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Patterns of Use of Mental Health Services and Prescription Medications

Analysis of patterns of use of MBS subsidised mental health-related services and PBS subsidised mental health-related medications in 2011

Reference period
2011
Released
24/03/2016
Next release Unknown
First release

Introduction

This publication is the second in a series of analyses based on data from the Mental Health Services-Census Integrated Dataset. It further explores patterns of use of Medicare Benefits Schedule (MBS) subsidised mental health-related services and Pharmaceutical Benefits Scheme (PBS) subsidised mental health-related medications in 2011, building upon the first release of information in Characteristics of People using Mental Health Services and Prescription Medication, 2011 (cat. no. 4329.0).

Individual types of service use (e.g. consultations with psychologists) and medications (e.g. antidepressants) are considered in more detail, in conjunction with the number of mental health-related consultations and prescriptions Australians accessed in 2011. Combinations of types of treatments are also considered, while logistic regression modelling has been used to identify the likelihood of a person transitioning from services to medications and vice versa. In the Integrated Dataset, the Census of Population and Housing provides insight into a range of socio-demographic characteristics including age, sex, remoteness, socio-economic disadvantage, household income, labour force status, educational attainment and others.

Mental health-related treatments in Australia

People seeking assistance in managing or treating mental health conditions in Australia may have a number of options available to them. The particular option(s) a person follows may be influenced by a range of factors, such as their diagnosis, the severity of the condition, treatment options available as well as personal preference. Options, for example, can include community based services, hospital-based care, Commonwealth subsidised treatments through the Medicare Benefits Schedule (MBS) and Pharmaceutical Benefits Scheme (PBS), on-line facilities (such as those available from beyondblue) and telephone counselling services (such as Lifeline Australia).

Mental health-related treatments included in this publication refer to MBS subsidised mental health-related services and/or PBS subsidised mental health-related medications only.

Mental health-related services provided by the following five groups are included:

  • Psychiatrists;
  • General Practitioners;
  • Clinical Psychologists;
  • Other Psychologists; and
  • Other Allied Health Professionals.


Mental health-related medications for the following four groups are included:

  • Antipsychotics;
  • Anxiolytics/Hypnotics and sedatives;
  • Antidepressants; and
  • Psychostimulants, agents used for ADHD and nootropics.
     

See Appendix 1 and Appendix 2 respectively for more detail about specific mental health-related services and medications listed on the MBS and PBS and covered in this analysis.

The following examples illustrate two possible treatment options and are included to demonstrate how such treatments would be reflected in the Integrated Dataset used for this analysis:

Diagram showing two examples of possible mental health-related treatment options
Diagram showing two examples of possible mental health-related treatment options over time from January 2011 to January 2012. The first example shows treatment started with GP followed by Antidepressants then GP then Antidepressants and Psychologist. The second example shows before to January 2011 there was 'Prior history of anxiety disorder' then after January 2011 four incidents of Anxiolytics, Hypnotics and sedatives.

In Example 1, a person attends their GP and explains they have been feeling down recently. After discussion, the GP prescribes antidepressants and arranges for a subsequent consultation in two months. At this second consultation the person explains they are still feeling down, and therefore the GP prescribes a different antidepressant as well as referring the person to a psychologist. In the Mental Health Services-Census Integrated Dataset this person would therefore have three MBS subsidised mental health-related services in 2011 and two PBS subsidised mental health-related medications.

In Example 2, a person was diagnosed with an anxiety disorder prior to 2011 which is being managed with ongoing medication. This person would therefore have had an MBS subsidised mental health-related service prior to 2011, three PBS subsidised mental health-related medications in 2011, and a further prescription in 2012.

Data quality considerations

There are a number of factors that should be considered when interpreting information presented in this publication.

While the MBS items included in analysis include a range of subsidised mental health-related services provided in Australia, consultations with some medical practitioners such as paediatricians were not captured in the Mental Health Services-Census Integrated Dataset, even if they were related to mental health. Consultations with GPs that may have involved discussion of mental health issues but were not recorded as mental-health related services were also not captured.

Additionally, people who accessed mental health-related medications in 2011 for whom no mental health-related service was recorded in 2011 should not be considered to have obtained the medication without a prescription; rather, the consultation at which the medication was prescribed may not have been recorded as a mental health-related service, or may have occurred earlier than 2011.

Finally, while the four groupings of medications included in analyses are commonly prescribed for treating mental health conditions, they may also be prescribed to treat other conditions. A person's use of mental health-related services or medications does not imply a diagnosis of a mental health condition. For information on people who reported having a mental or behavioural condition in Australia in 2014-15 (4.0 million people) see National Health Survey: First Results, 2014-15 (cat. no. 4364.0.55.001).

Overview of subsidised mental health-related treatments

In 2011 there were 3.2 million people (15.0% of all Australians) who accessed at least one MBS or PBS subsidised mental health-related treatment (either a service such as a consultation with a psychologist, or medication, or both). Overall, females were more likely to have used a mental health-related treatment than males: almost one in five females (18.2%) compared with around one in nine males (11.7%).

Of the 3.2 million people who accessed at least one MBS or PBS subsidised mental health-related treatment in 2011, around one-quarter (27.0%, or 872,700 people) used services only while 20.7% (668,000 people) used both services and medications. Around one half (52.3%, or 1.7 million people) used medications only in 2011 (note these people should not be considered to have obtained medications without a prescription, as the consultation at which the medication was prescribed may not have been recorded as a mental health-related service, or may have occurred earlier than 2011).

Younger people were more likely to use MBS subsidised mental-health related services only than were older people, while older people were more likely to use PBS subsidised mental health-related medication only. Of children aged 0-14 years who used at least one MBS or PBS subsidised treatment in 2011, the majority (61.8%) used MBS services only. Of people aged 75 years and over who used at least one MBS or PBS subsidised treatment in 2011, nine in ten (90.8%) people used PBS medications only, compared with 2.3% accessing MBS services only.

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Source(s): The Mental Health Services-Census Integrated Dataset

Differences in types of use also existed for other socio-demographic characteristics.

Of people who had at least one MBS or PBS subsidised mental health-related treatment in 2011, those living in Major Cities had higher rates of using services only than those living in Remote/Very Remote areas of Australia (30.2% compared with 18.6% respectively). Conversely, people living in Remote/Very Remote areas had higher rates of using medications only than people in Major Cities (66.8% compared with 48.5% respectively).

Around one in five (18.1%) people living in the most disadvantaged areas of Australia who had at least one MBS or PBS subsidised mental health-related treatment in 2011 used services only, compared with 39.1% of people living in areas of least disadvantage. Conversely, 60.1% of people living in the most disadvantaged areas who had at least one MBS or PBS subsidised mental health-related treatment in 2011 used medications only, compared with 41.1% of people living in areas of least disadvantage.

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  1. A lower Index of Disadvantage quintile (e.g. Quintile 1) indicates an area with relatively greater disadvantage. A higher Index of Disadvantage (e.g. Quintile 5) indicates an area with a relative lack of Disadvantage.

Source(s): The Mental Health Services-Census Integrated Dataset

Of people who had at least one MBS or PBS subsidised mental health-related treatment in 2011, people with a need for assistance with core activities (for example, those relating to self-care, communication and mobility) had lower rates of using services only than other people (6.6% compared with 30.8% respectively) and higher rates of using medications only (74.1% compared with 48.2% respectively).

