental health-related separations was discharge to ‘home’ (89.5%), 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 93.5% for Queensland to 51.2% for Western Australia.

 

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Figure SD.1 Alternative text - Source data: Same day public admitted mental health-related care 2016-17 Table SD.7 (844KB XLS).

Patient demographics

In 2016–17, the rate of same day public admitted mental health-related separations with specialised psychiatric care was highest for patients aged 65 years and older and lowest for those aged less than 15 (15.8 and 2.8 per 10,000 population respectively) (Figure SD.2). Overall, the separation rate was higher for females than males (10.3 and 7.9 per 10,000 population respectively).

 

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Figure SD.2 Alternative text - Source data: Same day public admitted mental health-related care 2016-17 Table SD.7 (844KB XLS).

Aboriginal and Torres Strait Islander people had a rate of same day public mental health-related separations with specialised psychiatric care that was nearly double that of other Australians (12.6 and 8.0 per 10,000 population respectively).

Those patients living in Major cities (10.7 per 10,000 population) had the highest rate of same day public mental health-related separations with specialised psychiatric care in 2016–17 whilst those living in Remote and Very remote areas (1.3 per 10,000 population) had the lowest.

In 2016–17, the highest rate of same day public mental health-related separations with specialised psychiatric care was for those patients living in the second least disadvantaged socioeconomic quintile (10.1 per 10,000 population) and the lowest rate was for those living in the second most disadvantaged quintile (6.5).

Principal diagnosis

The most frequently reported principal diagnosis in 2016–17 for same day public mental health-related separations with specialised psychiatric care was Depressive episode (ICD-10-AM code: F32) (23.0%), followed by Other anxiety disorders (F41) (9.3%) and Schizophrenia (F20) (8.6%).

 

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Figure SD.3 Alternative text - Source data: Same day public admitted mental health-related care 2016-17 Table SD.7 (844KB XLS).

Mental health legal status

Mental health legal status refers to whether or not a person was treated in hospital involuntarily under the relevant state or territory mental health legislation. In 2016–17, there were 4,550 same day public mental health-related separations with specialised psychiatric care where the mental health legal status was ‘involuntary’— representing roughly a fifth (20.7%) of all same day public mental health-related separations with specialised psychiatric care. The majority of these (3,940 or 86.6%) occurred in public acute hospitals.

Involuntary separations accounted for 19.3% and 38.4% of same day separations with specialised psychiatric care in public acute hospital and public psychiatric hospitals respectively.

 

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Figure SD.4 Alternative text - Source data: Same day public admitted mental health-related care 2016-17 Table SD.7 (844KB XLS).

Procedures

The most frequently reported procedure block for same day public mental health-related separations with specialised psychiatric care was Electroconvulsive therapy and Cerebral anesthesia (both 23.4%). Cerebral anesthesia is a form of general anesthesia most likely associated with the administration of electroconvulsive therapy, a form of treatment for depression, which was the most common principal diagnosis for separations with specialised psychiatric care.

The next most frequently reported procedure block was Generalised allied health interventions, which was recorded for 1 in 14 (6.9%) of these separations. Of these allied health interventions, procedures provided by Social work were the most common (38.3% of allied health interventions), followed by Psychology (23.1%) and Occupational therapy (16.1%).

Non-specialised admitted patient mental health care

Service provision

Non-specialised admitted patient mental health care takes place outside of a designated psychiatric unit, as mentioned earlier, 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 usually 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 same day public mental health-related separations without specialised psychiatric care was 17.4 per 10,000 population. The Northern Territory had the highest rate (62.6 per 10,000 population) while Western Australia had the lowest (10.7) (Figure SD.5). 

 

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Figure SD.5 Alternative text - Source data: Same day public admitted mental health-related care 2016-17 Table SD.7 (844KB XLS).

For public hospitals in 2016–17, the majority (93.8%) of same day public mental health-related separations without specialised psychiatric care had a funding source of Public patients (e.g. the health service budget or reciprocal health care agreement). This ranged from 98.4% for South Australia to 90.2% for New South Wales.

In 2016–17 the most common mode of separation for same day public mental health-related separations without specialised psychiatric care was discharge to ‘home’ (73.9%), which includes discharge to usual residence/own accommodation/welfare institution (including prisons, hostels and group homes providing primarily welfare services), followed by separation to an(other) acute hospital (15.4%). This ranged from 94.8% for Tasmania to 61.8% for New South Wales.

Patient demographics

In 2016–17, the highest rate of same day public mental health-related separations without specialised psychiatric care was for patients aged 35 to 44 years (24.0 per 10,000 population) and the lowest for those aged under 15 (5.4 per 10,000 population) (Figure SD.6). The separation rate was slightly higher for males than females (17.6 and 17.2 per 10,000 population respectively).

Aboriginal and Torres Strait Islander people had a rate of same day public mental health-related separations without specialised psychiatric care that was four times that of other Australians (63.5 and 15.9 per 10,000 population respectively).

The highest rate of same day public mental health-related separations without specialised psychiatric care in
2016–17 was for those living in Remote and Very remote areas (39.4 per 10,000 population) and the lowest for those in Major cities (15.8 per 10,000 population).

In 2016–17, the highest rate for same day public mental health-related separations without specialised psychiatric care was for those living in the most disadvantaged area (socioeconomic quintile 1) (24.0 per 10,000 population) and the lowest rate was seen for those living in the least disadvantaged quintile (11.1).

 

Visualisation not available for printing

Figure SD.6 Alternative text -Source data: Same day public admitted mental health-related care 2016-17 Table SD.7 (844KB XLS).

Principal diagnosis

In 2016–17, the most frequently reported principal diagnosis for same day public mental health-related separations without specialised psychiatric care were Mental and behavioural disorders due to use of alcohol (ICD-10-AM code F10) (22.5%), followed by Depressive episode (F32) (14.6%) (Figure SD.7).

 

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Figure SD.7 Alternative text - Source data: Same day public admitted mental health-related care 2016-17 Table SD.14 (844KB XLS).

Procedures

The most frequently reported procedure block for same day public mental health-related separations without specialised psychiatric care was Cerebral anesthesia (22.6% of separations) followed by Electroconvulsive therapy (21.3%). Cerebral anesthesia is a form of general anesthesia most likely associated with the administration of electroconvulsive therapy, a form of treatment for depression, which was the second most common principal diagnosis for separations without specialised psychiatric care.

The next most frequently reported procedure block was Generalised allied health interventions, which was recorded for 1 in 16 (6.8%) of these separations. Of these allied health interventions, Social work procedures were the most common (49.5% of allied health interventions), followed by Physiotherapy (12.7%) and Occupational therapy (10.3%).