Mental Health
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Indicator:
Mental health related hospitalisations for selected age group
Policy context:
A mental illness is a clinically diagnosable disorder that impairs an individuals’ cognitive, emotional and/or social abilities.¹ There are various types and severities of mental illnesses.
In a large-scale survey conducted in 2015, 13.9% of Australian children aged between 4 and 17 were assessed as having had a mental health disorder in the last 12 months.² The most common mental illnesses in children and adolescents were ADHD, anxiety disorders, major depressive disorder and conduct disorders.² These illnesses place a significant personal burden on individuals in this age group as well as the health system in general. The rates of mental illness in this age group should also be understood as an important indicator of future health and demand for services because various studies have shown that many adults with mental illnesses had their first onset of symptoms in childhood.
Mental health is related to a range of social factors such as economic disadvantage, poor housing, a lack of social support and access to health services.² As such, understanding the proportion of mental illness in young people by geographical area can be utilised to ensure policy and services are meeting the needs of young people in their communities. Examining proportions of mental illness alongside other demographic factors (e.g. unemployment) for certain geographic areas can help policy makers and providers understand where mental illness in young people could be better addressed.
References:
Australian Government: Department of Health. 1.4 - National Mental Health Plan 2003-2008. [cited 2018 Jun 4]. Available from: https://www.health.gov.au/sites/default/files/documents/2020/11/national-mental-health-policy-2008.pdf
Australian Bureau of Statistics. Canberra ACT. 4326.0 - National Survey of Mental Health and Wellbeing: Summary of Results. 2007 [cited 2018 Jun 4]. Available from: http://www.abs.gov.au/ausstats/abs@.nsf/mf/4326.0
Data source:
Compiled by UWA and Telethon Kids Institute based on Hospital Morbidity Data Collection, Department of Health Western Australia; ABS Estimated Residential Population estimates
Numerator:
Mental health related hospitalisations for selected age group
Denominator:
Total ERP for selected age group
Unit of measure:
Per 10,000 population
Geography:
SA2, SA3, LGA, HR, RDC
Data confidentiality:
Areas with count values 1 to 4 and where population is less than 50 have been suppressed.
Prior moving averages combine a sequence of 3 or 5 years of data prior to, and including, the selected year. The series are presented as overlapping sequences until the most recent year is included. Moving averages make it possible to combine more years of data to maximize sample size at each point while maintaining data confidentiality.
Notes:
The HMDC includes all episodes of care that occur in the following Western Australian health services:
Public acute hospitals
Public psychiatric hospitals
Private acute hospitals (licensed by WA Health System)
Private psychiatric hospitals (licensed by WA Health System
Private day surgeries (licensed by WA Health System)
Mental illness diagnoses were identified using the following ICD classification codes
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Indicator:
Births to mothers with a mental illness diagnosis
Policy context:
A mental illness is a clinically diagnosable disorder that impairs an individuals’ cognitive, emotional and/or social abilities.¹ There are various types and severities of mental illnesses. It is estimated that around half of the Australian adult population will experience a mental illness in their lifetime and that approximately 1 in 5 adults have experienced a mental illness in the last 12 months.²
The most common mental illnesses experienced by mothers in this period are major depression, bipolar disorder and anxiety disorders.³ Children whose mothers have a perinatal mental health disorder (22 completed weeks of gestation to 1 year after birth) are at increased risk of developmental and psychological disturbances such as; depression and anxiety, emotional regulation problems, poorer social behaviour, insecure attachment, increased behaviour problems and impaired physical and cognitive development.³ʼ⁴ This likely results from a combination of genetic inheritance and environmental risk factors associated with a parent having a mental illness.⁵ʼ⁶
In addition to biological and psychological factors, mental health is related to a range of social factors such as economic disadvantage, poor housing, a lack of social support and access to health services.² Therefore, understanding the number of births to mothers with a mental illness in particular geographic regions, especially when examined alongside information about social factors, can inform policy to help improve perinatal mental health care.