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  1. Whether needs assistance with disability, long term illness or problems related to old age for core activities, including self-care, mobility and communication.

Source(s): The Mental Health Services-Census Integrated Dataset

Similarly, of people aged 15-64 years who had at least one MBS or PBS subsidised mental health-related treatment in 2011, people not in the labour force had lower rates of using services only than people in the labour force (20.1% compared with 43.9% respectively) and higher rates of using medications only (50.1% compared with 32.2% respectively).

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  1. Persons aged 15-64 years.

Source(s): The Mental Health Services-Census Integrated Dataset

For information on other socio-demographic characteristics of people who had at least one MBS or PBS subsidised mental health-related treatment in 2011 see Data downloads section.

MBS subsidised mental health-related services

MBS subsidised mental health-related services provided by the following five groups are included in analysis in this publication:

  • Psychiatrists;
  • General Practitioners;
  • Clinical Psychologists;
  • Other Psychologists; and
  • Other Allied Health Professionals.
     

Appendix 1 provides more detail about specific mental health-related services listed on the MBS covered in this analysis.

There were 1.5 million people (7.2% of all Australians) who used at least one MBS subsidised mental health-related service in 2011. On average, these people had 5.2 MBS subsidised mental-health related consultations in 2011. Further information on people accessing the different types of services is provided in following sections of this publication.

People who used at least one MBS subsidised mental health-related service in 2011, type of service

Type of serviceNumber of peopleProportion (%)(a)Average number of consultations(b)
Psychiatrist
296 400
1.4
7.1
General Practitioner
1 224 900
5.7
1.8
Clinical Psychologist
260 300
1.2
5.2
Other Psychologist
438 600
2.0
4.9
Other Allied Health Professional
45 700
0.2
5.2
Total persons who used at least one MBS subsidised mental health-related service in 2011
1 540 800
7.2
5.2
a. Proportion of the total Australian population.
b. Average number of consultations of the particular service in 2011, of people who had at least one consultation of the particular service in 2011.
 

Psychiatrists

Medicare-subsidised psychiatrist services are services provided by a psychiatrist (or, in some circumstances, by another medical practitioner) on a fee-for-service basis that are partially or fully funded under the Australian Government’s Medicare program. These services cover patient consultations provided in different settings as well as services such as group psychotherapy, telepsychiatry, case conferences and electroconvulsive therapy[1].

Number of people with consultations with Psychiatrists in 2011

There were 296,400 Australians (1.4% of the total population) who had at least one MBS subsidised consultation with a Psychiatrist in 2011. Overall, females were slightly more likely to have had a consultation with a Psychiatrist than males (1.5% compared with 1.3%).

Women aged 35-54 years recorded the highest rates of Psychiatrist consultations in 2011 (around 2% of all women aged 35-54 years).

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Source(s): The Mental Health Services-Census Integrated Dataset

For information on other socio-demographic characteristics of people who had at least one MBS subsidised consultation with a Psychiatrist in 2011 see Data downloads section Table 2.

Combinations of treatment type

Of all people who had at least one MBS subsidised consultation with a Psychiatrist in 2011, more than half (56.9%) also had at least one prescription filled for Antidepressant medications in 2011, one-third (33.4%) also had at least one mental health-related consultation with a GP, and 31.2% also had at least one prescription filled for Antipsychotic medications. Around one in five (19.3%) saw a Psychiatrist only, with no other MBS or PBS subsidised mental health-related treatment in 2011.

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Source(s): The Mental Health Services-Census Integrated Dataset

For information on socio-demographic characteristics of people who had at least one MBS subsidised consultation with a Psychiatrist in 2011 in combination with other treatment types see Data downloads section Table 2.

Number of consultations with Psychiatrists

In 2011, people who had at least one MBS subsidised consultation with a Psychiatrist had an average of 7.1 consultations over the year, with around one-quarter (23.2%) having one consultation only. A further 15.5% had two consultations, 10.8% had three consultations, and the remainder (50.5%) had four or more consultations over the calendar year.

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  1. People who had at least one mental health-related consultation with a Psychiatrist in 2011.

Source(s): The Mental Health Services-Census Integrated Dataset

Of people who had an MBS subsidised consultation with a Psychiatrist in 2011, females had higher numbers of consultations (7.9 consultations on average) than males (6.0 consultations).

Of people who had an MBS subsidised consultation with a Psychiatrist in 2011, children had fewer consultations than adults (3.7 consultations on average for 0-14 year olds compared with 7.7 consultations for people aged 45-64 years).

Of all people who had an MBS subsidised consultation with a Psychiatrist in 2011, people living in Major Cities had more consultations on average than people in other areas of Australia (7.4 consultations on average for people in Major Cities compared with 4.0 consultations for people in Remote/Very Remote Australia).

Similarly, of all people who had an MBS subsidised consultation with a Psychiatrist in 2011, people living in areas of the least disadvantage in Australia had more consultations on average (8.2 consultations) than people living in areas of most disadvantage (5.7 consultations).

For information on other socio-demographic characteristics of people who had an least one MBS subsidised consultation with a Psychiatrist in 2011 by number of consultations, see Data downloads section Table 5.

Endnotes

  1. Australian Institute of Health and Welfare, 2012, Mental Health Services in Australia, https://www.aihw.gov.au/reports/mental-health-services/mental-health-services-in-brief-2012/contents/table-of-contents, last accessed 18/03/2016.

General Practitioners

General Practitioners (GP) play a central role in the delivery of health care to the Australian community. Typically GPs are the first point of contact in matters of personal health, providing coordination of patient care, referral of patients to other specialists, and other services[1].

Under the Medicare Benefits Schedule (MBS), GPs provide a range of subsidised mental health-related services such as the preparation of GP Mental Health Treatment Plans which provide a framework to undertake early intervention, assessment and management of patients with mental disorders, as well as providing referral pathways to clinical psychologists, registered psychologists, and appropriately trained social workers and occupational therapists[2].

In this publication, consultations with GPs refer to those that were recorded as mental health-related services. Appendix 1 lists the relevant MBS items. Consultations with GPs that may have involved discussion of mental health issues but were not recorded as mental-health related services were not captured in the Mental Health Services-Census Integrated Dataset.

Number of people with mental health-related consultations with General Practitioners in 2011

There were 1.2 million Australians (5.7% of the total population) who had at least one MBS subsidised mental health-related consultation with a GP in 2011. Females were more likely than males to have had a mental health-related consultation with a GP (7.1% compared with 4.2%).

Women aged 35-44 years had the highest rate of mental health-related GP consultations in 2011 (10.5%).

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Source(s): The Mental Health Services-Census Integrated Dataset

For information on other socio-demographic characteristics of people who had at least one MBS subsidised mental health-related consultation with a GP in 2011 see Data downloads section Table 2.

Combinations of treatment type

Of all people who had at least one MBS subsidised mental health-related consultation with a GP in 2011, around one-third (34.7%) also had at least one PBS subsidised prescription filled for Antidepressant medications in 2011, while 29.3% also had at least one MBS subsidised consultation with an Other Psychologist. Around three in ten (28.6%) saw only a GP, with no other MBS or PBS subsidised mental health-related treatment in 2011.

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  1. MBS subsidised mental health-related General Practictioner services.

Source(s): The Mental Health Services-Census Integrated Dataset

For information on socio-demographic characteristics of people who had at least one MBS subsidised mental health-related consultation with a GP in 2011 in combination with other treatment types see Data downloads section Table 2.

