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Latest mental health services data released
Mental health services: who sought care from where, what drugs were prescribed, and how much was spent?
Around 11% of Australia’s population accessed a Medicare-subsidised mental health-specific service in 2021–22.
The Australian Institute of Health and Welfare (AIHW) has released its latest report aimed at providing insights into how mental health services are delivered.
It is estimated almost half (42.9%) of Australians aged 16–85 years will experience a mental health disorder at some point in their life, with anxiety the most common among this age group.
And over the past two decades, mental health disorders, including substance use, have been responsible for around 12% of Australia’s total disease burden and 24% of the non-fatal disease burden.
Showing mental health services activity monitoring for the 2023 June quarter (3 April – 2 July), the AIHW report provides comparisons to previous years. It also tracks how the mental health system is responding to population needs and events, such as COVID-19, natural disasters and policy changes.
GPs’ provision of care
GPs are often the first port of call to manage mental illness and help to coordinate appropriate access to care for patients.
According to the RACGP’s 2022 General Practice: Health of the Nation report, 38% of all weekly GP encounters were mental health-related. Meanwhile, yet-to-be published data from this year’s Health of the Nation survey shows that trend is continuing, with mental health again the top emerging patient health issue causing GPs the most concern for the future, and the top reason for patient presentations.
Medicare-subsidised mental health services provided by multidisciplinary teams including GPs, psychiatrists, psychologists and allied health, and delivered across a range of settings, are billed as mental health-related items.
But according to the AIHW, tracking only these items underestimates the total mental health-related activity, especially for services provided by GPs.
‘The reported number of patients is unlikely to represent all patients who receive mental health care as it is unclear how many people receive GP mental health-related care that is billed as a consultation against, for example, a general MBS item number,’ the report states.
During 2021–22, the Medicare-subsidised mental health-specific service rate was 529 services per 1000 population in Australia, with the highest rate (143) provided by GPs.
Around 11% of Australia’s population (2.8 million) accessed 13.6 million Medicare-subsidised mental health-specific services in 2021–22. The highest rate of access was in Victoria (12%) and the lowest in the Northern Territory (6%).
While psychologists recorded the highest proportion of these services (49%) of this care, GPs still provided 27% of care, even when not taking into account mental health care provided using general MBS item numbers.
In the June quarter, 3,237,199 MBS mental health services were processed nationally, with 20% delivered by telehealth, compared with 27% and 21% delivered via telehealth during the same quarter in 2022 and 2021, respectively.
Medication dispensed
During the 2023 June quarter, 11,452,937 PBS listed mental health-related medications were dispensed, a figure 3% higher than the same quarter in 2022 and 5% higher than in 2021.
In 2021–22, around 44.4 million prescriptions were generated for 4.7 million patients – 32.7 million (74%) of which were for antidepressant medication.
After antidepressants, the next most commonly dispensed medications were:
- antipsychotics (4.3 million)
- anxiolytics (3 million)
- psychostimulants, agents used for ADHD and nootropics (2.6 million)
- hypnotics and sedatives (1.8 million).
GPs prescribed the majority (85%) of these medications, except for psychostimulants and nootropics for conditions like ADHD.
Tasmania had the highest proportion of residents who were dispensed a mental health-related prescription in 2021–22 at 23% of the population, with the Australian Capital Territory and New South Wales the lowest (both at 17%).
This data excludes the Northern Territory, where the AIHW considers figures to be an underestimate because a proportion of PBS-subsidised medicines in remote Aboriginal communities is funded through the
Aboriginal Health Services program, where medicines are supplied directly to patients.
More people (22%) living in inner-regional areas were dispensed mental health-related medications than people living in other areas of remoteness.
For age groups, the proportion of people receiving mental health-related prescriptions in 2021–22 was lowest for the youngest and increased by age. A higher proportion of females (22%) were dispensed mental health-related prescriptions than males (15%).
Demographics of services usage
During the 2023 June quarter, the age group most likely to receive mental health care services was 18–24 years (18%), with females having a higher rate (13%) compared to males (8%).
Rates of service usage decreased according to remoteness, with major cities and inner-regional areas at 11%, dropping to 3% in very remote areas. People living in the least disadvantaged areas were the most likely to receive services (15%), decreasing to 8% for people in the most disadvantaged areas.
Expenditure
In 2020–21, an estimated $11.6 billion, or $451 per person, was spent on mental health-related services in Australia, an increase from $418 per person in 2016–17.
Almost $11 billion of this was government mental health expenditure, representing 7% of total health expenditure.
This included:
- $7 billion, or $273 per person, spent on state and territory specialised services
- $1.6 billion, or $61 per person, spent on Medicare-subsidised services
- $619 million, or $24 per person, spent on PBS prescriptions.
Around $635 million was spent on mental health-related prescriptions in 2021–22, translating to $24 per person.
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