Lexi Webster
Mental health in Australia has evolved significantly over the last five decades, with the country witnessing a substantial shift in its approach to mental healthcare. Australia was among the first nations to establish a national mental health strategy, launching its National Mental Health Strategy in 1992. Since then, the country has introduced six national mental health care plans, reflecting a commitment to addressing mental health issues. Despite these efforts, Australia's mental health landscape faces challenges, including shortfalls in service access and quality, and a persistent gap between funding and the burden of mental health disorders, which contribute 13% to Australia's total disease burden. The COVID-19 pandemic also impacted mental health, with increased psychological distress among Aboriginal and Torres Strait Islander adults, and elevated rates of perinatal depression among mothers.
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What You'll Learn
Mental health funding and spending
Australia has a mixed healthcare system, with both public and private healthcare. The public system includes a government-run insurance scheme called Medicare, which aids mental health schemes. Australia has been celebrated for its sophisticated mental health management systems, however, critics have called for an increase in funding.
In 2015, mental health accounted for 5.2% of the overall yearly health budget, although mental disorders equated to 12% of the total burden of disease. This gap between funding and burden of disease is a factor inhibiting the nationwide development of Australia's mental health services. The Australian government spent $9.1 billion on mental health-related services in 2017, averaging $375 per person. This was a rise from $359 the year prior. In 2016-2017, 7.4% of the Australian government's health expenditure went towards mental health services.
In 2020, during the COVID-19 pandemic, there were 84.4 mental health nurses, 78.4 psychologists, and 11.6 psychiatrists working in full-time clinical roles per 100,000 people. This was an increase from 2013, when there were 75.8 nurses, 61.8 psychologists, and 10.1 psychiatrists per 100,000 people. However, the overall services and workforce are concentrated in urban areas, with increasing gaps in other regions.
In 2020-2022, 17.6% of Australians aged 16-85 (3.5 million people) were dispensed at least one PBS-subsidized mental health-related medication in the 12 months prior to their interview. Of the 4.3 million Australians aged 16-85 with a 12-month mental disorder, 607,700 (14.3%) accessed other services for their mental health by phone, internet, or other digital technology.
Australia's National Mental Health Strategy began in 1992, with the first National Mental Health Care Plan. There have been six national mental health care plans to date. Despite these efforts, Australia's fragmented approach to mental healthcare has led to a confusing and problematic system, with significant shortfalls in both mental health service access and quality. The new Federal government, elected in May 2022, has expressed its intention to pursue mental health reform.
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$53.19 $55.99
Suicide and suicidal behaviour
Suicide is the leading cause of death for Australians aged 15 to 49 years. About 3,000 Australians end their lives each year, which equates to about 8 people a day. It is the third leading cause of premature death from injury or disease. The suicide rate among Aboriginal and/or Torres Strait Islander people is higher than in the general Australian population. This can be due to stigma and discrimination experienced by some gay, lesbian, bisexual, transgender, and intersex youth, which can contribute to social isolation or family rejection.
Suicidal behaviour is complex, with many influencing factors. Dealing with stressful or traumatic past or present events, death, separation, loss, bullying, mental ill-health, alcohol and drugs can play a role in causing emotional pain. Other factors may include life-changing events, family history and relationships, work, education, and social pressures. People who have previously attempted suicide are more likely to die by suicide than those who haven't. The risk of re-attempt remains high throughout their lives but is much higher in the first year following their attempt.
The risk of suicide for older people increases when they don't seek help for mental health issues. This is more common in men, as stigma and lack of access to or knowledge of the available services may play a role. It is important to pay attention to the well-being of older people and seek help if they need it. Protective factors that improve resilience and reduce the chance of suicidal behaviour include having strong, healthy relationships with family and friends.
The Australian Government has taken steps to prevent suicide and provide support for those at risk. The National Study of Mental Health and Wellbeing (NSMHW) measures the prevalence of mental disorders among Australians aged 16–85 years. In 2020–2021, 17.6% of Australians (3.5 million people) aged 16–85 years were dispensed at least one PBS-subsidized mental health-related medication in the 12 months prior to their interview. Recent investment in Medicare-subsidized psychology services has seen growth in the number of Australians receiving mental health treatment, from 35% to 46%.
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Mental health treatment access
Australia has a mixed healthcare system, with both public and private healthcare options available. The public system includes Medicare, a government-run insurance scheme that aids mental health services. Despite being celebrated for its sophisticated mental health management systems, Australia's fragmented approach to mental healthcare has led to a confusing and problematic system. Each state has its own mental health legislation, which has resulted in inconsistencies in the regulation of involuntary treatment.
In 2017, the Australian government spent $9.1 billion on mental health-related services, averaging $375 per person. This amount has increased from previous years, but critics have requested further funding, arguing that the mental health budget is insufficient. Mental health's share of total health spending has remained stagnant at 7.3% between 1992-1993 and 2020-2021. This gap between funding and mental health's share of the burden of disease inhibits the nationwide development of Australia's mental health services.