Number of mental health-related consultations with General Practitioners

Almost two-thirds (65.0%) of people who had a mental health-related GP consultation in 2011 had one consultation only. A further 20.2% had two consultations in 2011, 6.9% had three consultations, and 8.0% had four or more consultations.

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  1. People who had at least one mental health-related consultation with a GP in 2011.

Source(s): The Mental Health Services-Census Integrated Dataset

While females were more likely than males to have had a mental health-related consultation with a GP in 2011 (7.1% compared with 4.2%), the pattern of use in terms of their numbers of consultations was similar. Around two-thirds (66.7%) of females who had a mental health-related GP consultation in 2011 had one consultation only, similar to the proportion of males (64.0%).

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Source(s): The Mental Health Services-Census Integrated Dataset

Patterns of use in terms of number of consultations by other socio-demographic characteristics such as state/territory of usual residence, remoteness and household income were similar. For example, 64.3% of people living in areas of most disadvantage in Australia who had a mental health-related GP consultation in 2011 had one consultation only, similar to the proportion for people living in areas of least disadvantage (66.2%).

However, of people who had a mental health-related GP consultation in 2011, children aged 0-14 years were more likely to have had one consultation only (78.9%) than people aged 15 years and over (63.8%).

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  1. People who had at least one mental health-related consultation with a GP in 2011.

Source(s): The Mental Health Services-Census Integrated Dataset

For information on other socio-demographic characteristics of people who had at least one MBS subsidised mental health-related consultation with a GP in 2011 by number of consultations, see Data downloads section Table 5.

Endnotes

  1. Royal Australian College of General Practitioners, Becoming a GP in Australia, http://www.racgp.org.au/becomingagp/what-is-a-gp/, last accessed 18/03/2016.
  2. Department of Health, 2012, GP Mental Health Treatment Medicare Items, http://www.health.gov.au/internet/main/publishing.nsf/content/pacd-gp-mental-health-care-pdf-qa#1, last accessed 18/03/2016.

Clinical Psychologists

Clinical Psychologists diagnose, treat and prevent a wide range of mental and general health issues affecting adults, children and families. Medicare-subsidised Psychologist services are services provided by psychologists that are rebatable by Medicare through psychological therapy services, focussed psychological strategies and enhanced primary care items[1].

Number of people with consultations with Clinical Psychologists in 2011

There were 260,300 Australians (1.2% of the total population) who had at least one MBS subsidised consultation with a Clinical Psychologist in 2011. Females were more likely than males to have had a consultation with a Clinical Psychologist (1.5% compared with 0.9%).

Women aged 25-34 years and 35-44 years had the highest rates of consultations with Clinical Psychologists in 2011 (2.3% for both age groups).

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Source(s): The Mental Health Services-Census Integrated Dataset

For information on other socio-demographic characteristics of people who had at least one MBS subsidised consultation with a Clinical Psychologist in 2011 see Data downloads section Table 2.

Combinations of treatment type

Of all people who had at least one MBS subsidised consultation with a Clinical Psychologist in 2011, around four in five (81.3%) also had at least one MBS subsidised mental health-related consultation with a GP, while around one-third (31.0%) also had at least one PBS subsidised prescription filled for Antidepressant medications. Around one in nine (11.0%) saw a Clinical Psychologist only, with no other MBS or PBS subsidised mental health-related treatment in 2011.

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Source(s): The Mental Health Services-Census Integrated Dataset

For information on socio-demographic characteristics of people who had at least one MBS subsidised consultation with a Clinical Psychologist in 2011 in combination with other treatment types see Data downloads section Table 2.

Number of consultations with Clinical Psychologists

In 2011, people who had at least one MBS subsidised consultation with a Clinical Psychologist had an average of 5.2 consultations over the year, with one in six (16.7%) people having one consultation only.

The small peaks in the rates of people having either six (9.1%) or ten (6.2%) consultations (see graph below) are consistent with the Australian Government's Better Access to Psychiatrists, Psychologists and General Practitioners through the MBS (Better Access) initiative which enables GPs, psychiatrists and paediatricians to refer patients for an initial six (and further four) subsidised MBS mental health-related consultations with appropriately qualified GPs and eligible psychologists, social workers and occupational therapists[2]. A similar pattern is apparent for consultations with Other Psychologists and Other Allied Health Professionals.

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  1. People who had at least one mental health-related consultation with a Clinical Psychologist in 2011.

Source(s): The Mental Health Services-Census Integrated Dataset

While females were more likely than males to have had at least one MBS subsidised consultation with a Clinical Psychologist in 2011 (1.5% compared with 0.9%) their patterns of numbers of consultations were similar, with females having an average of 5.3 consultations and males an average of 5.0 consultations over the year.

Of people who had at least one MBS subsidised consultation with a Clinical Psychologist in 2011, people of middle age had the highest number of consultations. People aged 45-54 years as well as those aged 55-64 years had 5.4 consultations on average with Clinical Psychologists in 2011. In comparison, children aged 0-14 years and older people (75 years and over) had 4.6 consultations on average.

Of people who had at least one MBS subsidised consultation with a Clinical Psychologist in 2011, people living in Major Cities had more consultations on average than people in other areas of Australia (5.3 consultations on average for people in Major Cities compared with 3.9 consultations for people in Remote/Very Remote Australia).

For information on other socio-demographic characteristics of people who had at least one MBS subsidised consultation with a Clinical Psychologist in 2011 by number of consultations, see Data downloads section Table 5.

Endnotes

  1. Australian Institute of Health and Welfare, 2012, Mental health services in Australia, https://www.aihw.gov.au/reports/mental-health-services/mental-health-services-in-brief-2012/contents/table-of-contents, last accessed 18/03/2016.
  2. Department of Health, 2015, Better access to mental health care: fact sheet for patients, https://www1.health.gov.au/internet/main/publishing.nsf/Content/AD7820EAC9F90D90CA25817900186FB2/$File/Fact%20sheet%20-%20BA%20for%20patients.pdf, last accessed 18/03/2016.

Other Psychologists

MBS subsidised Other Psychologist services include a range of mental health-related services such as focussed psychological strategies provided by mental health workers, occupational therapists and social workers[1].

Number of people with consultations with Other Psychologists in 2011

There were 438,600 Australians (2.0% of the total population) who had at least one MBS subsidised consultation with an Other Psychologist in 2011. Females were more likely than males to have had a consultation with an Other Psychologist (2.5% compared with 1.5%), with women aged 35-44 years having the highest rate of consultations (3.9%).

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Source(s): The Mental Health Services-Census Integrated Dataset

For information on other socio-demographic characteristics of people who had at least one MBS subsidised consultation with an Other Psychologist in 2011 see Data downloads section Table 2.

Combinations of treatment type

Similar to people who saw a Clinical Psychologist in 2011, around four in five (81.9%) people who had at least one MBS subsidised consultation with an Other Psychologist in 2011 also had at least one MBS subsidised mental health-related consultation with a GP, while around one-third (31.9%) also had at least one PBS subsidised prescription filled for Antidepressant medications. Around one in nine (11.5%) saw an Other Psychologist only, with no other MBS or PBS subsidised mental health-related treatment in 2011.

