Psychosocial disability

This article uses data from the 2018 Survey of Disability, Ageing and Carers (SDAC) to examine the prevalence of psychosocial disability in Australia

Released
25/09/2020

Key statistics

In 2018, 4.6% of Australians (1.1 million people) had psychosocial disability. Of these:

  • 85.5% had at least one other disabling condition
  • 38.8% had a profound limitation
  • 24.1% experienced discrimination, up from 21.5% in 2015.

Prevalence

In 2018, of the 4.4 million Australians with any disability over one-quarter (26.0%) had psychosocial disability:

  • 1,137,800 people, up from 1,045,900 in 2015
  • 4.6% of all Australians, similar to 2015 (4.5%)
  • 85.5% of those with psychosocial disability (972,100 people) had at least one other disabling condition
  • 14.5% (165,400 people) had no other disabling condition, that is their psychosocial disability was their only disability.

Definitions

People with Psychosocial disability includes all those who reported:

  • a nervous or emotional condition; memory problems or periods of confusion; or social or behavioural difficulties which cause restrictions in everyday activities;
  • a brain injury, including stroke, which results in any of the above conditions; or
  • a mental illness for which help or supervision is required.

These conditions must have lasted, or be expected to last, for six months or more.

Other disabling condition (other disability) includes any other condition (excluding those listed in the psychosocial disability definition above) which cause a limitation, restriction or impairment, which has lasted or is likely to last for at least six months and restricts everyday activities.

Age and sex

The rate of psychosocial disability generally increased with age, with similar prevalence rates for males and females except in the youngest and oldest age groups:

  • 3.4% of boys aged 0-14 years had psychosocial disability, compared with 1.9% of girls, largely due to the higher prevalence of autism among boys in this age group
  • over one-quarter (27.2%) of women aged 85 years and over had psychosocial disability, compared with 21.9% of men, due in part to higher prevalence of anxiety related disorders among women in this age group.
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The pattern of psychosocial disability across age was similar in both 2015 and 2018, though there has been a small change among females aged 35-44 years (3.4%, down from 4.5% in 2015).

There have been no significant changes among men of any age group between 2015 and 2018.

States and territories

Psychosocial disability prevalence varied between Australia's states and territories:

  • Tasmania had the highest rate of psychosocial disability at 8.3%
  • Northern Territory and Western Australia had the lowest rates of psychosocial disability (3.4%* and 3.6%, respectively).

The ACT had the largest increase among the states and territories (5.6%, up from 3.5% in 2015), driven in part by an increase in psychosocial disability among those aged 45-64 years.

Table 1. Persons with psychosocial disability, by state and territory of usual residence, 2018 and 2015

 2018   2015 
State or territory of usual residence'000%RSE of EstimateAge standardised rate(a) %%Age standardised rate(a) %
New South Wales338.84.34.74.14.24.0
Victoria294.24.54.64.44.84.7
Queensland253.25.15.05.04.54.3
South Australia88.95.210.55.05.95.5
Western Australia89.83.66.03.53.33.3
Tasmania43.48.310.67.76.56.3
Northern Territory6.0*3.442.94.12.33.1
Australian Capital Territory23.25.611.15.83.53.5
Total1,137.804.62.44.44.54.3
a. Age standardised rates are calculated to remove the effects of different age structures when comparing populations over time. For more information see the glossary. * Estimate has a Relative Standard Error (RSE) between 25-50% and should be used with caution.

Impairments contributing to psychosocial disability

People with psychosocial disability have one or more psychosocial impairments which cause limitations or restrictions in their everyday activities. Of the 1.1 million people with psychosocial disability:

  • over half (58.0%) had a nervous or emotional condition, similar to 2015 (57.7%)
  • 42.3% had memory problems or periods of confusion, down from 45.3% in 2015
  • 41.1% had social or behavioural problems, similar to 2015 (40.5%)
  • 40.2% had mental illness, such as schizophrenia, similar to 2015 (40.7%).

Coexisting disability

Most (85.5%) people with psychosocial disability also reported having one or more other impairments or restrictions, that is, another disability in addition to their psychosocial disability. Of the 1.1 million people with psychosocial disability:

  • almost two-thirds (63.0%) also had a physical disability (down from 66.2% in 2015)
  • almost two-fifths (38.3%) also had an intellectual disability (difficulties in learning or understanding), similar to 2015 (39.5%)
  • one-third (33.4%) also had a sensory disability (speech difficulties, or loss of sight or hearing), down from 34.9% in 2015.

