Specialised mental health service organisations

There were 170 specialised mental health service organisations responsible for the administration of the 1,589 state and territory specialised mental health facilities (excluding private hospitals) during 2017–18.

Of organisations that provided two types of services within an organisational structure, the most common pairing was specialised mental health public hospital services and Community mental health care services (68 organisations or 40.0%). These organisations accounted for over half of the beds and patient days (54.4% and 53.6% respectively) provided by specialised mental health public hospital services and over two-fifths (43.7%) of all community mental health care service contacts.

Furthermore, the majority of organisations provided specialised Community mental health care services (135 of 170, or 79.4%). A smaller majority provided specialised mental health public hospital services (117 of 170, or 68.8%), and a minority provided Residential mental health services (75 of 170 or 44.1%).

Consumer and carer involvement

Specialised mental health organisations employ mental health consumer workers and mental health carer workers for the expertise developed from their lived experience of mental illness and caring for people with mental illness. The definition used to describe this component of the workforce changed for the 2010–11 collection to better capture a variety of contemporary roles. Caution is therefore required when interpreting time series data for this workforce. More information can be found in the key concepts. In addition to reporting the number of employed workers, specialised mental health organisations also report the extent to which consumer committee representation arrangements are in place.

Mental health consumer and carer worker employment

Of the 170 specialised mental health service organisations reported nationally in 2017–18, 77 (45.3%) employed mental health consumer workers and 46 (27.1%) employed mental health carer workers. Queensland had the highest proportion of mental health organisations employing consumer workers (14 of 20) and South Australia had the highest proportion employing carer workers (12 of 21).

Nationally, the rate of mental health consumer workers employed increased from 26.8 FTE per 10,000 mental health care provider FTE staff in 2013–14 to 64.3 FTE in 2017–18; an annual average increase of 24.4%. Over the same period, the rate of mental health carer workers employed increased from 14.2 FTE per 10,000 mental health FTE staff in 2013–14 to 24.0 in 2017–18; an annual average increase of 14.1%. Caution is required when interpreting these data since consumer worker and carer worker FTE is relatively small, and therefore small changes in these FTE may have a relatively large percentage impact on the rates of change. 

Consumer committee representation arrangements

In 2017–18, 106 (62.4%) specialised mental health organisations reported that they had a formal position on their organisation’s management committee or that a specific consumer advisory committee exists to provide advice on all relevant mental health services managed (Level 1 in the classification of consumer participation arrangements—the data source section provides full descriptions of each level). Levels 2–4 represent less consumer committee representation within the organisation.

The proportion of specialised mental health service organisations with Level 1 consumer committee representation arrangements increased from 58.6% in 2013–14 to 62.4% in 2017–18 (Figure FAC.2); and is substantially higher than the 16.8% in 1993–94, the first year of reported data. Conversely, the proportion of specialised mental health service organisations with Level 4 consumer committee representation (no consumer representation on any advisory committee) has substantially decreased from 46.7% in 1993–94 to 25.3% in 2017–18. This transformation to a higher proportion of representation essentially occurred in the years immediately following 1993–94, with 1998–99 being the first year in which over half of organisations were classified as Level 1. Between 1998–99 and 2017–18 the proportion classified as Level 1 has fluctuated in a range between 49.3% to 65.4%.

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Figure FAC.2: Specialised mental health organisations, by level of consumer committee representation, 1993-94 to 2017-18

A stacked area chart showing the level of consumer committee representation arrangements in mental health organisations from 1993–94 to 2017–18. Level 1 consumer representation has grown from a minority to majority arrangement over this time period. Level 2 consumer participation has consistently been the least common arrangement from 2003–04 onwards. Refer to Table FAC.8. 

Description of figure FAC.2 - Source data: Specialised mental health care facilities tables (512KB XLS)

National standards for mental health services

Services provided by specialised mental health organisations are measured against the National Standards for Mental Health Services (the National Standards). There are 8 levels available to describe the degree to which a specialised mental health service unit meets the National Standards, from Level 1 (a service unit has met all national standards) through to Level 8 (national standards do not apply). Reporting levels for National Standards can be found in the data source section, which provides full descriptions of all 8 levels and how they are grouped into 4 levels for reporting purposes.

To accurately reflect the proportion of mental health services meeting the various National Standards levels, the expenditure reported for each service unit is used to calculate the proportion of services meeting the four reporting levels. In this way, the relative size of a service unit is accounted for when calculating the proportion of services meeting the National Standards levels. It is important to note that the accreditation process is cyclical in nature and therefore state and territory results may vary greatly from year to year.

Using this approach, 85.1% of all service units which were reviewed by an external accreditation agency, such as the Australian Council on Healthcare Standards (ACHS) or the Quality Improvement Council (QIC), met the National Standards (Level 1) in 2017–18. The jurisdictions reporting the highest proportion of service units meeting Level 1 were Queensland (99.8%), South Australia (99.4%), Western Australia (96.1%), and New South Wales (90.1%). The Northern Territory reported that all service units were assessed under service accreditation standards that do not include certification for the National Standards for Mental Health Services, therefore it has reported that 100% of service units meet Level 4.