Key concepts

State and territory community mental health care services

Key concept Description
Community mental health care Community mental health care refers to government‑funded and-operated specialised mental health care provided by community mental health care services and hospital‑based ambulatory care services, such as outpatient and day clinics.  
The state and territory mental health acts and regulations provide the legislative cover that safeguards the rights and governs the treatment of patients with mental illness in admitted patient care, residential care and community-based services. The legislation varies between the state and territory jurisdictions but all contain provisions for the assessment, admission and treatment of patients on an involuntary basis, defined as ‘persons who are detained in hospital or compulsorily treated in the community under mental health legislation for the purpose of assessment or provision of appropriate treatment or care’.
Service contacts Service contacts are defined as the provision of a clinically significant service by a specialised mental health service provider for patient/clients, other than those admitted to psychiatric hospitals or designated psychiatric units in acute care hospitals and those resident in 24‑hour staffed specialised residential mental health services, where the nature of the service would normally warrant a dated entry in the clinical record of the patient/client in question. Any one patient can have one or more service contacts over the relevant financial year period. Service contacts are not restricted to face‑to‑face communication but can include telephone, video link or other forms of direct communication. Service contacts can also be either with the patient or with a third party, such as a carer or family member, and/or other professional or mental health worker, or other service provider.
Target population

Some specialised mental health services data are categorised using 5 target population groups (see METeOR identifier 493010):

  1. Child and adolescent services focus on those aged under 18 years.
  2. Older person services focus on those aged 65 years and over.
  3. Forensic health services provide services primarily for people whose health condition has led them to commit, or be suspected of, a criminal offence or make it likely that they will reoffend without adequate treatment or containment.
  4. General services provides services to the adult population, aged 18 to 64, however, these services may also provide assistance to children, adolescents or older people.
  5. Youth services target children and young people generally aged 16–24 years.

Note that, in some states, specialised mental health beds for aged persons are jointly funded by the Australian and state and territory governments. However, not all states or territories report such jointly funded beds through the National Mental Health Establishments Database.

Treatment day

Treatment day refers to any day on which one or more service contacts (direct or indirect) are recorded for a registered patient (that is, a patient identifier number is assigned to a uniquely identified person) during an ambulatory care episode.

Alternative text for figures for Community mental health care section

Figure CMHC.1

Vertical bar chart showing community mental health care patient rates for states and territories in 2017–18. Vic reported the lowest rate of patients per 1,000 population and the NT the highest rate. NSW (16.6), Vic (11.5), Qld (20.6), WA (23.5), SA (23.1), Tas (18.1), ACT (25.9), NT (28.5) and Total (17.6) per 1,000 population. Refer to Table CMHC.1. Back to figure CMHC.1

Figure CMHC.2

A stacked vertical bar chart showing length of treatment period and the proportion of registered patients and treatment days that fall into each of the treatment period lengths. For patients, 35.6% received very brief treatment (1–14 days), 23.8% received short term treatment (15–91 days) and 40.6% received medium to longer term treatment (92+ days). For reported treatment days, 5.7% received very brief treatment, 12.9% received short term treatment and 81.4% received medium to longer term treatment. Refer to table CMHC.24. Back to figure CMHC.2

Figure CMHC.3

Horizontal bar chart showing the rates of patients (per 1,000 population), by demographic variables, 2017–18. The rate for patients aged 0–4 years was the lowest of the age groups (1.7 people per 1,000 age specific population), the highest rate was for patients aged 12–17 years (32.6 patients per 1,000 age-specific population), followed by patients aged 18–24 years (26.3 patients per 1,000 age-specific population). Male and Female patients had similar rates per 1,000 population (17.4 and 17.7, respectively). Rates were lowest per 1,000 population for patients living in Major cities (15.3), Inner regional (20.3), Outer regional (24.3), Remote (32.7) and highest for Very remote (36.7). Rates for patients living in SEIFA quintile 1 were the highest (22.8 per 1,000 population), decreasing with each quintile to be the lowest in SEIFA quintile 5 (11.5 per 1,000 population). Refer to Table CMHC.8. Back to figure CMHC.3

Figure CMHC.4

Horizontal bar chart showing 5 most commonly reported specific principal diagnoses for community mental health care service contacts in 2017–18. The most frequently reported principal diagnosis was schizophrenia (22.4%), followed by depressive episode (6.8%), schizoaffective disorders (6.0%), bipolar affective disorders (5.3%), reaction to severe stress and adjustment disorders (4.7%). Refer to Table CMHC.15. Back to figure CMHC.4

Figure CMHC.5

Population pyramid comparing the rate per 1,000 population of community mental health care service contacts of males and females with a principal diagnosis of schizophrenia, across age groups in 2017–18. For both males and females, people aged 35–44 accessed services at the highest rate (243.0 and  77.7 per 1,000 population respectively) . Refer to Table CMHC.18. Back to figure CMHC.5

Figure CMHC.6

Stacked horizontal bar chart showing the duration of community mental health service contacts by session duration and patient participation status (whether the patient was present or absent) in 2017–18. The most frequent duration was 5–15 minutes, and slightly more than half of contacts occurred with the patient present. Contacts more than 3 hours were more likely to include the patient present, while those 5 minutes or less were more likely to be without the patient present (patient absent). Refer to Table CMHC.21. Back to figure CMHC.6

Figure CMHC.7

Horizontal bar chart comparing the number of voluntary and involuntary contacts for 5 most commonly reported principal diagnoses. Of involuntary contacts, those with a diagnosis of Schizophrenia were the most common amounting to 618,626 contacts. Involuntary contacts with a principal diagnosis of reaction to severe stress and adjustment disorders were the least common with 6,741 contacts. Refer to Table CMHC.27. Back to figure CMHC.7