Long-term health conditions

A person with psychosocial disability may have a number of long-term health conditions, including those that contribute to their psychosocial disability, as well as other unrelated conditions. Of the 1.1 million people with psychosocial disability:

  • over one-third (35.1%) had depression/mood affective disorders, similar to 2015 (37.6%)
  • 31.0% had phobic and anxiety disorders, up from 27.8% in 2015
  • one-quarter (25.0%) had arthritis, down from 27.4% in 2015
  • one-quarter (24.7%) had back problems, similar to 2015 (24.5%).
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  1. Excludes post-natal depression
  2. Includes Alzheimer’s disease
  3. Includes Rett syndrome and Asperger’s syndrome
  4. Excludes all people who have a psychosocial disability, regardless of whether they also had another disability

Definitions

Long-term health condition - a disease or disorder that has lasted, or is likely to last, for six months or more. The SDAC collects information about long-term health conditions and through a series of screening questions, determines whether they restrict a person’s ability to complete everyday activities. People whose long-term conditions limit their activities are identified as having disability.

Severity of disability

People with psychosocial disability generally report more severe limitations than those with other disability.

Of the 1.1 million Australians with psychosocial disability:

  • almost two in five (38.8%) had a profound limitation, almost four times the rate of those with other disability (10.5%)
  • one in five (20.3%) had a severe limitation, almost twice the rate of those with other disability (12.4%).
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  1. Excludes those with no specific limitation or restriction. For more information see glossary.

Profound or severe limitations

The prevalence of profound or severe limitation among people with psychosocial disability varies by age, following a similar, though more pronounced, pattern to those with other disability. Among people with psychosocial disability:

  • almost all (95.0%) of those aged 85 years and over had a profound or severe limitation, almost twice the rate for those of the same age with other disability (49.3%)
  • around four in five (81.9%) children aged 0-14 years had a profound limitation, compared with less than half (46.4%) of those of the same age with other disability.
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Definition

 Profound limitation means the person is unable to do or always needs help with, at least one of the core activities of self-care, mobility and/or communication. See ‘Core activity limitation’ in glossary.

Severe limitation means the person sometimes needs help with a core activity task and/or has difficulty understanding or being understood by family or friends or can communicate more easily using sign language of other non-spoken forms of communication. See ‘Core activity limitation’ in glossary.

Living arrangements

While most (87.4% or 994,600) people with psychosocial disability lived in households, one in eight (12.7% or 144,000 people) lived in cared-accommodation, including hospitals and aged care facilities. (For more information see the Glossary.)

The remaining analysis in this article focuses on people with psychosocial disability living in households only unless otherwise specified.

Need for assistance

Many people with disability require assistance (or experience difficulty) with one or more aspects of daily living. Of the 994,600 people with psychosocial disability (living in households), the majority (94.9% or 943,400) needed assistance or experienced difficulty with at least one activity of daily life. People with psychosocial disability most commonly needed assistance or experienced difficulty with:

  • cognitive and emotional tasks (85.5% of all those with psychosocial disability)
  • mobility (54.9%)
  • health care (51.5%).

Given many people with psychosocial disability had one or more coexisting disabilities, their need for assistance or experience of difficulty may not always be due to their psychosocial disability alone.

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  1. Living in households

Assistance received

In 2018 there were 836,800 people (living in households) who reported that they needed assistance with at least one activity of daily life:

  • almost all (95.5%) reported receiving assistance with at least one activity
  • over half (56.4%) received assistance from both informal and formal care providers
  • almost one-third (30.0%) received assistance from informal providers only
  • one in ten (9.1%) received assistance from formal providers only.

Informal assistance

People with psychosocial disability may receive informal assistance from one or more family members or friends.

Of the 724,800 people with psychosocial disability (living in households) who received informal assistance, the most common providers of assistance were a:

  • parent (41.2%)
  • partner (33.3%)
  • child (20.7%).

Parents of people with psychosocial disability were the most common informal care providers of assistance with tasks such as:

  • oral communication (66.9%)
  • cognitive and emotional tasks (50.2%).