References:
Australian Government: Department of Health. 1.4 - National Mental Health Plan 2003-2008. [cited 2018 Jun 4]. Available from: http://www.health.gov.au/internet/publications/publishing.nsf/Content/mental-pubs-n-infopri2-toc~mental-pubs-n-infopri2-pt1~mental-pubs-n-infopri2-pt1-4
Australian Bureau of Statistics. Canberra ACT. 4326.0 - National Survey of Mental Health and Wellbeing: Summary of Results. 2007 [cited 2018 Jun 4]. Available from: http://www.abs.gov.au/ausstats/abs@.nsf/mf/4326.0
O’Hara M, Wisner K. Perinatal mental illness: Definition, description and aetiology. Best Practice & Research Clinical Obstetrics & Gynaecology. 2014; 28(1):3-12. https://doi.org/10.1016/j.bpobgyn.2013.09.002
Stein A, Pearson R, Goodman S, Rapa E, Rahman A, Mccallum M, et al. Effects of perinatal mental disorders on the fetus and child. The Lancet, 2014; 384(9956). https://doi.org/10.1016/S0140-6736(14)61277-0
Reupert A, Maybery D, Kowalenko N. Children whose parents have a mental illness: Prevalence, need and treatment. The Medical Journal of Australia, 2013; 199(3):7-9. https://doi.org/10.5694/mja11.11200
Maybery D, Ling L, Szakacs E, Reupert A. Children of a parent with a mental illness: Perspectives on need. Australian e-Journal for the Advancement of Mental Health, 2005; 4(2):78-88. https://doi.org/10.5172/jamh.4.2.78
Data source:
Compiled by UWA and Telethon Kids Institute based on Hospital Morbidity Data Collection, Mental Health Information Data Collection, and Midwives Notification System, Department of Health Western Australia
Numerator:
Live births to mothers who had a mental illness diagnosis 12 months prior to, or 12 months post, the child’s birth
Denominator:
All live births
Unit of measure:
Percent (%)
Geography:
SA2, SA3, LGA, HR, RDC
Data confidentiality:
Areas with count values 1 to 4 and where population is less than 50 have been suppressed.
Prior moving averages combine a sequence of 3 or 5 years of data prior to, and including, the selected year. The series are presented as overlapping sequences until the most recent year is included. Moving averages make it possible to combine more years of data to maximize sample size at each point while maintaining data confidentiality.
Notes:
The HMDC includes all episodes of care that occur in the following Western Australian health services:
Public acute hospitals
Public psychiatric hospitals
Private acute hospitals (licensed by WA Health System)
Private psychiatric hospitals (licensed by WA Health System
Private day surgeries (licensed by WA Health System)
The MIND collects demographic and clinical information on patients who have:
Community mental health episodes or service contacts
Admitted episodes with specialised mental health inpatient services
National Outcome Casemix Collection (NOCC) data for patients who have community, admitted or residential episodes in public specialised mental health services
Mental illness diagnoses for mothers were identified using the following ICD classification codes:
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Indicator:
Substance abuse disorder related hospitalisations for selected age group
Policy context:
A substance abuse disorder involves a pattern of substance use that results in an impairment or distress in daily activities.¹ For example, individuals with a substance abuse disorder commonly have repeatedly failed to stop using the substance, used more than planned, experienced craving for or withdrawal from the substance and/or, continued to use a substance despite its negative impact on their lives.¹
‘Substance’ can refer to: alcohol, caffeine, cannabis, hallucinogens, inhalants, opioids, sedatives, hypnotics, anxiolytics, stimulants, tobacco, and other or unknown substances.¹ Alcohol, tobacco and cannabis are the substances most frequently used by young people.²
Substance abuse disorders are among the most common mental health disorders experienced by young people in Australia and the fourth highest contributor to the burden of disease in this age group.³ʼ⁴
There is evidence that substance abuse can be reduced by addressing relevant risk factors such as early exposure to a substance or poor mental health, and by increasing protective factors such as early patterns of healthy behaviours.⁵ʼ⁶
Being able to understand rates of substance abuse disorder within geographical area therefore has the advantage of allowing policy makers and service providers to make informed choices when working to improve outcomes.