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Source(s): The Mental Health Services-Census Integrated Dataset

For information on socio-demographic characteristics of people who had at least one MBS subsidised consultation with an Other Psychologist in 2011 in combination with other treatment types see Data downloads sections Table 2.

Number of consultations with Other Psychologists

In 2011, people who had at least one MBS subsidised consultation with an Other Psychologist had an average of 4.9 consultations during the year, with around one-fifth (18.3%) having one consultation only.

The small peaks in the rates of people having either six (8.8%) or ten (5.4%) consultations (see graph below) are consistent with the Australian Government's Better Access to Psychiatrists, Psychologists and General Practitioners through the MBS (Better Access) initiative which enables GPs, psychiatrists and paediatricians to refer patients for an initial six (and further four) subsidised MBS mental health-related consultations with appropriately qualified GPs and eligible psychologists, social workers and occupational therapists[2]. A similar pattern is apparent for consultations with Clinical Psychologists and Other Allied Health Professionals.

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  1. People who had at least one mental health-related consultation with an Other Psychologist in 2011.

Source(s): The Mental Health Services-Census Integrated Dataset

While females were more likely than males to have had at least one MBS subsidised consultation with an Other Psychologist in 2011 (2.5% compared with 1.5%) their patterns of numbers of consultations were similar, with men having an average of 4.8 consultations and females an average of 5.0 consultations.

Of people who had at least one MBS subsidised consultation with an Other Psychologist in 2011, people of middle age had the highest average number of consultations. People aged 55-64 years had 5.2 consultations on average with Other Psychologists in 2011 while people aged 45-54 years had 5.1 consultations on average. Older and younger people had the fewest number of consultations on average. People aged 75 years and over who saw an Other Psychologist in 2011 had 4.4 consultations on average, while children aged 0-14 years as well as 15-24 years olds had 4.7 consultations on average.

For information on other socio-demographic characteristics of people who had at least one MBS subsidised consultation with an Other Psychologist in 2011 by number of consultations, see Data downloads section Table 5.

Endnotes

  1. Australian Institute of Health and Welfare, 2012, Mental health services in Australia, https://www.aihw.gov.au/reports/mental-health-services/mental-health-services-in-brief-2012/contents/table-of-contents, last accessed 18/03/2016.
  2. Department of Health, 2015, Better access to mental health care: fact sheet for patients, https://www1.health.gov.au/internet/main/publishing.nsf/Content/AD7820EAC9F90D90CA25817900186FB2/$File/Fact%20sheet%20-%20BA%20for%20patients.pdf, last accessed 18/03/2016.

Other Allied Health Professionals

Other Allied Health Professionals provide a range of Medicare-subsidised mental health-related services such as focussed psychological strategies and enhanced primary care services. Other Allied Health Professionals include Indigenous health workers, mental health nurses, occupational therapists and some social workers as well as psychologists[1].

Number of people with consultations with Other Allied Health Professionals in 2011

There were 45,700 Australians (0.2% of the total population) who had at least one MBS subsidised mental health-related consultation with an Other Allied Health Professional in 2011.

Females were more likely than males to have had at least one mental health-related consultation with an Other Allied Health Professional in 2011 (0.3% compared with 0.1% respectively). Women aged 25-54 years recorded the highest rates of Other Allied Health Professional consultations (around 0.4%), although these are relatively small compared with the proportion of women of the same age who accessed MBS subsidised services such as Psychiatrists and Clinical and Other Psychologists (around 1.7%–3.9%).

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Source(s): The Mental Health Services-Census Integrated Dataset

For information on other socio-demographic characteristics of people who had at least one MBS subsidised mental health-related consultation with an Other Allied Health Professional in 2011 see Data downloads section Table 2.

Combinations of treatment type

Of all people who had at least one mental health-related consultation with an Other Allied Health Professional in 2011, around four in five (79.9%) also had at least one mental health-related consultation with a GP in 2011 while around one-third (30.4%) also had at least one prescription filled for Antidepressant medications.

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  1. MBS subsidised mental health-related Allied Health Professional services.

Source(s): The Mental Health Services-Census Integrated Dataset

For information on socio-demographic characteristics of people who had at least one MBS subsidised mental health-related consultation with an Other Allied Health Professional in 2011 in combination with other treatment types see Data downloads section Table 2.

Number of consultations with Other Allied Health Professionals

In 2011, people who had at least one MBS subsidised mental health-related consultation with an Other Allied Health Professional had an average of 5.2 consultations during the year, with 17.5% having one consultation only.

The small peaks in the rates of people having either six (8.4%) or ten (5.8%) consultations with Other Allied Health Professionals in 2011 (see graph below) are consistent with the Australian Government's Better Access to Psychiatrists, Psychologists and General Practitioners through the MBS (Better Access) initiative which enables GPs, psychiatrists and paediatricians to refer patients for an initial six (and further four) subsidised MBS mental health-related consultations with appropriately qualified GPs and eligible psychologists, social workers and occupational therapists[2]. A similar pattern is apparent for consultations with Clinical Psychologists and Other Psychologists.

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  1. People who had at least one mental health-related consultation with an Allied Health Professional in 2011.

Source(s): The Mental Health Services-Census Integrated Dataset

For information on socio-demographic characteristics of people who had at least one MBS subsidised mental health-related consultation with an Other Allied Health Professional in 2011 by number of consultations see Data downloads section Table 5.

Endnotes

  1. Australian Institute of Health and Welfare, 2012, Mental health services in Australia, https://www.aihw.gov.au/reports/mental-health-services/mental-health-services-in-brief-2012/contents/table-of-contents, last accessed 18/03/2016.
  2. Department of Health, 2015, Better access to mental health care: fact sheet for patients, https://www1.health.gov.au/internet/main/publishing.nsf/Content/AD7820EAC9F90D90CA25817900186FB2/$File/Fact%20sheet%20-%20BA%20for%20patients.pdf, last accessed 18/03/2016.

PBS subsidised prescription medications

PBS subsidised mental health-related medications

PBS subsidised mental health-related medications in this publication include:

  • Antipsychotics;
  • Anxiolytics/Hypnotics and sedatives;
  • Antidepressants; and
  • Psychostimulants, agents used for ADHD and nootropics.
     

Appendix 2 provides more detail about specific mental health-related medications listed on the PBS.

There were 2.4 million people (10.9% of all Australians) who had at least one script filled for a PBS subsidised mental health-related medication in 2011. On average, these people had 9.4 scripts filled for PBS subsidised mental-health related medications in 2011. Further information on people accessing the different types of medications is provided in following sections of this publication.

People who accessed had at least one PBS subsidised mental health-related medication in 2011, type of medication

Type of medicationNumber of peopleProportion (%)(a)Average number of prescriptions(b)
Antipsychotics
349 900
1.6
8.3
Anxiolytics/Hypnotics and sedatives
921 100
4.3
5.3
Antidepressants
1 678 900
7.8
8.2
Psychostimulants, agents used for ADHD and nootropics
81 400
0.4
7.0
Total persons who had at least one script filled for a PBS subsidised mental health-related medication in 2011
2 354 100
10.9
9.4
a. Proportion of the total Australian population.
b. Average number of prescriptions filled of the particular medication in 2011, of people who had at least one prescription filled for the particular medication in 2011.
 

Antipsychotics

Antipsychotics consist of a group of medications used to treat symptoms of psychosis. While they do not provide a 'cure' for psychosis, they can be an effective part of treatment. During a psychotic episode, a person may experience delusions, hallucinations or thought disturbances. Antipsychotic medications work to minimise these symptoms[1].

