Specialised mental health beds and patient days

During 2018–19, there were 12,830 specialised mental health beds available nationally, with 7,003 beds provided by public hospital services, 3,309 by private hospitals, and 2,518 by Residential mental health care services (Figure FAC.3).

 

Figure FAC.3: Distribution of specialised mental health beds in Australia, 2018–19

Figure FAC.3 shows the distribution of specialised mental health beds in 2018–19. The table shows that the majority of beds were provided by hospitals, while residential beds accounted for approximately 1 in 4 beds. Public hospitals provided more than twice the number of beds that private hospitals provided and the majority of public hospital beds were for acute care. The majority of Residential mental health care services beds were provided by government-operated services. Most of the residential beds in government-operated services were provided in 24-hour staffed residential services, whereas in non-government operated services, more beds were provided in non-24 hour staffed services.

Source data: Specialised mental health care facilities 2018–19 tables (540KB XLSX)

Public sector specialised mental health hospital beds

In 2018–19, there were 7,003 public sector specialised mental health hospital beds available in Australia. About three quarters of these (77.1% or 5,397 beds) were in specialised psychiatric units or wards within public acute hospitals, with the remainder in public psychiatric hospitals (1,606 beds).

New South Wales (34.0) had the highest number of beds per 100,000 population in 2018–19, while the Northern Territory had the lowest (17.5), compared to the national rate of 27.8 beds per 100,000 population.

Public sector specialised mental health hospital beds can also be described by the target population or program type category of the specialised mental health service unit, or a combination of both.

Target population

During 2018–19, the majority of public sector specialised mental health hospital beds (5,002 or 71.4%) were in General services, 950 beds (13.6%) were in Older person services, 678 (9.7%) were in Forensic services and 303 (4.3%) were in Child and adolescent services. A small number of beds were located in Youth services (70 beds or 1.0%); a service category that was introduced in 2011–12.

The proportion of specialised mental health hospital beds for each target population category varied among the states and territories, reflecting the different service profile adopted in each state/territory. The majority of beds were in services classified as General, accounting for at least 64.7% of beds in each state/territory (Figure FAC.4). 

 

Figure FAC.4: Proportion of public sector specialised mental health hospital beds, by target population, state and territries, 2018-19

Stacked bar chart showing the proportion of public sector specialised mental health hospital beds by target population and states and territories in 2018–19. Beds in General services had the highest proportion across all jurisdictions. Refer to Table FAC.14.

Visualisation not available for printing

Source data: Specialised mental health care facilities 2018–19 tables (540KB XLSX)

New South Wales had the highest number of hospital beds per 100,000 population for both General services (40.3) and Child and adolescent services (6.6) compared to the national rates of 32.0 and 5.4 per 100,000 population respectively. Western Australia (39.8) had the highest number of Older person hospital beds per 100,000 population (national average 23.9) and the Australian Capital Territory (6.1) had the most Forensic hospital beds per 100,000 population (national average 3.5). The Northern Territory reported the highest number of Youth beds per 100,000 population (17.4) compared to the national rate of 2.4 per 100,000 population.

Program type

Almost three-quarters (5,209 beds or 74.4%) of all public sector specialised mental health hospital beds across Australia were in Acute services during 2018–19 (Figure FAC.3).

The proportion of acute beds differed among the target population groups. The majority of General beds (75.8%), Child and adolescent beds (88.8%), Youth beds (100.0%), and Older person beds (79.9%) were in Acute services in 2018–19, compared with less than half of Forensic beds (47.2%).

Residential mental health service beds

In 2018–19, there were 2,518 residential mental health service beds available nationally. These can be further characterised by the level of staffing provided, target population and the service operator (government or non-government), reflecting the service profile mix in each state or territory.

The total number of beds in government-operated services was 1,645 (65.3%). About three quarters (1,982 or 78.7%) of all residential beds were operated with mental health trained staff working in active shifts for 24 hours a day, with the majority of these beds in government operated services (1,628 beds). By contrast, non-24-hour staffed residential beds were predominantly provided by the non-government sector. More than two-thirds (1,777 beds or 70.6%) of all residential beds were in General services with more of these beds in 24-hour staffed facilities (1,348 or 75.8%) than in non-24-hour staffed facilities (429 or 24.2%).

In the Australian Capital Territory, from 2015–16 to 2016–17 there was a decline in the reported number of non-24 hour staffed residential beds, from 45 to 5 beds. There were also 5 beds in 2017–18 and 2018-2019. These beds are still operational but as they are funded under the National Disability Insurance Scheme (NDIS), they are now out of scope for reporting to the Mental Health Establishments (MHE) NMDS. It is anticipated that as the NDIS is fully implemented across Australia, the number of non-24-hour staffed residential specialised mental health beds being reported to the MHE NMDS will decrease.

In 2018–19, there were 10.0 residential mental health beds per 100,000 population nationally. Amongst jurisdictions, Tasmania (33.1) had the highest number per 100,000 population, while New South Wales (0.7) had the lowest (Figure FAC.5). Western Australia was the only jurisdiction where non-24-hour staffed residential services provided more beds than 24-hour staffed services. 24-hour staffed services provided more beds across all other jurisdictions.

