• Print
  • National Mental Health Establishments Database

    Collection of data for the Mental Health Establishments (MHE) NMDS began on 1 July 2005, replacing the Community Mental Health Establishments NMDS and the National Survey of Mental Health Services. The main aim of the development of the MHE NMDS was to expand on the Community Mental Health Establishments NMDS and replicate the data previously collected by the National Survey of Mental Health Services. The National Mental Health Establishments Database is compiled as specified by the MHE NMDS.

    The scope of the MHE NMDS includes all specialised mental health services managed or funded, partially or fully, by state or territory health authorities. Specialised mental health services are those with the primary function of providing treatment, rehabilitation or community health support targeted towards people with a mental disorder or psychiatric disability. These activities are delivered from a service or facility that is readily identifiable as both specialised and serving a mental health care function.

    The MHE NMDS data are reported at a number of levels: state, regional, organisational and individual mental health service unit. The data elements at each level in the NMDS collect information appropriate to that level. The state, regional and organisational levels include data elements for revenue, grants to non-government organisations and indirect expenditure. The organisational level also includes data elements for salary and non-salary expenditure, numbers of full-time-equivalent staff and consumer and carer worker participation arrangements. The individual mental health service unit level comprises data elements that describe the function of the unit. Where applicable, these include target population, program type, number of beds, number of accrued patient days, number of separations, and number of service contacts and episodes of residential care. In addition, the service unit level also includes salary and non-salary expenditure and depreciation.

    Data Quality Statements for National Minimum Data Sets (NMDSs) are published annually on the Metadata Online Registry (METeOR). Statements provide information on the institutional environment, timelines, accessibility, interpretability, relevance, accuracy and coherence.

    Data validation

    Data presented in this publication are the most current data for all years presented. The validation process rigorously scrutinises the data for consistency in the current collection and across historical data. The validation process applies hundreds of rules to the data to test for potential issues. Jurisdictional representatives respond to each issue before the data are accepted as the most reliable current data collection. This process may highlight issues with historical data. In such cases, historical data may be adjusted to ensure data are more consistent. Therefore, comparisons made to previous versions of Mental health services in Australia publications should be approached with caution.

    Consumer committee representation arrangements

    Specialised mental health organisations report the extent to which consumer participation arrangements are in place to promote the inclusion of mental health consumers in the planning, delivery and evaluation of the service. Organisations report their consumer participation arrangements at various levels, as detailed below.

    Data source FAC.1 Levels of consumer participation arrangements
    Level Description
    Level 1 Formal position(s) for consumers exist on the organisation’s management committee for the appointment of person(s) to represent the interests of consumers. Alternatively, specific consumer advisory committee(s) exists to advise on all relevant mental health services managed by the organisation.
    Level 2 Specific consumer advisory committee(s) exists to advise on some but not all relevant mental health services managed by the organisation.
    Level 3 Consumers participate on a broadly based advisory committee that includes a mixture of organisations and groups representing a wide range of interests.
    Level 4 Consumers are not represented on any advisory committee but are encouraged to meet with senior representatives of the organisation as required. Alternatively, no specific arrangements exist for consumer participation in planning and evaluation of services.

    Consumer and carer participation strategies

    Western Australia has advised that the data presented in tables FAC.5-FAC.10 do not fully represent consumer and carer participation strategies used in Western Australia. High priority is given to the involvement of consumers and carers at a state, regional and health service level in developing a responsive mental health service. Several key consumer and carer advisory groups are supported and provided with financial assistance. Collectively, these groups provide advice and representations on consumer and carer issues. Data for consumer arrangements are for public sector services only.

    Note that average annual change calculations are only valid on the proportion of the organisations reporting consumer and carer participation strategies reported in tables FAC.5-FAC.10. The change in the number of organisations reporting against these variables is not reflective of policy in cases where there has been a state-wide organisational restructure.

    National standards for mental health services review status

    There are 8 levels used to describe the extent to which a service unit has implemented the National Standards during 2014–15, as shown in the table below.

    Data source FAC.2 National standards for mental health services review status levels
    Level Description
    1 The service unit had been reviewed by an external accreditation agency and was judged to have met the national standards.
    2 The service unit had been reviewed by an external accreditation agency and was judged to have met some but not all of the national standards.
    3 The service unit was in the process of being reviewed by an external accreditation agency but the outcomes were not known.
    4 The service unit was booked for review by an external accreditation agency and was engaged in self‑assessment preparation prior to the formal external review.
    5 The service unit was engaged in self‑assessment in relation to the national standards but did not have a contractual arrangement with an external accreditation agency for review.
    6 The service unit had not commenced the preparations for review by an external accreditation agency but this was intended to be undertaken in the future.
    7 It had not been resolved whether the service unit would undertake review by an external accreditation agency under the national standards.
    8 The national standards are not applicable to this service unit.