Number of people accessing Antipsychotic medications in 2011

There were 349,900 people (1.6% of the Australian population) who had at least one PBS subsidised prescription for an Antipsychotic medication filled in 2011.

Overall, males and females were equally likely to have had a prescription for Antipsychotic medications filled in 2011, however, their relative patterns of use differed across age. While rates of use generally increased with increasing age for both males and females, males aged 0-44 years had higher rates of use than females of the same age, while males aged 55 years and over had lower rates than females of the same age. People aged 75 years and over had the highest rate of use of any age group, of one in twenty people (5.0%).

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Source(s): The Mental Health Services-Census Integrated Dataset

For information on other socio-demographic characteristics of people who accessed at least one PBS subsidised Antipsychotic medication in 2011 see Data downloads section Table 2.

Combinations of treatment type

Of all people who had at least one PBS subsidised prescription for Antipsychotic medications filled in 2011, more than half (55.3%) also had at least one PBS subsidised prescription filled for Antidepressant medications in 2011 while almost one-third (32.2%) also had at least one script filled for Anxiolytic/Hypnotic and sedative medications. Around one-quarter also had at least one MBS subsidised consultation with either a Psychiatrist (26.5%) or General Practitioner (26.2%) in 2011.

Around one in five (22.7%) people had only a prescription for Antipsychotic medications filled in 2011, with no other type of MBS or PBS subsidised mental health-related treatment in 2011. When interpreting this, it should be noted that some consultations with health professionals at which Antipsychotic medications were prescribed may not have been recorded as a mental-health related service, or may have occurred earlier than 2011. These consultations were not captured in the Mental Health Services-Census Integrated Dataset on which this analysis is based.

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Source(s): The Mental Health Services-Census Integrated Dataset

For information on socio-demographic characteristics of people who accessed at least one PBS subsidised Antipsychotic medication in 2011 in combination with other treatment types see Data downloads section Table 2.

Number of prescriptions for Antipsychotics filled in 2011

People who had at least one PBS subsidised prescription for Antipsychotic medications filled in 2011 had an average of 8.3 scripts filled over the year. Around one in seven people (14.8%) had only one Antipsychotic script filled, while 16.7% had 11–13 scripts. This would equate to around one script per month in 2011.

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  1. People who had at least one Antipsychotic medication in 2011.

Source(s): The Mental Health Services-Census Integrated Dataset

Males who had at least one PBS subsidised prescription for Antipsychotic medications filled in 2011 had an average of 8.4 scripts filled during the year, similar to the average for females of 8.2 scripts.

Across age, of people who had at least one PBS subsidised prescription for Antipsychotic medications filled in 2011, people of middle age had the highest averages. People aged 45-54 years had 9.4 scripts filled on average followed by people aged 55-64 years (9.3 scripts). Children aged 0-14 years who had at least one PBS subsidised prescription for Antipsychotic medications filled in 2011 had an average of 5.3 scripts filled during the year.

For information on other socio-demographic characteristics of people who accessed at least one PBS subsidised Antipsychotic medication in 2011 by number of prescriptions filled, see Data downloads section Table 5.

Endnotes

  1. Victoria State Government, 2015, Antipsychotic medications, https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/antipsychotic-medications, last accessed 18/03/2016.

Anxiolytics and Hypnotics and sedatives

Anxiolytic medications are preparations used in the treatment of neuroses and psychosomatic disorders associated with anxiety and tension, and Hypnotics and sedatives are preparations with mainly sedative or hypnotic actions[1].

Number of people accessing Anxiolytic/Hypnotic and sedative medications in 2011

There were 921,100 people (4.3% of the Australian population) who had at least one PBS subsidised prescription for Anxiolytic/Hypnotic and sedative medications filled in 2011.

Overall, females were more likely than males to have had a prescription for Anxiolytic/Hypnotic and sedative medications filled in 2011 (5.4% compared with 3.1% respectively). Rates of use increased with age, and particularly sharply around ages 65-74 years. Almost one-quarter (23.0%) of women aged 75 years and over had at least one PBS subsidised prescription for an Anxiolytic/Hypnotic and sedative medication filled in 2011.

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Source(s): The Mental Health Services-Census Integrated Dataset

For information on other socio-demographic characteristics of people who accessed at least one PBS subsidised Anxiolytic/Hypnotic and sedative medication in 2011 see Data downloads section Table 2.

Combinations of treatment type

Of all people who had at least one PBS subsidised prescription for Anxiolytic/Hypnotic and sedative medications in 2011, nearly half (46.7%) also had at least one PBS subsidised prescription filled for Antidepressant medications in 2011, while 17.5% also had at least one MBS subsidised mental health-related consultation with a GP.

Almost half (44.8%) had only a prescription for Anxiolytic/Hypnotic and sedative medications filled in 2011, with no other type of MBS or PBS subsidised mental health-related treatment in 2011. When interpreting this, it should be noted that some consultations with health professionals at which Anxiolytic/Hypnotic and sedative medications were prescribed may not have been recorded as a mental-health related service, or may have occurred earlier than 2011. These consultations were not captured in the Mental Health Services-Census Integrated Dataset on which this analysis is based.

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Source(s): The Mental Health Services-Census Integrated Dataset

For information on socio-demographic characteristics of people who accessed at least one PBS subsidised Anxiolytic/Hypnotic and sedative medication in 2011 in combination with other treatment types see Data downloads section Table 2.

Number of prescriptions for Anxiolytics/Hypnotics and sedatives filled in 2011

People who had at least one PBS subsidised prescription for Anxiolytic/Hypnotic and sedatives medication filled in 2011 had an average of 5.3 scripts filled in the year. Around one-third (37.4%) had only one Anxiolytic/Hypnotic and sedative script filled and a further 29.7% had 2–4 scripts filled in 2011.

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  1. People who had at least one Anxiolytic, Hypnotic or sedative medication in 2011.

Source(s): The Mental Health Services-Census Integrated Dataset

While females were more likely than males to have had a prescription for Anxiolytic/Hypnotic and sedative medications filled in 2011 (5.4% compared with 3.1% respectively), their average number of scripts were similar (5.3 scripts on average for females and 5.4 for males).

Of people who had at least one PBS subsidised prescription for Anxiolytic/Hypnotic and sedative medications filled in 2011, people with a need for assistance with core activities (for example, those relating to self-care, communication and mobility) had the highest average number of scripts filled (7.3 scripts compared with 4.7 scripts on average for people with no need for assistance).

Across age, people aged 35-44 years and 45-54 years had the highest average number of scripts for Anxiolytic/Hypnotic and sedatives medication filled (6.5 and 6.6 scripts in 2011, respectively), while children aged 0-14 years had the lowest (2.1 scripts). Similarly, people living in the most disadvantaged areas of Australia had higher average numbers of scripts compared with people in least disadvantaged areas (6.0 scripts on average compared with 4.3 respectively).

For information on other socio-demographic characteristics of people who accessed at least one PBS subsidised Anxiolytic/Hypnotic and sedative medication in 2011 by number of prescriptions filled, see Data downloads section Table 5.

Endnotes

  1. WHO Collaborating Centre for Drug Statistics Methodology, 2013, Guidelines for ATC classification and DDD assignment. http://www.whocc.no/filearchive/publications/1_2013guidelines.pdf, last accessed 18/03/2016.