Figure FAC.5: Residential mental health service beds per 100,000 population, by hours staffed, states and territories, 2018-19

Figure FAC.5 shows a stacked vertical bar chart of residential mental health service beds per 100,000 population by hours staffed and states and territories in 2018–19. NSW (0.7), Vic (22.1), Qld (5.6), WA (12.5), SA (9.8), Tas (33.1), ACT (5.0), NT (14.6) and national total (10.0). Western Australia was the only jurisdiction where non-24-hour staffed residential services provided more beds per 100,000 population than 24-hour staffed services. 24-hour staffed services provided more beds across all other jurisdictions. Refer to Table FAC.17.

Visualisation not available for printing

Source data: Specialised mental health care facilities 2018–19 tables (540KB XLSX)

Victoria (49.6) had the highest number of residential mental health beds per 100,000 population in Older persons 24-hour staffed care services. Tasmania had the highest number of residential beds per 100,000 population in General services for both 24-hour staffed care (23.0) and non-24-hour staffed care (19.8). New South Wales (0.6 beds per 100,000 population) was the only state or territory that reported residential mental health service beds for Child and adolescent services in 2018–19. Four jurisdictions reported specialised Youth services, with Victoria reporting 17.3 beds per 100,000 population, Queensland 0.2, Western Australia 5.5 and the Australian Capital Territory 20.1.

24-hour staffed public sector care

Mental health services with staff employed in active shifts for 24 hours a day are provided through either public sector specialised mental health hospital services (inpatient care) or 24-hour staffed Residential mental health care services. Comparisons between states and territories are possible when the data for these different types of 24‑hour staffing are combined.

Victoria had the highest number of 24-hour staffed public sector beds per 100,000 population (41.2) in 2018–19, followed closely by Tasmania (39.5), while Queensland (30.8) and the Northern Territory (32.1) had the lowest, compared with the national average of 35.7 (Figure FAC.6). Across the majority of jurisdictions, the highest number of beds per 100,000 were provided by acute hospital services, except for Tasmania where 24-hour staffed residential services had the highest number of beds per 100,000 population.

Figure FAC.6: Specialised mental health beds per 100,000 population, by 24-hour care setting, states and territories, 2018-19

Stacked vertical bar chart showing specialised mental health beds per 100,000 population, by 24-hour care setting and states and territories in 2018–19. NSW (34.6), Vic (41.2), Qld (30.8), WA (35.3), SA (35.1), Tas (39.5), ACT (32.7), NT (32.1), Total (35.7). Across the majority of jurisdictions, the highest number of beds per 100,000 were provided by acute hospital services, except for Tasmania where 24-hour staffed residential services had the highest number of beds per 100,000 population. Refer to Table FAC.23.

Visualisation not available for printing

Source data: Specialised mental health care facilities 2018–19 tables (540KB XLSX)

Private hospital specialised mental health beds

There were 3.309 available beds (13.1 per 100,000 population) in private psychiatric hospitals in 2018–19, including specialised units or wards in private hospitals.

Available beds over time

The number of public sector specialised mental health hospital and residential mental health service beds increased from 9,366 beds in 2014–15 to 9,521 beds in 2018–19. The combined number of hospital and residential specialised mental health beds per 100,000 population has gradually but consistently declined since reporting began in 1992–93 from 50.2 beds per 100,000 population to 35.7 in 2018–19.

Public sector specialised mental health hospital beds

There was a decrease in the number of public psychiatric hospital beds reported from 1,717 beds in 2014–15 to 1,606 beds in 2018–19. By contrast, there was an increase in the number of beds in specialised psychiatric units or wards in public acute hospitals over the same period (from 5,179 beds in 2014–15 to 5,397 beds in 2018–19). Time series comparisons should be approached with caution. In 2017–18 Queensland reported specialised residential mental health service beds to the Mental Health Establishments collection for the first time due to the reclassification of some public sector mental health hospital beds.

Residential mental health service beds

The number of specialised residential mental health service beds increased from 2,471 in 2014–15 to 2,518 in 2018–19. Reported residential beds per 100,000 population nationally have remained broadly stable for about 2 decades, being about 10 since 1999–00.

Supported housing places

In addition to the services described above, jurisdictions also provide supported housing places for people with a mental illness. There were 4,420 supported housing places available in 2018–19 for people with a mental illness. Western Australia (52.8 per 100,000 population) had the highest rate of supported housing places, compared with the national average of 17.6 places. However, caution should be exercised when comparing rates across jurisdictions as not all jurisdictional mental health housing support schemes are in-scope for the Mental Health Establishment NMDS. The data source section provides further information.

Patient days

Public sector specialised mental health hospital services

Around 2.3 million patient days were provided by public hospital specialised mental health services during 2018–19. Over three-quarters (77.3%) of all patient days were in specialised psychiatric units or wards in public acute hospitals, mirroring the number of beds for this service type. New South Wales (107.3) had the highest number of patient days per 1,000 population, while Tasmania (56.0) had the lowest, compared with the national rate of 89.7.

Residential mental health services

During 2018–19, Residential mental health care services provided nearly 774,000 patient days. More than three-quarters (78.2%) of all patient days were for residents of 24-hour staffed services. Tasmania (146.1) had the highest number of patient days per 1,000 population in General services, while New South Wales (3.3) had the lowest; compared with the national rate of 34.9.

Private hospital specialised mental health services

During 2018–19, private specialised mental health hospital services provided about 1.2 million patient days, equating to 49.2 days per 1,000 population. However, in contrast with public sector services, this figure also includes same-day separations.