    Source: National Standards for Mental Health Services (DHFS 1996).

    Reporting levels for national standards

    To match definitions in the National Key Performance Indicator set for Mental health services, the data presented are restricted to 4 levels. Level 1 represents code 1, Level 2 represents code 2, Level 3 represents codes 3 and 4 and Level 4 represents codes 5–7. Code 8 is excluded as the standards do not apply to these units.

    The national standards for mental health services were revised in 2010 (DoH 2010). In addition to these mental health-specific national standards, other national standards have been published and implemented against which mental health services may also be measured. Work is ongoing to improve the method for reporting the standards against which a service is measured.

    New South Wales CADE and T-BASIS services

    All New South Wales Confused and Disturbed Elderly (CADE) 24–hour staffed residential mental health services were reclassified as specialised mental health non-acute admitted patient hospital services, termed Transitional Behavioural Assessment and Intervention Service (T-BASIS), from 1 July 2007. All data relating to these services have been re-classified from 2007-08 onwards, including number of services, number of beds, staffing and expenditure. Comparison of data over time should therefore be approached with caution.

    New South Wales HASI Program

    Since 2006, New South Wales has been developing the NSW Housing Accommodation Support Initiative (HASI) Program. This model of care is a partnership program between NSW Ministry of Health, Housing NSW and the non-government organisation (NGO) sector that provides housing linked to clinical and psychosocial rehabilitation services for people with a range of levels of psychiatric disability. These services are out-of-scope as residential services according to the Mental Health Establishments NMDS, however, are reported as Supported housing places. See the above hyperlink for further information about the NSW HASI program.

    Rates calculations

    Calculations of rates for target populations are based on age-specific populations as defined by the MHE NMDS metadata and outlined below.

    • General services: persons aged 18–64.
    • Child and adolescent services: persons aged 0–17.
    • Youth services: persons aged 16–24.
    • Older person: persons aged 65 and over.
    • Forensic services: persons aged 18 and over.

    Crude rates were calculated using the Australian Bureau of Statistics estimated resident population (ERP) at the midpoint of the data range (for example, rates for 2014–15 data were calculated using ERP at 31 December 2014). Historical rates have been recalculated using revised ERPs based on the 2011 Census of Population and Housing, as detailed in the online technical information. Previously, rates from 1992–93 to 1995–96 were calculated using ERP at 30 June of the earlier reference year (for example, rates for 1992–93 were calculated using ERP at 30 June 1992). December ERP data became available in 2012–13 and rates were recalculated using the December ERPs so comparisons with earlier versions of the data tables are not valid.

    Data for the Australian Capital Territory were not available for the 2014–15 reporting period. Crude rates for national totals were calculated using the unadjusted Australian estimated resident population as described above. National rates may therefore be an under-estimate and time series analyses should be approached with caution.


    References

    DoH (Department of Health) 2010. National Standards for Mental Health Services. Canberra: Commonwealth of Australia. Viewed December 2015.

    DHFS (Commonwealth Department of Health and Family Services) 1996. National Standards for Mental Health Services. Canberra: Commonwealth of Australia.


    Private Health Establishments Collection

    The ABS conducts a census of all private hospitals licensed by state and territory health authorities and all freestanding day hospitals facilities approved by the Commonwealth Department of Health. As part of that census, data on the staffing, finances and activity of these establishments are collected and compiled in the Private Health Establishments Collection. Additional information on the Private Health Establishments Collection can be obtained from the ABS publication Private hospitals, Australia (ABS 2016).

    The data definitions used in the Private Health Establishments Collection are largely based on definitions in the National health data dictionary(NHDD) published on the AIHW's Metadata Online Registry (METeOR) website. The ABS defines private psychiatric hospitals as those licensed or approved by a state or territory health authority and which cater primarily for admitted patients with psychiatric, mental or behavioural disorders (ABS 2016). This is further defined as those hospitals providing 50% or more of the total patient days for psychiatric patients. This definition can be extended to include specialised units or wards in private hospitals, consistent with the approach in the public sector. For further technical information see the Private psychiatric hospital data section of the National mental health report 2013 (DoH 2013).

    The most recent data were collected for the 2014–15 period. Increases in psychiatric beds were the result of improvements in methodology to apportion the data between psychiatric and alcohol/drug treatment wards, new establishments reporting for the first time, and a general increase in psychiatric beds in establishments that have reported psychiatric units in the past. Caution is required when comparing data for 2010–11 to other years as the survey was altered such that psychiatric units could no longer be separately identified from alcohol/drug treatment units. Therefore, the data for beds, patient days, separations and staffing were estimates based on reported 2010–11 data and trends observed in previous years. Data from the Private Mental Health collection suggest that these data may be underestimates (PMHA 2013).