Antidepressants

Antidepressants are medicines that are typically used to treat depression, anxiety and related conditions, such as eating disorders, obsessive-compulsive disorder and post-traumatic stress disorder[1].

Number of people accessing Antidepressant medications in 2011

There were 1.7 million people (7.8% of the Australian population) who had at least one PBS subsidised prescription for Antidepressant medications filled in 2011.

Overall, females were more likely than males to have had a prescription for Antidepressant medications filled in 2011 (9.9% compared with 5.6% respectively), with rates of use increasing with age. Almost one-quarter (24.0%) of all females aged 75 years or over had at least one PBS subsidised prescription for an Antidepressant medication filled in 2011.

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Source(s): The Mental Health Services-Census Integrated Dataset

For information on other socio-demographic characteristics of people who accessed at least one PBS subsidised Antidepressant medication in 2011 see Data downloads section Table 2.

Combinations of treatment type

Of all people who had at least one PBS subsidised prescription for Antidepressant medications filled in 2011, one-quarter (25.6%) also had at least one PBS subsidised prescription filled for Anxiolytic/Hypnotic and sedative medications in 2011 while one-quarter (25.3%) also had at least one MBS subsidised mental health-related GP consultation.

Almost half (46.9%) had only a prescription for Antidepressant medications filled in 2011, with no other type of MBS or PBS subsidised mental health-related treatment in 2011. When interpreting this, it should be noted that some consultations with health professionals at which Antidepressant medications were prescribed may not have been recorded as a mental-health related service, or may have occurred earlier than 2011. These consultations were not captured in the Mental Health Services-Census Integrated Dataset on which this analysis is based.

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Source(s): The Mental Health Services-Census Integrated Dataset

For information on socio-demographic characteristics of people who accessed at least one PBS subsidised Antidepressant medication in 2011 in combination with other treatment types see Data downloads section Table 2.

Number of prescriptions for Antidepressants filled in 2011

People who had at least one PBS subsidised prescription for Antidepressant medications filled in 2011 had an average of 8.2 scripts filled during the year. Around one in seven (14.4%) had only one Antidepressant script filled while nearly one-quarter (24.6%) had 11–13 scripts. This would equate to around one script per month in 2011.

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  1. People who had at least one Antidepressant medication in 2011.

Source(s): The Mental Health Services-Census Integrated Dataset

While females were more likely than males to have had a prescription for Antidepressant medications filled in 2011 (9.9% compared with 5.6% respectively), their average number of scripts filled were similar (8.4 scripts on average for females and 8.0 for males).

Of people who had at least one PBS subsidised prescription for Antidepressant medications filled in 2011, older people and people with a need for assistance with core activities (for example, those relating to self-care, communication and mobility) had the highest average number of scripts filled. People aged 65-74 years had 9.0 scripts filled on average in 2011 while people with a need for assistance had 9.9 scripts filled on average. Children aged 0-14 years who had at least one PBS subsidised prescription for Antidepressant medications filled in 2011 had an average of 5.4 scripts filled.

For information on other socio-demographic characteristics of people who accessed at least one PBS subsidised Antidepressant medication in 2011 by number of prescriptions filled, see Data downloads section Table 5.

Endnotes

  1. Health Direct Australia, Antidepressants medicines, http://www.healthdirect.gov.au/#!/antidepressant-medicines, last accessed 18/03/2016.

Psychostimulants, agents used for ADHD and nootropics medications

Psychostimulants, agents used for ADHD and nootropics are medications used for treating attention-deficit hyperactivity disorder (ADHD) and to improve impaired cognitive abilities[1].

Number of people accessing Psychostimulant, agents used for ADHD and nootropics medications in 2011

There were 81,400 people (0.4% of the Australian population) who had at least one PBS subsidised prescription for Psychostimulants, agents used for ADHD and nootropic medications filled in 2011. Almost two-thirds (65.2%) of these were males aged 0-24 years and a further 17.5% were females of the same age.

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Source(s): The Mental Health Services-Census Integrated Dataset

For information on other socio-demographic characteristics of people who accessed at least one PBS subsidised Psychostimulant, agents used for ADHD and nootropic medication in 2011 see Data downloads section Table 2.

Combinations of treatment type

Of all people who had at least one PBS subsidised prescription for Psychostimulants, agents used for ADHD and nootropic medications filled in 2011, around one in five (21.4%) also had at least one MBS subsidised consultation with a Psychiatrist in 2011, 18.1% also had at least one MBS subsidised mental health-related consultation with a GP, and 17.0% also had at least one PBS subsidised prescription filled for Antidepressant medications.

More than half (53.7%) had only a prescription for Psychostimulants, agents used for ADHD and nootropic medications filled in 2011, with no other type of MBS or PBS subsidised mental health-related treatment in 2011. It should however be noted that paediatrician services were not captured in the Mental Health Services-Census Integrated Dataset on which this analysis is based, and that a proportion of these people may have received their scripts from paediatricians in 2011.

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Source(s): The Mental Health Services-Census Integrated Dataset

For information on socio-demographic characteristics of people who accessed at least one PBS subsidised Psychostimulant, agents used for ADHD and nootropic medication in 2011 in combination with other treatment types see Data downloads section Table 2.

Number of prescriptions for filled in 2011

People who had at least one PBS subsidised prescription for Psychostimulants, agents used for ADHD and nootropic medications filled in 2011 had an average of 7.0 scripts filled during the year. Around one in nine (11.2%) had only one script filled in 2011, while around one in five (19.1%) had 11–13 scripts. This would equate to around one script per month in 2011.

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  1. People who had at least one Psychostimulant etc. medication in 2011.

Source(s): The Mental Health Services-Census Integrated Dataset

While males were more likely than females to have had a prescription for Psychostimulants, agents used for ADHD and nootropic medications filled in 2011 (0.6% compared with 0.2% respectively), their average numbers of scripts filled were similar (7.1 scripts on average for males and 6.9 scripts for females).

Across age there was relatively little variation in the average number of scripts filled by people who accessed Psychostimulants, agents used for ADHD and nootropic medications in 2011. Similarly there was relatively little variation across other socio-demographic characteristics such as geography, labour force status and household income.

For information on other socio-demographic characteristics of people who accessed at least one PBS subsidised Psychostimulant, agents used for ADHD and nootropic medication in 2011 by number of prescriptions filled, see Data downloads section Table 5.

Endnotes

  1. Australian Institute of Health and Welfare, 2009, Mental health-related prescriptions, http://www.aihw.gov.au/WorkArea/DownloadAsset.aspx?id=6442457113, last accessed 18/03/2016.

Combinations of treatments

The four MBS subsidised mental health-related services and five PBS subsidised mental health-related medication groups included in the Mental Health Services-Census Integrated Dataset means there are a potential 510 different combinations of services and medications possible for any one person (including instances of a single service or medication). In the Integrated Dataset there were 420 different combinations of treatments accessed by people in 2011.

The most common combinations of treatments in 2011 were:

  • Antidepressants only: 787,100 people, or almost one-quarter (24.4%) of the 3.2 million people who accessed at least one MBS or PBS subsidised mental health-related treatment in 2011;
  • Anxiolytics/Hypnotics and sedatives only: 412,800 people (12.8%);
  • General Practitioner only: 350,900 people (10.9%);
  • Antidepressants and Anxiolytics/Hypnotics and sedatives: 242,200 people (7.5%);
  • General Practitioner and Other Psychologist: 201,500 people (6.2%);
  • General Practitioner and Antidepressants: 137,000 people (4.2%); and
  • General Practitioner and Clinical Psychologist: 116,600 people (3.6%).
     

