Mental health services in Australia

The Specialist Homelessness Services (SHS) Collection describes clients who receive services from specialist homelessness agencies, and the assistance they receive, including clients with a current mental health issue.

This section presents information provided by SHS agencies on clients with a current mental health issue who received services in 2017–18. Due to improvements in agency response and statistical linkage key (SLK) validity rates, data for 2017–18 were not weighted. Unweighted data for 2017–18 onwards are directly comparable with weighted data for 2011–12 to 2016–17.

A client has been identified as having a current mental health issue if they provided any of the following information:

• They indicated at the beginning of a support period they were receiving services or assistance for their mental health issues, or had received them in the last 12 months.
• Their formal referral source to the specialist homelessness agency was a mental health service.
• They reported ‘Mental health issues’ as a reason for seeking assistance.
• Their dwelling type either a week before presenting to an agency, or when presenting to an agency, was a psychiatric hospital or unit.
• They had been in a psychiatric hospital or unit in the last 12 months.
• At some stage during their support period, a need was identified for psychological services, psychiatric services or mental health services.

Data downloads:

Specialist Homelessness Services 2017–18 tables (854KB XLS)

Specialist Homelessness Services 2017–18 section (747KB)

Data coverage includes the time period 2011–12 to 2017–18. This section was last updated in July 2019.

Key points

Clients with a current mental health issue

Around 241,000 people aged 10 years and older were assisted by specialist homelessness agencies nationally in 2017–18 (AIHW 2019). Of these, 1 in 3 (just over 81,000 or 33.6%) were clients with a current mental health issue.

In 2017–18, there were 374.9 SHS clients per 100,000 population (Figure SHS.1) nationally with a current mental health issue. Tasmania had the highest rate of clients (630.5) with a current mental health issue, followed by Victoria (574.0) and the Northern Territory (538.7).

Figure SHS.1 Alternative text - Source data: Specialist homelessness services tables (854KB XLS)

The national rate of SHS clients with a current mental health issue has been increasing since the beginning of the collection in 2011–12 (Figure SHS.2). These clients represent one of the fastest growing sub-groups within the SHS collection. Factors, such as increased identification, community awareness and reduced stigma, have all potentially contributed to the increase in reporting of mental illness among SHS clients. Some of the increase may also be due to changes in service delivery models by some states and territories. Nationally, the proportion of SHS clients aged 10 years and older with a current mental health issue increased from 22% in 2013–14 to 28% in 2017–18 (AIHW 2019). Nationally, the population rate of clients with a current mental health issue increased between 2013–14 and 2017–18 at an annual average rate of 7.8%. The national population rate of all SHS clients increased over the same period at an annual average of 3.3% (AIHW 2019). The average annual change in the rate of clients with a current mental health issue since 2013–14 varied between jurisdictions, ranging from –4.0% in the Australian Capital Territory to 13.9% in the Northern Territory.

Figure SHS.2 Alternative text - Source data: Specialist homelessness services tables (854KB XLS)

Client characteristics

In 2017–18, the rate of SHS clients with a current mental health issue was highest for 15–17 year olds, followed by 18–24 year olds (726.2 and 643.7 per 100,000 population, respectively). The rate of SHS clients without a current mental health issue was also highest for 15–17 year olds in 2017–18, followed by 18–24 year olds (1,289.1 and 1,121.7 per 100,000 population, respectively). The population rate of service use was higher for clients without a current mental health issue, compared to clients with, in all age groups, from 1.7 times as high in people aged 18–24, 35–44 and 45–54, and up to 5.0 times as high for those aged 65+ (Figure SHS.3).

Figure SHS.3 Alternative text - Source data: Specialist homelessness services tables (854KB XLS)

In 2017–18, the rate of SHS clients with a current mental health issue was higher for females (446.3 per 100,000 population) than for males (301.6). This difference reflects the higher proportion of female SHS clients (63.2%) than male clients (36.8%) overall rather than indicating that female SHS clients are more likely to have a mental health issue than male SHS clients (32.0% and 36.3% of females and males respectively).

The rate of SHS clients with a current mental health issue was over 7 times higher for Indigenous Australian clients than non-Indigenous Australian clients in 2017–18(1,933.1 and 265.8 per 100,000 population respectively).

In 2017–18, almost half (47. 2%) of SHS clients with a current mental health issue reported an episode of homelessness in the 12 months before presenting to an agency, compared with about a third (31.7%) of clients without a current mental health issue. It should be noted that many SHS clients are at risk of homelessness. Around half of all SHS clients with a current mental health issue were at risk of homelessness (53% or around 42,100 clients) at the beginning of their support in 2017–18 (AIHW 2019).

Sources of referral

For clients with a current mental health issue, the most frequently recorded source of referral to an SHS agency was a Specialist homelessness agency/outreach worker (26.1%), followed by Other (government or non-government) agency (20.2%) and Mental health service (8.1%).

Reasons for seeking assistance

In 2017–18, 24.5% of SHS clients with a current mental health issue reported Housing crises as the main reason for seeking assistance, followed by Domestic and family violence (18.8%), Inadequate or inappropriate dwelling conditions (11.1%) and Financial difficulties (9.4%) (Figure SHS.4). Clients without a current mental health issue reported the same top 4 reasons, with Domestic and family violence as the main reason (31.6%) followed by Housing crisis (20.1%), Financial difficulties (12.5%) and Inadequate or inappropriate dwelling conditions (9.4%).  About 1 in 24 (4.2%) SHS clients with a current mental health issue had Mental health issues recorded as their main reason for seeking assistance.

Figure SHS.4 Alternative text - Source data: Specialist homelessness services tables (854KB XLS)

SHS clients can nominate other reasons for seeking assistance alongside their main reason for seeking assistance. When all presenting reasons for seeking assistance are considered; Financial difficulties (53.7%), Mental health issues (52.7%), and Housing crises (52.3%) were the most frequently reported reasons for clients with a current mental health issue. By contrast, for clients without a current mental health issue; Domestic and family violence (38.9%), Financial difficulties (36.7%), and Housing crises (34.8%) were the most frequently reported reasons.