    References

    ABS 2016. Private hospitals, Australia, 2014–15. ABS cat. no. 4390.0. Canberra: ABS.

    AIHW 2012. National health data dictionary (NHDD) Version 16. Cat. no. HWI 119. Canberra: AIHW. Viewed November, 2016.

    DoH (Department of Health) 2013. National mental health report: tracking progress of mental health reform in Australia, 1993–2011. Canberra: Commonwealth of Australia.

    PMHA 2013. Private Hospital-based Psychiatric Services 1 July 2011 to 30 June 2012. PMHA-CDMS annual statistical report for the 2011–2012. Private Mental Health Alliance.

     

    Key concepts

    Specialised mental health care facilities

    Key concept Description
    Beds The number of available specialised mental health beds refers to the average number of beds that are immediately available for use by an admitted patient within the mental health facility over the financial year, estimated using monthly figures (METeOR identifier 374151). Data prior to 2005–06 was sourced from the National Survey of Mental Health Services, which reported the total number of beds available as at 30 June. Comparison of historical data should therefore be approached with caution.
    Carer A carer is a person whose life is affected by virtue of a family or close relationship and caring role with a mental health consumer.
    Community mental health care services Community mental health care services include hospital outpatient clinics and non‑hospital community mental health care services, such as crisis or mobile assessment and treatment services, day programs, outreach services, and consultation/liaison services.
    Consumer A consumer is a person who is currently utilising, or has previously utilised, a mental health service. Mental health service consumers include persons receiving care for their own, or another person’s mental illness or psychiatric disability.
    Consumer committee representation arrangements Specialised mental health organisations report the level of consumer committee representation arrangements. To be regarded as having a formal position on a management or advisory committee, the consumer representative needs to be a voting member (METeOR identifier 288855). This is independent to the employment of consumer and carer consultants. See data source section for the levels available.
    Government-operated residential mental health services Government‑operated residential mental health services are specialised residential mental health services that:
    • are operated by a state or territory government
    • employ mental health-trained staff on‑site for a minimum of 6 hours per day and at least 50 hours per week
    • provide rehabilitation, treatment or extended care to residents for whom the care is intended to be on an overnight basis and in a domestic‑like environment
    • encourage the resident to take responsibility for their daily living activities.
    Health care providers

    Health care providers refers to following staffing categories: salaried medical officers, nurses, diagnostic and allied health professionals, other personal care staff and mental health consumer and carer workers

    Mental health carer worker Mental health carer workers are employed (or engaged via contact) on a part-time or full-time basis specifically for their expertise developed from their experience as a mental health carer (METeOR identifier 450730). Mental health carer workers include the job titles of, but not limited to, carer consultants, peer support workers, carer support workers, carer representatives and carer advocates. Roles that mental health carer workers may perform include, but are not limited to, mental health policy development, advocacy roles and carer support roles.
    Mental health consumer worker Mental health consumer workers are employed (or engaged through contracts) on a part-time or full-time basis specifically due to the expertise developed from their lived experience of mental illness (METeOR identifier 450727). Mental health consumer workers include the job titles of, but not limited to, consumer consultants, peer support workers, peer specialists, consumer companions, consumer representatives, consumer project officers and recovery support workers. Roles that mental health consumer workers may perform include, but are not limited to, participation in mental health service planning, mental health service evaluation and peer support roles.
    National standards for mental health services

    The National standards for mental health services (DHFS 1996) were developed under the First National Mental Health Plan and are applicable to individual service units. There are 8 levels available to describe a service unit’s status (METeOR identifier 287800). See the data source section for the full description of all 8 levels. For reporting purposes, the data are restricted to the following 4 levels:

    • Level 1: the service unit has been reviewed by an external accreditation agency and was judged to have met the standards
    • Level 2: the service unit was in the process of being reviewed by an external accreditation agency but the outcomes were not known.
    • Level 3: the service unit was in the process of being reviewed by an external accreditation agency but the outcomes are not known; or the service unit is booked for review by an external accreditation agency.
    • Level 4: the service unit does not meet the criteria detailed in levels 1 to 3.
    Non-government-operated residential mental health services Non‑government‑operated residential mental health services are specialised residential mental health services which meet the same criteria as government‑operated residential mental health services. These services, while partially or fully funded by governments, are operated by non‑government agencies. Expenditure reported as non-government-operated residential mental health services includes the total operating costs for the residential service, not the total operating costs of the non-government organisation as an entity. Expenditure reported as grants to non-government organisations includes grants made by state and territory government departments to non-government organisations specifically for mental health-related programs and initiatives and are reported separately to expenditure reported for non-government-operated residential mental health services.
    Patient days Patient days are days of admitted patient care provided to admitted patients in public psychiatric hospitals or specialised psychiatric units or wards in public acute hospitals and in residential mental health services. The total number of patient days is reported by specialised mental health service units. For consistency in data reporting, the following patient day data collection guidelines apply: admission and discharge on the same day equals 1 day; all days are counted during a period of admission except for the day of discharge; and leave days are excluded from the total. Note that the number of patient days reported to the National Mental Health Establishments Database is not directly comparable with the number of patient days reported to neither the National Hospital Morbidity Database (Admitted patient mental health-related care section) nor the number of residential care days reported to the National Residential Mental Health Care Database (Residential mental health care section).
    Private psychiatric hospital A private psychiatric hospital is an establishment devoted primarily to the treatment and care of admitted patients with psychiatric, mental or behavioural disorders. The data are sourced from the Private Health Establishments Collection (PHEC), held by the Australian Bureau of Statistics (ABS), which identifies private psychiatric hospitals as those that are licensed/approved by a state or territory health authority and which cater primarily for admitted patients with psychiatric, mental or behavioural disorders (ABS 2015), that is, providing 50% or more of the total patient days for psychiatric patients. The data published in this section also includes psychiatric units or wards in private hospitals. See data source for additional information.
    Program type Public sector specialised mental health hospital services can be categorised based on program type, which describes the principal purpose(s) of the program rather than the classification of the individual patients. Acute care admitted patient programs involve short‑term treatment for individuals with acute episodes of a mental disorder, characterised by recent onset of severe clinical symptoms that have the potential for prolonged dysfunction or risk to self and/or others. Non‑acute care refers to all other admitted patient programs, including rehabilitation and extended care services (see METeOR identifier 288889).
    Psychiatric units or wards Psychiatric units or wards are specialised units or wards that are dedicated to the treatment and care of admitted patients with psychiatric, mental or behavioural disorders.
    Public acute hospital A public acute hospital is an establishment that provides at least minimal medical, surgical or obstetric services for admitted patient treatment and/or care and provides round-the-clock comprehensive qualified nursing services as well as other necessary professional services. They must be licensed by the state or territory health department or be controlled by government departments. Most of the patients have acute conditions or temporary ailments and the average length of stay is relatively short.
    Public psychiatric hospital A public psychiatric hospital is an establishment devoted primarily to the treatment and care of admitted patients with psychiatric, mental or behavioural disorders that is controlled by a state or territory health authority and offers free diagnostic services, treatment, care and accommodation to all eligible patients.
    Service setting Staffing of specialised mental health service units is reported as service setting level data for three specialist mental health service types. These settings are admitted patient services in public psychiatric hospitals and public acute hospitals with specialised psychiatric units or wards; community mental health care services; and residential mental health services, including government and non-government-operated services; and at the organisational overhead setting. The organisational overhead setting level has been included from 2012–13 capturing staff employed by specialised mental health service organisations, performing oragnisational management roles.
    Specialised mental health service organisation A specialised mental health service organisation is a separate entity within states and territories responsible for the clinical governance, administration and financial management of services providing specialised mental health care. For most states and territories, a specialised mental health service organisation is equivalent to the area/district mental health service. These organisations may consist of one or more specialised mental health service units, sometimes based in different locations. Each separately identifiable unit provides either specialised mental health admitted patient hospital services, residential mental health services or community mental health care services (METeOR identifier 286449).
    Staff

    Staff numbers reported in this section refer to the average number of full-time-equivalent (FTE) staff employed, that is, the total hours actually worked divided by the number of normal hours worked by a full-time staff member (METeOR identifier 269172).

    Supported housing places Supported housing places are reported by jurisdictions to describe the capacity of supported housing targeted to people affected by mental illness (METeOR identifier 390929). This is reported at the number available at 30 June and is therefore not comparable to the average available beds measures for specialised mental health hospital and residential services.
    Target population

    Some specialised mental health services data are categorised using 5 target population groups (see METeOR identifier 445778):

    • Child and adolescent services focus on those aged under 18 years.
    • Older person programs focus on those aged 65 years and over.
    • Forensic health services provide services primarily for people whose health condition has led them to commit, or be suspected of, a criminal offence or make it likely that they will reoffend without adequate treatment or containment.
    • General provides services to the adult population, aged 18 to 64, however, these services may also provide assistance to children, adolescents or older people.
    • Youth services target children and young people generally aged 16–24 years.

    Note that, in some states, specialised mental health beds for aged persons are jointly funded by the Australian and state and territory governments. However, not all states or territories report such jointly funded beds through the National Mental Health Establishments Database.

    References

    ABS 2015. Private hospitals, Australia, 2013–14. ABS cat. no. 4390.0. Canberra: ABS.

    DHFS (Commonwealth Department of Health and Family Services) 1996. National Standards for Mental Health Services. Canberra: Commonwealth of Australia.

    Health (Department of Health) 2010. National Standards for Mental Health Services. Canberra: Commonwealth of Australia. Viewed November 2014.


    < Staffing |