DATA QUALITY CONSIDERATIONS
There are a number of factors that should be considered when interpreting information presented in this publication.
The Mental Health Services-Census-Mortality Integrated Dataset on which analysis is based includes a subset of persons who accessed the mental health system in Australia; that is, persons who accessed MBS subsidised mental health-related services and/or PBS subsidised mental health-related prescription medications in 2011.
Information on persons who accessed other mental health-related services such as state and territory government funded services (for example, mental health care services delivered in public hospitals) are not captured in the dataset, although recipients of these services may have also accessed MBS and/or PBS subsidised mental health-related treatments. Also not captured is information about persons who accessed services through the Aboriginal Health Services Program and medications subsidised through the Repatriation Pharmaceutical Benefits Scheme (RPBS). Nevertheless, MBS subsidised mental health-related services and PBS subsidised mental health-related prescription medications comprise a significant component of Australia’s mental health system, with around 8 million mental health-related services and more than 20 million prescriptions for mental health-related medications accessed by Australians in 2011.
Consultations with general practitioners (GPs) that may have involved discussion of mental health issues but were not recorded as mental-health related services were not captured in the dataset. People who accessed mental health-related medications in 2011 for whom no mental health-related service was recorded in 2011 should therefore not be considered to have obtained the medication without a prescription. Note that persons with poor mental health may have co-existing physical health conditions and may access GP consultations to discuss multiple aspects of their health.
Mental health-related medications may not always be prescribed for mental health-related reasons; for example, the antidepressant nortriptyline may be prescribed to assist smoking cessation. Additionally, while persons may have had scripts filled for mental health-related medications, the dataset cannot indicate actual use of the medication.
It should also be noted that a person's use of mental health-related services or medications does not imply a diagnosis of a mental health condition. For information on the 4.0 million people who reported having a mental or behavioural condition in Australia in 2014-15 see National Health Survey: Mental Health and co-existing physical health conditions, Australia, 2014-15 (cat. no. 4329.0.00.004).
In addition, it is important to note that while results presented in this publication indicate a relationship between accessing mental health-related treatments and mortality rates, this does not necessarily imply causality. That is, while persons who accessed mental health-related treatments in 2011 were found to have higher rates of mortality, this should not be attributed to their access of mental health-related treatments per se. Instead, results highlight the complex interplay between mental and physical health and may imply some additional levels of risk that these persons may be exposed to. Further study to understand treatment patterns and underlying conditions which are being treated would be beneficial.