In contrast, partners of people with psychosocial disability were the most common informal care providers for most other tasks including:

  • household chores (44.2%)
  • private transport (39.6%)
  • property maintenance (38.5%).

Formal assistance

Formal assistance can come from a range of sources, and people can receive formal care from more than one provider. Of the 546,300 people with psychosocial disability (living in households) who received formal assistance, the most common providers of assistance were:

  • private commercial organisations (59.1%)
  • government organisations (51.2%)
  • private non-profit organisations (20.9%).

Government organisations most commonly provided formal assistance with:

  • communication (61.0%)
  • mobility (52.1%)
  • household chores (48.6%).

In contrast, private commercial organisations most commonly helped with:

  • property maintenance (61.3%)
  • health care (59.3%)
  • cognitive or emotional tasks (55.1%).

Whether need for assistance was met

A person who needs assistance with an activity may or may not receive the help they need. Of the 836,800 people with psychosocial disability (living in households) who needed assistance:

  • almost half (48.7%) felt their needs were fully met
  • almost half (49.2%) felt their needs were only partly met
  • 2.0% felt their needs were not met.

These results varied with level of core activity limitation or restriction.

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  1. Living in households
  2. Excludes those with no specific limitation or restriction

*Proportion of those with profound or severe core activity limitation whose needs were not met has a high margin of error and should be used with caution.

Use of aids and equipment

Of all people with psychosocial disability (living in households and cared accommodation), more than half (57.4%) reported using aids or equipment because of their condition(s).

Almost one-third (30.0%) used aids to assist with oral communication, up from 26.6% in 2015. Other common activities for which aids or equipment were used included:

  • health conditions (22.8%)
  • showering or bathing and moving around places away from home (both 21.4%).

Education

There have been some increases in the educational attainment of people with psychosocial disability. Among those aged 15 years and over (living in households), 55.2% had completed Year 12 (or equivalent) or higher, up from 51.8% in 2015. This was largely driven by increases for those with a profound or severe limitation (increasing from 43.0% to 48.7%).

Whether a person with psychosocial disability (aged 15 years and over, living in households) completed year 12 or higher varied by disability status:

  • 48.7% of those with a profound or severe limitation
  • 57.7% of those with a moderate or mild limitation
  • 67.3% of those with a schooling or employment restriction only.

Education difficulty and support

Of the 212,800 people with psychosocial disability aged 5 years and over (living in households) who were studying, over two-thirds (68.9%) experienced difficulties at their school or educational institution due to their condition, compared with 41.5% of those with other disability. The main difficulties reported by people with psychosocial disability were:

  • fitting in socially (45.2%), more than three times higher than those with other disability (14.2%) and
  • learning difficulties (39.2%, compared to 27.1% of those with other disability).

Over half (60.9%) the students with psychosocial disability reported that they received educational support or special arrangements, compared with 36.4% of those with other disability. The most common support or special arrangements for those with psychosocial disability were:

  • disability support person or counsellor (30.5%), three times the rate of those with other disability (10.2%)
  • special tuition (29.2%, compared with 19.8% of those with other disability).

Employment

People with psychosocial disability were less likely to be working than those with other disability. Of all people with psychosocial disability aged 15-64 years (living in households):

  • one-third (33.5%) were in the labour force compared with almost two-thirds (62.3%) of those with other disability
  • one in four (25.7%) were employed, compared with 57.9% of those with other disability and 80.3% of those without disability
  • 7.9% were unemployed, compared with 4.5% of those with other disability and 3.9% of those with no disability.
  • there has been an increase in the proportion working full-time (10.9%, up from 8.1% in 2015).
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  1. Living in households
  2. Excludes all people who have a psychosocial disability, regardless of whether they also had another disability

Employment restrictions

People with psychosocial disability were more likely than those with other disability to report employment restrictions because of their disability:

  • 84.6% of those aged 15-64 years with psychosocial disability
  • 60.2% of those aged 15-64 years with other disability.

Income

With lower levels of labour force participation compared with those with other (or no) disability, people with psychosocial disability of working age (15-64 years) who were living in households were more likely to rely on government pensions and have lower incomes. Among those with psychosocial disability, the main sources of income reported were:

  • government pension or allowance (59.2%), down from 66.8% in 2015
  • wages or salary (17.7%), similar to 2015 (15.6%).

