National mental health report 2013

4.1 Introduction

Page last updated: 2013

Key messages:

  • State and territory data are provided on a range of indicators of resourcing levels, outputs and outcomes.
  • The comparisons emerging from the data highlight differences in service levels and mix, outputs and outcomes, as well as identifying common ground between the various mental health service systems in Australia.
  • In interpreting relative progress, it is important to recognise the different histories, circumstances and priorities of each jurisdiction, and the requirement for mental health service planning to be based on local population needs.
Part 4 brings together relevant information for each jurisdiction and summarises the situation in relation to:
  • the progress of the state or territory in several key policy areas as gauged by performance indicators developed specifically to monitor changes under the National Mental Health Strategy and
  • the state or territory position on each of these indicators relative to national averages.
Part 4 provides a convenient reference point for readers seeking information about a particular jurisdiction. Assembling the data in this way is not intended to substitute for assessment of service quality within each jurisdiction, or the strengths and problems experienced at a local level. The emphasis is upon presenting the factual information as a basis to assess where each state and territory is positioned throughout the Strategy, in relation to other jurisdictions and the goals it sets itself.

In interpreting relative progress, it is important to recognise the different histories, circumstances and priorities of each jurisdiction, and the requirement for mental health service planning to be based on local population needs. As such, the Strategy created scope for the balance of services to differ substantially between the jurisdictions. The National Mental Health Report can therefore only make broad comparisons between states and territories, and over time, chart their progress against their own baselines. Top of page

A consistent structure is used in the pages that follow, providing details on a range of indicators of resourcing levels, outputs and outcomes at state or territory level, including services administered by the Australian Government. These include some of the indicators reported in previous National Mental Health Reports and selected new indicators that align with the directions of the Fourth Plan. There are variations in the length of the time series shown for each indicator, depending on the availability of data and its comparability over time. For some indicators, the complete time series from 1992-93 to 2010-11 was available, for others a shorter time series was available, while for others only a single year of data was available.

The information presented includes a summary table of key indicators detailing the state or territory position in each of three milestone years:

  • at the beginning of the National Mental Health Strategy (1992-93)
  • at the end of the Third National Mental Health Plan (2007-08) and
  • at the mid-point of the Fourth National Mental Health Plan (2010-11).
Each jurisdiction is also presented in 18 figures, selected to convey a graphical summary of progress over the 1992-93 to 2010-11 period. Of these figures:
  • seven are based on resourcing indicators on the provision of mental health services, a reduced set of those presented in previous National Mental Health Reports
  • nine are based on selected Fourth Plan indicators, considered to be relevant for reporting at jurisdiction level and
  • two are based on indicators selected from the 15 Key Performance Indicators for Australian Public Mental Health Services.
The purpose of each of the figures is described in Table 13. For all figures, 'n.a.' signifies that the indicator is not available. Where there is
no data point shown, this signifies that the indicator is zero.

Data sources and explanatory notes for data presented in Part 4 are provided in Appendix 4. Top of page