When interpreting this data, it should be noted that some consultations with health professionals at which mental health-related medications were prescribed may not have been recorded as a mental-health related service, or may have occurred earlier than 2011. These consultations were not captured in the Mental Health Services-Census Integrated Dataset on which this analysis is based.

Together the above combinations accounted for around two-thirds (69.7%) of all people who accessed at least one MBS or PBS subsidised mental health-related treatment in 2011, while the remainder of combinations (978,700 people in total; 30.3%) accounted for less than 3.0% each.

The two most common combinations of any three treatments were:

  • General Practitioner, Other Psychologist and Antidepressants: 63,700 people, or 2.0% of all people who received at least one MBS or PBS subsidised mental health-related treatment in 2011); and
  • General Practitioner, Antidepressants and Anxiolytics/Hypnotics and sedatives: 47,130 people (1.5%).
     

Of males and females who used at least one MBS or PBS subsidised mental health-related treatment in 2011, females were more likely than men to have used Antidepressant medications only (25.5% compared with 22.7% respectively) and Antidepressants in conjunction with Anxiolytics/Hypnotics and sedatives (8.4% compared with 6.1% respectively), reflecting females' higher use of Antidepressants and Anxiolytics/Hypnotics and sedatives overall.

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Source(s): The Mental Health Services-Census Integrated Dataset

For more information on socio-demographic characteristics of people with different combinations of treatments in 2011 see Data downloads section Table 3.

Types of use and transitions between treatments

The following analysis examines patterns of use of MBS and PBS subsidised mental health-related services and/or medication over the period January 2011 to December 2012 using logistic regression modelling. The results of this analysis assist with better understanding the extent to which particular personal, family and household characteristics impact on a person’s transitions between treatments. Details of the modelling are outlined in the Methodology page.

Types of use

To investigate whether particular socio-demographic characteristics were associated with an increased likelihood of receiving different combinations of mental health-related treatments, people who received at least one MBS or PBS subsidised mental health-related service or medication between January 2011 and December 2012 were split into five groups:

  • single MBS transaction (or ‘single service only’) – a person had only one MBS transaction and no PBS transactions between January 2011 and December 2012
  • multiple MBS transactions (‘multiple services only’) – the person had two or more MBS transactions and no PBS transactions
  • single PBS transaction (‘single medication only’) – the person had only one PBS transaction and no MBS transactions
  • multiple PBS transactions (‘multiple medications only’) – the person had two or more PBS transactions and no MBS transactions
  • mixed MBS and PBS transactions (‘mixed service(s) and medication(s)’) – the person had one or more MBS transactions and one or more PBS transactions.
     

The following table shows the distribution of people by type of use. Around one-third (31.0%) of all people who received a mental health-related treatment received multiple services only (i.e. the person had multiple MBS transactions only), while one-quarter (24.7%) used multiple medications only. A further 16.0% received mixed service(s) and medication(s). Almost the same proportion of people received a single service only (14.9%) or had a single use of medication only (13.4%).

People who accessed at least one MBS or PBS subsidised mental health-related treatment in 2011-2012, type of use

Type of useProportion (%)(a)
Single service only
14.9
Multiple services only
31.0
Single medication only
13.4
Multiple medications only
24.7
Mixed service(s) and medication(s)
16.0
a. Proportion of all people who accessed at least one MBS or PBS subsidised mental health-related treatment in 2011.
 

A number of socio-demographic characteristics were associated with an increased likelihood of particular types of use of MBS or PBS subsidised mental health-related medications or services.

After controlling for the effects of other variables included in the model, males were more likely than females to use single medications only, multiple medications, and mixed services and medications. Conversely, females were more likely than males to use single and multiple services only.

The likelihood of receiving mental health-related services, either as single or multiple services, decreased with age, while the likelihood of using medications increased. In particular, young people aged 0-19 years were more likely to have received multiple services, and to a lesser extent a single service, than other types of use, while older people (aged 60 years and over) were more likely to have used medications (either multiple or single).

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Source(s): The Mental Health Services-Census Integrated Dataset

Type of use differed by state and territory. People living in New South Wales and Victoria were more likely to use multiple mental health-related services with no medications than any other type of use, while people living in the Australian Capital Territory and Western Australia were more likely to use multiple mental health-related medications than any other type of use.

The more remote an area was, the more likely its residents accessed mental health-related medications and less likely they accessed multiple mental health-related services.

People living in the most disadvantaged areas of Australia were more likely to use mental health-related medications (either single or multiple) with no services, and less likely to use multiple mental health-related services with no medications, relative to people in other areas of Australia.

A number of other socio-demographic characteristics were associated with different types of use:

  • married people were more likely than unmarried people to use single or multiple services with no medications, and less likely to have used multiple medications with no services and mixed services and medications,
  • people born overseas were more likely than people born in Australia to use multiple medications with no services and mixed services and medications, and less likely to use a single service with no medications;
  • people with higher levels of educational attainment were more likely to use multiple services with no medications, compared with people with lower levels of educational attainment, while the use of medications decreased with increasing level of educational attainment;
  • labour force status also influences the likelihood of particular service and medication uses. Unemployed people and people not in the labour force were more likely to use medications and no services compared with employed people.
  • people with lower incomes were more likely to use medications (either single or multiple) and no services, and less likely to use services with no medications, compared with people with higher incomes.
  • people living in special dwellings (such as aged care facilities) were more likely to use multiple medications with no services, and less likely to use single or multiple services with no medications, than people who lived in private dwellings.
     

Transitions between treatments

Further logistic modelling was used to investigate whether certain socio-demographic characteristics were associated with a likelihood to transition from receiving an MBS subsidised mental health-related service to a PBS subsidised mental-health related medication, or vice versa. Modelling took into account the number of services and medications an individual had prior to their most recent transaction (that is, service or medication), as well as the sequence of transactions the individual had.

In general, the probability of changing from using a service to using a medication or vice versa is highest after one service or medication in a sequence, and decreases as the length of the sequence increases. Additionally, the probability of changing from a service to a medication is always higher than the probability of changing from a medication to a service, for the same length sequence.

Age and sex

After controlling for the effects of other variables included in the models, males were slightly more likely than females to change from using a mental health-related service to a medication. However, there was almost no difference between males and females in the likelihood of changing from a mental health-related medication to a service.

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Source(s): The Mental Health Services-Census Integrated Dataset

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Source(s): The Mental Health Services-Census Integrated Dataset

Age showed a significant influence on the likelihood of transition, with the probability of changing from a mental health-related service to a medication increasing sharply with increasing age and the probability of changing from a medication to a service decreasing slowly.

Children aged 0-9 years were least likely to change from using a mental health-related service to a medication, while older people, particularly those aged 70 years or over, had the highest probability of changing from using a mental health-related service to a medication and the lowest probability of changing from a medication to service, especially in short sequences (after 1-3 services or medications). Even after using a mental health-related service a number of times, the probability of people aged 70 years or over changing from a service to a medication was still relatively high in comparison to other ages.