In contrast, 28.2% of those with other disability and 7.0% of those with no disability received a government pension or allowance as their main source of income.

Income level

Of people with psychosocial disability (aged 15-64):

  • the median gross income was $450 per week, less than half the $1,016 per week income of a person without disability
  • almost half (47.6%) lived in households in the lowest two quintiles for equivalised gross household income, compared with 31.7% of those with other disabilities and 16.7% of those without disability.
  • 5.9% lived in households with incomes in the highest quintile compared to 18.4% of those without disability.

Discrimination

Discrimination results below refers to unfair treatment received because of disability in the previous 12 months.

People with psychosocial disability were more likely to experience discrimination because of their disability than those with other disability. Of people with psychosocial disability aged 15 years and over (living in households):

  • almost one-quarter (148,500 people or 24.1%) experienced discrimination, four times higher than those with other disability (6.3%)
  • rates of discrimination have increased (from 21.5% in 2015)
  • rates of discrimination were similar for men (22.1%) and women (25.8%)
  • rates of discrimination were generally lower among older people (those aged 65 years and over).
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  1. Aged 15 years and over living in households
  2. In the previous 12 months

*Estimate for people with psychosocial disability has a high margin of error and should be used with caution.

Source of discrimination

The most common sources of discrimination for people with psychosocial disability were:

  • service and hospitality staff (including restaurant staff, teachers, health staff, transport staff) (36.8%)
  • family or friends (26.3%)
  • employers or work colleagues (23.0%).

Avoiding situations

People with psychosocial disability were more likely to avoid situations because of their disability. Of those aged 15 years and over (living in households):

  • over two thirds (67.0%) avoided situations, compared with 25.2% of those with other disability
  • rates were similar for women (69.3%) and men (63.9%).

The most common  situations or places avoided by people with psychosocial disability were:

  • visiting family or friends (50.1%)
  • shops, banks and similar public venues (42.8%)
  • restaurants, cafes and bars (38.3%).

NDIS participation

People with disability may qualify for support from the National Disability Insurance Scheme (NDIS). Overall, the 2018 SDAC estimated that around 211,000 people with disability were receiving an NDIS funded package at the time of the survey.

Of the 1 million people identified as having psychosocial disability in the 2018 SDAC (living in households), one in eight (124,400 people, or 12.5%) reported they were receiving an NDIS package. Of these, 90.3% had at least one other disabling condition and therefore their NDIS participation may or may not be related to their psychosocial disability.

Interpreting NDIS data

In interpreting these results, it is important to note the following:

  • At the time of the 2018 SDAC, the NDIS was still rolling out in many jurisdictions and therefore data reflect only those who reported receiving an agreed NDIS package at the time of the survey and do not reflect full Scheme numbers.
  • In general, the definition and scope of disability is much broader in the SDAC compared with NDIS eligibility criteria.
  • In terms of psychosocial disability, the NDIS provides individualised plans to support those who have a permanent and significant disability as a result of their mental health condition which substantially impacts on their ability to complete everyday activities. The SDAC definition is broader, including all those who reported one or more of the following conditions, where the condition has lasted or is expected to last 6 months or more and causes restrictions in everyday activities: a nervous or emotional condition, memory problems or periods of confusion, social or behavioural difficulties, or a brain injury (including stroke) which results in any of the above conditions. In addition, people with a mental illness for which help or supervision is required are also considered to have a psychosocial disability according to the SDAC.
  • The NDIS requires a person to be under the age of 65 when they apply for access to the Scheme. The SDAC measures disability in people of all ages which means SDAC estimates include a higher proportion of people aged over 65 compared with NDIS numbers.

For more information see www.ndis.gov.au.

Changes in data collection

Prior to 2015, the SDAC collected information about psychological disability, which was narrower in scope than psychosocial disability. For more information on previous collections see ABS cat. no. 4430.0 – Disability, Ageing and Carers, Australia: Summary of Findings, 2015 - Psychosocial Disability. For time series comparisons two data cubes have been included with this release, one containing psychosocial disability data and another with corresponding psychological disability data.

Data downloads

Psychosocial disability

Psychological disability