Using this data alongside other social information (such as unemployment and income) could be especially important as a range of social factors are risk factors associated with alcohol and drug abuse.⁶
References:
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5®). American Psychiatric Pub; 2013.
White V, Bariola E. Australian secondary school students' use of tobacco, alcohol, and over-the counter and illicit substances in 2011. Cancer Council of Victoria, 2012. Available from: https://darta.net.au/wp-content/uploads/2023/05/ASSAD-2011.pdf
Gore F, Bloem J, Patton G, Ferguson J, Joseph V, Coffey C, et al. Global burden of disease in young people aged 10-24 years: A systematic analysis. The Lancet, 2011; 377(9783): 2093-2102. https://doi.org/10.1016/S0140-6736(11)60512-6
Australian Institute of Health and Welfare. Canberra ACT. Impact of alcohol and illicit drug use on the burden of disease and injury in Australia: Australian Burden of Disease Study 2011. Available from: https://www.aihw.gov.au/reports/burden-of-disease/impact-alcohol-illicit-drug-use-on-burden-disease/contents/table-of-contents
Bränström R, Sjöström E, Andréasson S. Individual, group and community risk and protective factors for alcohol and drug use among Swedish adolescents. European Journal of Public Health, 2007; 18(1):12-8. https://doi.org/10.1093/eurpub/ckm038
Hawkins JD, Catalano RF, Miller JY. Risk and protective factors for alcohol and other drug problems in adolescence and early adulthood: Implications for substance abuse prevention. Psychological Bulletin, 1992; 112(1):64. http://dx.doi.org/10.1037/0033-2909.112.1.64
Data source:
Compiled by UWA and Telethon Kids Institute based on Hospital Morbidity Data Collection, Department of Health Western Australia; ABS Estimated Residential Population estimates
Numerator:
Substance abuse disorder related hospitalisations for selected age group
Denominator:
Total ERP for selected age group
Unit of measure:
Per 10,000 population
Geography:
SA2, SA3, LGA, HR, RDC
Data confidentiality:
Areas with count values 1 to 4 and where population is less than 50 have been suppressed.
Prior moving averages combine a sequence of 3 or 5 years of data prior to, and including, the selected year. The series are presented as overlapping sequences until the most recent year is included. Moving averages make it possible to combine more years of data to maximize sample size at each point while maintaining data confidentiality.
Notes:
The HMDC includes all episodes of care that occur in the following Western Australian health services:
Public acute hospitals
Public psychiatric hospitals
Private acute hospitals (licensed by WA Health System)
Private psychiatric hospitals (licensed by WA Health System
Private day surgeries (licensed by WA Health System)
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Indicator:
Emergency Department presentations that were mental health related in children and young people
Policy context:
Mental health disorders are the most common chronic conditions experienced by young people in the developed world and are a significant burden to public health in Australia.¹ʼ² Additionally, many mental health disorders of adulthood have their onset in childhood or adolescence.³
In recent years, the number of young people presenting to emergency departments with mental health conditions has steadily increased.⁴ The most common nature of presentation is for intentional self-harm.⁴ Other common presentations are for substance abuse, and mood, behavioural, or emotional disorders.⁴
Understanding the proportion of paediatric presentations to ED that are because of mental health has important implications for policy and service delivery.⁴ Geographic statistics can provide insight into where hospitals need to be better equipped to effectively deal with mental health presentations and where non-hospital services have not been sufficient to meet the needs of individuals experiencing mental health conditions. They can also indicate where mental health and health service education may be lacking, leading individuals to present to an emergency department rather than an alternative service that may be better suited to their needs.
Understanding the prevalence of mental health emergency department presentations in young people is therefore useful for informing effective policy to improve the outcomes of young people across the state.