There have been six National Mental Health Care Plans since 1992, with the most recent one published in May 2021. The Australian government has also invested in Medicare-subsidised psychology services, leading to an increase in the number of Australians receiving mental health treatment from 35% to 46%. However, the outcomes of this treatment are unclear.
In terms of access, there are still significant shortfalls in mental health service access and quality, with services and the workforce concentrated in urban areas. During the COVID-19 pandemic in 2020, there were 84.4 mental health nurses, 78.4 psychologists, and 11.6 psychiatrists working in full-time clinical roles per 100,000 people. Additionally, 17.6% of Australians aged 16-85 years were dispensed at least one PBS-subsidized mental health-related medication between 2020 and 2022. It is important to note that mental health-related medications may also be prescribed for other conditions, so the data does not necessarily reflect the specific usage for mental health treatment.
Digital technologies have also played a role in improving access to mental health services. Between 2020 and 2022, 14.3% of Australians with a 12-month mental disorder accessed services by phone, internet, or other digital technology. Females and individuals aged 16-34 were more likely to utilize these digital options.
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Indigenous mental health
Australia has a national mental health strategy and has invested in Medicare-subsidised psychology services, which has resulted in an increase in the number of Australians receiving mental health treatment. However, the outcomes of this treatment are unclear, and the country's fragmented approach to mental healthcare has led to a confusing and inconsistent system.
Indigenous Australians experience a higher rate of mental health issues than non-Indigenous Australians. Suicide rates are almost twice as high, hospitalisation rates for intentional self-harm are three times as high, and the rate of high/very high psychological distress is 2.4 times higher. From July 2017 to June 2019, there were 3,258 hospitalisations involving specialised psychiatric care for Indigenous Australians, a rate of 2.0 per 1,000 population. Between 2009-10 and 2018-19, the hospitalisation rate for Indigenous Australians due to mental health-related conditions increased by 52%. The rate of hospitalisation for mental health-related conditions increased by 58% for Indigenous females and 46% for Indigenous males.
Social, historical, and economic disadvantages contribute to the high rates of mental health problems among Indigenous Australians. A long history of trauma, grief, loss, and cultural disconnection means that mental health issues in this community can be complex. Indigenous Australians who consume alcohol are more likely to do so at dangerous levels, which may exacerbate mental health conditions. However, it is important to note that First Nations people are more likely to abstain from alcohol than non-Indigenous Australians.
The Australian government has a program that funds Primary Health Networks to engage culturally appropriate, evidence-based mental health services for Aboriginal and Torres Strait Islander people. These services are tailored to meet the individual needs of the local population and are often delivered by local Aboriginal Community Controlled Health Services. The government also provides clear referral pathways to other services, such as drug and alcohol services, suicide prevention, and social and emotional wellbeing services.
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Mental health in mothers
Research from the Australian Longitudinal Study on Women's Health has contributed to the development of practical tools, guidelines, and Medicare changes to enhance mental health support for pregnant women and new mothers. Psychosocial health screening, which examines social and emotional factors, is recommended for all women giving birth in Australia. This screening includes questions about access to practical and emotional support, relationships, mental health history, substance use, and experiences of abuse or violence.
The Australian government has made significant investments in perinatal mental health, including the $85 million National Perinatal Depression Initiative from 2008 to 2015. However, mental health's share of total health spending has remained stagnant at 7.3% between 1992-1993 and 2020-2021. Recent investments in Medicare-subsidised psychology services have increased the number of Australians receiving mental health treatment, but the outcomes of this treatment are yet to be determined.
Socioeconomic status also plays a role in the mental health of mothers. Sole mothers with a lower socioeconomic status tend to have poorer psychological health than those with a higher socioeconomic status. Income-support recipients, including sole parents, are more likely to experience emotional problems, and there is a relationship between receiving income support and poor mental health.
Overall, while Australia has made strides in addressing mental health issues in mothers, particularly during the perinatal period, there is still room for improvement in terms of increasing access to quality mental health services and addressing the stigma surrounding perinatal mental health.
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Frequently asked questions
Mental health disorders contribute 13% to Australia's total burden of disease, the fourth-highest contributor. In the 2020-2022 National Study of Mental Health and Wellbeing, it was found that 4.3 million Australians aged 16-85 had a 12-month mental disorder.
Australia has seen a significant shift in mental health over the last 50 years, with the country instituting a British system of managing mental health since 1788. The country's first psychiatric facility opened in 1811. Australia's National Mental Health Strategy began in 1992, and there have been six national mental health care plans since. The country has also seen an increase in mental health professionals, with more mental health nurses, psychologists, and psychiatrists working in full-time clinical roles per 100,000 people in 2020 compared to 2013.
Despite Australia's sophisticated mental health management systems, there are still issues. There is a fragmented approach to mental healthcare, leading to a confusing and problematic system with significant shortfalls in access and quality. Critics have also called for an increase in funding, as mental health accounts for a larger share of the total burden of disease than the allocated budget.
The Australian government has identified mental health reform as a priority, aiming to work with various stakeholders to improve access and quality. There is a particular focus on supporting Indigenous individuals, as they experience higher rates of psychological distress than non-Indigenous Australians, with depression being the most common diagnosis.
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