Australia’s mental health system

There is a division of roles and responsibilities in Australia’s mental health system, with services being delivered and/or funded by the Australian Government, state and territory governments and the private and non-government sectors.

State and territory governments fund and deliver public sector mental health services that provide specialist care for people experiencing mental illness. These include specialised mental health care delivered in public acute and psychiatric hospital settings, state and territory specialised community mental health care services, and state and territory specialised residential mental health care services. In addition, states and territories provide non-specialised hospital services used by people with mental illness (such as emergency departments and non-specialised admitted units) and other mental health-specific services in community settings such as supported accommodation and social housing programs.

The Australian Government funds a range of mental health-related services through the Medicare Benefits Schedule (MBS), and the Pharmaceutical Benefits Scheme (PBS)/Repatriation Pharmaceutical Benefits Scheme (RPBS). The Australian Government also funds a range of programs and services which provide essential support for people with mental illness. These include income support, social and community support, disability services, workforce participation programs, and housing assistance, as well as telephone-based crisis lines, online crisis support services and additional programs run by Primary Health Networks (PHNs).

Private sector services include admitted patient care in a private psychiatric hospital and private services provided by psychiatrists, psychologists and other allied health professionals. Private health insurers fund treatment costs in private hospitals, public hospitals and out of hospital services provided by health professionals.

Non-government organisations are private organisations (both not-for-profit and for-profit) that receive government and/or private funding. Generally, these services focus on providing well-being programs, support and assistance to people who live with a mental illness rather than the assessment, diagnostic and treatment tasks undertaken by clinically-focused services.

Service access

The 2007 National Survey of Mental Health and Wellbeing collected data on mental health service access in the preceding 12 months. From this survey, it was estimated that about a third (35%) of people with symptoms of a mental disorder in the previous 12 months (equivalent to about 1.3 million people based on the estimated 2017 population) made use of mental health services (Slade et al. 2009). Of these:

  • 71% consulted a general practitioner
  • 38% consulted a psychologist
  • 23% consulted a psychiatrist.

Of those who did not access mental health care, the majority (86%) reported that they perceived having no need for any mental health care. More recent estimates suggest that the treatment rates identified in 2007 have increased (to 46% in 2009–10), due primarily to the introduction of government subsidised mental health treatment items to Medicare (Whiteford et al. 2014 ).

In 2017–18, 8.7% of the Australian population received clinical mental health services through a GP, and 1.9% received clinical mental health services through a public specialised service (for example, hospital or community care) (AIHW 2019).

The Intergenerational Health and Mental Health Study, which is scheduled to be undertaken from 2020 by the Australian Bureau of Statistics, will provide updated Australian statistics on the use of health services and barriers to accessing them (ABS 2019).

Service providers

Mental health‑related services are provided in Australia in a variety of ways including:

  • admitted patient care in hospital and other residential care
  • community mental health care services
  • consultations with specialist medical practitioners, general practitioners (GPs), psychologists and other allied health practitioners.

Access to psychiatrists, psychologists and other allied health professionals may, dependent on eligibility, be subsidised through initiatives such as the Better Access initiative through the preparation of a Mental Health Treatment Plan by a GP.

The Australian Government also subsidises mental health-related services through Primary Health Networks, headspace, the National Disability Insurance Scheme, the MBS and prescribed medications through the PBS and RPBS. State and territory governments fund and deliver services and assist with broader needs, such as accommodation support. No standard definition exists for ‘mental health‑related service’. Information about how specific mental health‑related services are defined is available in relevant sections of this report.

During the COVID-19 disease pandemic, the Australian Government expanded Medicare-subsidised telehealth services to allow Australians to access health services from home or place of care and help limit the potential exposure of patients and health practitioners to the virus. This included new temporary MBS items for service providers to provide telehealth services, either by videoconference or by telephone, as a substitution for existing face to face MBS consultation services (Department of Health, 2020).


References

ABS 2019. Australian Bureau of Statistics – Forward Work Program, 2019-20. ABS cat. No. 1006.0. Canberra: ABS.

AIHW (Australian Institute of Health and Welfare) 2019. Mental Health Services in Australia. Mental Health Indicators. Viewed 18 June 2020.

Department of Health 2020. Medicare Benefits Schedule Book, effective March 2020. Canberra: Department of Health.

Slade T, Johnston A, Teesson M, Whiteford H, Burgess P, Pirkis J, and Saw S (2009). The Mental Health of Australians 2. Report on the 2007 National Survey of Mental Health and Wellbeing. Department of Health and Ageing, Canberra.

Whiteford HA, Buckingham WJ, Harris MG, Burgess PM, Pirkis JE, Barendregt JJ et al. 2014. Estimating treatment rates for mental disorders in Australia. Australian Health Review 38:80-5