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Source(s): The Mental Health Services-Census Integrated Dataset

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Source(s): The Mental Health Services-Census Integrated Dataset

Remoteness

Remoteness showed a strong effect on the likelihood of transitioning between using mental health-related services and medications. People living in Remote/Very Remote areas of Australia were more likely to change from using a service to a medication than other areas, and less likely to change from medications to services. Conversely, people living in Major Cities of Australia were less likely to change from services to medications and more likely to change from medications to services.

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Source(s): The Mental Health Services-Census Integrated Dataset

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Source(s): The Mental Health Services-Census Integrated Dataset

Level of disadvantage

Level of disadvantage had an influence on the likelihood of transitioning between using mental health-related services and medications, but no effect on the likelihood of changing from mental health-related medications to services. People living in the most disadvantaged areas of Australia (Quintile 1) were slightly more likely to change from using services to medications than people who lived in other areas of Australia. Similar patterns were found for people with relatively lower household incomes – they were more likely to change from using services to medications than people on higher incomes.

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Source(s): The Mental Health Services-Census Integrated Dataset

Download

Source(s): The Mental Health Services-Census Integrated Dataset
 

Other socio-demographic characteristics

Other socio-demographic characteristics associated with the likelihood to transition to a different treatment type were:

  • marital status: unmarried people were more likely to change status than married people, particularly from using a mental health-related service to a medication; and
  • people with lower levels of educational attainment were more likely to change from using services to medications compared with people with higher levels of educational attainment, and conversely, people with higher levels of educational attainment were slightly more likely to change from medications to services.
     

No differences were found between people born in Australia or overseas in the likelihood to transition between services and medications or vice versa. This was also the case for people who lived in special dwellings (such as nursing homes) compared with those living in private dwellings.

Primary Health Networks

Primary Health Networks (PHNs) are geographic administrative regions which were established in July 2015 by the Australian Government with the key objectives of increasing the efficiency and effectiveness of medical services for patients, particularly those at risk of poor health outcomes, and to help improve the coordination of care to ensure patients receive appropriate care[1]. Geographic boundaries of PHNs are available at Primary Health Networks.

Rates of use of MBS and PBS subsidised mental health-related treatments vary across regions of Australia. Around one in five people (19.8%) living in North Coast NSW used at least one MBS subsidised mental health-related service or PBS subsidised mental health-related medication in 2011, the highest proportion of any PHN in Australia. Gippsland (18.3%) and Grampians and Barwon South West (17.8%) recorded the second and third highest rates of use of mental health-related services or medications in 2011.

People living in Northern Sydney who had at least one MBS subsidised mental health-related service in 2011 used an average of 6.6 mental health-related services during the year, compared with an average of 5.2 services for all people in Australia who had at least one MBS subsidised mental health-related service in 2011. People living in Central and Eastern Sydney who had at least one MBS subsidised mental health-related service in 2011 used an average of 6.3 mental health-related services during the year, followed by Eastern Melbourne (6.2 services).

People living in Grampians and Barwon South West who accessed at least one PBS subsidised mental health-related medication in 2011 had an average of 10.1 mental health-related prescriptions filled during the year, compared with an average of 9.4 prescriptions for all people in Australia who accessed at least one PBS subsidised mental health-related medication in 2011. People living in Gippsland who accessed at least one PBS subsidised mental health-related medication in 2011 had an average of 10.0 mental health-related prescriptions filled during the year, followed by Darling Downs and West Moreton (9.9 prescriptions).

Detailed information on socio-demographic characteristics of people who used MBS and PBS mental health-related services and medications in 2011 for each PHN in Australia is available from Data downloads section Tables 3 to 10 of Characteristics of People using Mental Health Services and Prescription Medication, 2011 (cat. no. 4329.0). Information for each PHN on the numbers of people who had mental health-related consultations and prescriptions filled in 2011 is available from Data downloads section Table 6 of this publication.

The following data quality issues should be considered when interpreting regional data:

  • variations in use between PHNs may be due to a number of reasons:
    • MBS subsidised services may not be as readily available in some PHNs than others;
    • alternative sources of services may be preferred in some PHNs (e.g. community based treatment programs);
    • different characteristics of people living in particular PHNs; for example, higher use of medications and lower use of services is associated with increasing age, which may be reflected in PHNs with older age profiles;
  • data for PHNs with a significant proportion of population in Remote and/or Very Remote areas are not representative of services and medications use. Block funding of Aboriginal Medical Services and provision of drugs under options such as Section 100 of the National Health Act, 1953 may lead to a gap in MBS and PBS data in these areas;
  • linkage rates achieved for the Mental Health Services-Census Integrated Dataset were in line with expected results, and were relatively consistent across most sub-populations, with the exception of the Northern Territory, Remote and Very Remote areas, and younger adults which had lower linkage rates (see the Explanatory for information on linkage rates).
     

Endnotes

  1. Department of Health, 2015, Primary Health Networks (PHNs), http://www.health.gov.au/internet/main/publishing.nsf/content/primary_health_networks, last accessed 18/03/2016.

About the Mental Health Services-Census Integrated Dataset

The Mental Health Services-Census Data Integration project brings together the breadth of 2011 Census of Population and Housing (Census) data with administrative information on people accessing subsidised mental health-related Medicare Benefits Schedule (MBS) services and Pharmaceutical Benefits Scheme (PBS) prescription medications. The project was initiated on behalf of the National Mental Health Commission (NMHC) with the aim of informing the National Review of Mental Health Services and Programmes.

Integrating a selected subset of data items from the MBS, PBS and 2011 Census has greatly increased the power of the data to support analysis of the circumstances and characteristics of people experiencing mental ill-health as they interact with the health care system. The Mental Health Services-Census Integrated Dataset includes people who responded to the 2011 Census and those who accessed subsidised mental health-related items listed on the MBS or PBS in 2011.

This Integrated Dataset contributes significantly to the pool of mental health-related data available in Australia to assist in the development and evaluation of mental health programs and support services now and into the future. Questions can be answered about people accessing subsidised mental health-related services and medications with evidence that up until now has not been available. For example, analysis of the integrated data answers questions about the relationship between mental health-related services, medication use and key socio-economic information such as education, employment and housing.

The confidentiality of these data are protected by the Census and Statistics Act (1905) and the Privacy Act (1988). MBS and PBS information provided by the Department of Health and the Department of Human Services to the ABS is treated in the strictest confidence as is required by the National Health Act (1953) and the Health Insurance Act (1973).

Data downloads

Table 1: Persons accessing MBS or PBS mental health-related services and/or medications in 2011

Table 2: Persons accessing MBS or PBS mental health-related services and/or medications in 2011, by type of service and/or medication

Table 3: Persons accessing MBS or PBS mental health-related services and/or medications in 2011, by most common combinations of services and/or medications

Table 4: Persons accessing MBS or PBS mental health-related services and/or medications in 2011, by number of consultations, prescriptions or both

Table 5: Persons accessing MBS or PBS mental health-related services and/or medications in 2011, by type of service/medication and number of consultations/prescriptions

Table 6: Persons accessing MBS or PBS mental health-related services and/or medications in 2011, Primary Health Network

Table 7: Odds ratios from logistic regression modelling

All data cubes

History of changes

Show all

31/03/2016 - The replacement contains corrections to broken links on the Contents pages of Data downloads section Tables 5, 6 and 7. No other corrections have been made.

Previous catalogue number

This release previously used catalogue number 4329.0.00.003.