Table 13: Purpose of jurisdiction level indicators presented in charts

IndicatorPurposeSource of indicator*
Figure 1. Overall spending on mental healthThese figures show the 18 year trends in expenditure on mental health services. They are designed to answer the question: 'To what extent has the jurisdiction increased its expenditure on mental health services relative to 1992-93, and to the national average?' Expenditure has been adjusted to remove Australian Government contributions made through National Mental Health Strategy grants and payments by the Department of Veteran's AffairsA
Figure 2. Change in spending mixThese figures are designed to answer the question: 'To what extent has the jurisdiction's relative investment in inpatients and community services changed over the course of the National Mental Health Strategy?'A
Figure 3. Changes in inpatient servicesThese figures show the 18 year trends within inpatient services and aim to answer the question: 'Have changes in the resources allocated to inpatient care (staff and money) been matched by equivalent changes in the number of beds and activity levels?'A
Figure 4. Changes in ambulatory careThese figures summarise the 18 year trends within ambulatory care services and aim to answer the question: 'Has increased spending on ambulatory services been matched by an equivalent growth in clinical staffing?'.A
Figure 5. Direct care workforceThese figures show the trends in the overall direct care mental health workforce and aim to answer the question: 'To what extent has the nu mber of clinical staff employed in mental health services increased since 1 992-93, and relative to the national average?' Direct care staffing levels are expressed as the number of full-time equivalents (FTEs) per 100,000 population.A
Figure 6. Inpatient and residential bedsThese figures summarise the trends in the number of inpatient and community residential beds (the latter category combines 24 hour staffed and less than 24 hour staffed beds) and are designed to answer the question: 'To what extent has the jurisdiction decreased the number of specialist psychiatric beds (inpatient and community residential) since 1992-93, and relative to the national average?' Bed numbers are expressed per 100,000 population.A
Figure 7. Trends in provision of public sector specialised beds - acute and non-acute beds per 100,000These figures show the trends in the number of public sector specialised mental health beds and are designed to answer the question: 'To what extent has the relative mix of acute and non-acute psychiatric beds changed in the jurisdiction since 1992-93?' Bed numbers are expressed per 100,000 population.A
Figure 8. Readmission to hospital within 28 days of dischargeThese figures summarise trends in the percentage of readmissions (i.e., admissions to public acute psychiatric units that occur within 28 days of the original discharge), and aim to answer the question: 'To what extent have readmissions decreased since 2005-06?'B
Figure 9. Rates of pre-admission community careThese figures show trends in the percentage of admissions to state/territory acute psychiatric units that are preceded by community care (in the seven days before admission). They are designed to answer the question: 'To what extent have rates of pre-admission community care increased since 2005-06?'B
Figure 10. Rates of post-discharge community careThese figures show trends in the percentage of discharges from state/territory acute psychiatric units that are followed by community care (in the seven days after discharge). They are designed to answer the question: 'To what extent have rates of post.discharge community care increased since 2005-06?'B
Figure 11. Average treatment days per three month community care periodThese figures are designed to answer the question: 'To what extent has the average number of community treatment days per episode of ambulatory care provided by community-based specialised public mental health services changed since 2005-06?' A 'treatment day' is any day on which one or more community contacts (direct or indirect) are recorded for a registered client during an ambulatory care episode.C
Figure 12. Percentage of population receiving state or territory community mental health servicesThese figures show trends in the numbers of people seen by state or territory community mental health services. They contribute to answering the question: 'To what extent has the percentage of population receiving mental health care increased since 2006-07?'B
Figure 13. Percentage of population receiving MBS-subsidised mental health servicesThese figures show trends in the numbers of people seen by MBS subsidised mental health services. They contribute to answering the question: 'To what extent has the percentage of population receiving mental health care increased since 2006-07?'B
Figure 14. New clients as a proportion of total clients under the care of state or territory specialised public mental health servicesThese figures aim to answer the question: 'To what extent has the percentage of new clients changed since 2009-10?' 'New' is defined as not having been seen in the five years preceding the first contact with a state or territory specialised public mental health service in the data period.C
Figure 15. Mental health outcomes for people who receive treatment from state or territory servicesThese figures are designed to answer the question: 'In 2010-11, what percentage of consumers showed significant improvement, no significant change and significant deterioration, taking into account the mental health care setting in which they received care?' Data on outcomes from the private sector were not available at jurisdiction level.B
Figure 16. Proportion of total mental health workforce accounted for by consumer and carer workersThese figures aim to answer the question: 'To what extent has the percentage of state/territory mental health workforce accounted for by consumer and carer workers increased since 2002-03?' Consumer and carer worker percentages are shown separately. Levels are expressed as the percentage of full-time equivalent (FTE) direct care staff accounted for by consumer and carer full-time FTE.B
Figure 17. Proportion of services reaching threshold standards of accreditation under the National Mental Health StandardsThese figures are designed to answer the question: 'What percentage of mental health services met each of the four levels of accreditation under the National Mental Health Standards in 201 0-11?'The four levels are: 1, meets all standards; 2, meets some standards; 3, review booked/in progress; and 4, does not meet criteria for levels 1-3.B
Figure 18. Percentage of mental health consumers living in stable housingThese figures show the percentage of adult and older adult consumers who, on admission to care, had no significant problems with their living conditions. They aim to answer the question: 'To what extent has the proportion of consumers living in stable housing improved since 2007/08?' The percentages shown are of consumers in each age specific population group.B

* Source of indicator:
A - Resource indicator reported in previous National Mental Health Reports
B - Fourth Plan Indicator
C - Key Performance Indicators for Australian Public Mental Health Services.