References:
Erskine H, Moffitt T, Copeland W, Costello E, Ferrari A, Patton G et al. A heavy burden on young minds: The global burden of mental and substance use disorders in children and youth. Psychological Medicine, 2015; 45(7):1551-63. https://doi.org/10.1017/S0033291714002888
Lawrence D, Hafekost J, Johnson S, Saw S, Buckingham W, Sawyer M et al. Key findings from the second Australian Child and Adolescent Survey of Mental Health and Wellbeing. Australian & New Zealand Journal of Psychiatry, 2016; 50(9):876-86. https://doi.org/10.1177/0004867415617836
Kessler R, Berglund P, Demler O, Jin R, Merikangas K, Walters E. Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry, 2005; 62(6):593-602. https://doi.org/10.1001/archpsyc.62.6.593
Hiscock H, Neely R, Lei S, Freed G. Paediatric mental and physical health presentations to emergency departments, Victoria, 2008-15. Medical Journal of Australia, 2018. https://doi.org/10.5694/mja17.00434
Data source:
Compiled by UWA and Telethon Kids Institute based on Emergency Department Data Collection, Department of Health Western Australia; ABS Estimated Residential Population estimates.
Numerator:
Number of presentations to public and private Emergency Departments with a primary presenting mental health condition for selected age group
Denominator:
Total ERP for selected age group
Unit of measure:
Per 10,000 population
Geography:
SA2, SA3, LGA, HR, RDC
Data confidentiality:
Areas with count values 1 to 4 and where population is less than 50 have been suppressed.
Prior moving averages combine a sequence of 3 or 5 years of data prior to, and including, the selected year. The series are presented as overlapping sequences until the most recent year is included. Moving averages make it possible to combine more years of data to maximize sample size at each point while maintaining data confidentiality.
Notes:
The EDDC captures data relating to services provided to patients within public hospital emergency departments, contracted health entities and emergency services provided in smaller hospitals without a designated ED. The collection excludes episodes of non-admitted patient care provided in outpatient clinics or hospital inpatient departments.
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Indicator:
Emergency Department presentations for deliberate self-harm in children and young people
Policy context:
Mental health disorders are the most common chronic conditions experienced by young people in the developed world and are a significant burden to public health in Australia.¹ʼ² In recent years, the number of young people presenting to emergency departments with mental health conditions has steadily increased.³ The most common nature of presentation is for deliberate self-harm.³
Deliberate self-harm refers to an intentional act of causing physical injury to oneself, without the intention for the injury to cause death.⁴ However, deliberate self-harm can lead to accidental fatality.⁴ Presentations to Emergency Departments for deliberate self-harm may indicate more life-threatening forms of self-injury. There is also an increased risk of completed suicide following presentation to hospital for deliberate self-harm.⁵
Understanding the proportion of paediatric presentations to ED that are because of deliberate self-harm has important implications for policy and service delivery.³ Geographic statistics can provide insight into where outpatient mental health services may need to focus prevention and intervention efforts to meet the needs of individuals experiencing acute mental illness, particularly around the prevention of suicide.
Understanding the prevalence of deliberate self-harm emergency department presentations in young people is therefore useful for informing effective policy to improve the outcomes of young people across the state.
References:
Erskine H, Moffitt T, Copeland W, Costello E, Ferrari A, Patton G et al. A heavy burden on young minds: The global burden of mental and substance use disorders in children and youth. Psychological Medicine, 2015; 45(7):1551-63. https://doi.org/10.1017/S0033291714002888
Lawrence D, Hafekost J, Johnson S, Saw S, Buckingham W, Sawyer M et al. Key findings from the second Australian Child and Adolescent Survey of Mental Health and Wellbeing. Australian & New Zealand Journal of Psychiatry, 2016; 50(9):876-86. https://doi.org/10.1177/0004867415617836
Hiscock H, Neely R, Lei S, Freed G. Paediatric mental and physical health presentations to emergency departments, Victoria, 2008-15. Medical Journal of Australia, 2018. https://doi.org/10.5694/mja17.00434
Lauw M, How CH, Loh C. Deliberate self-harm in adolescents. Singapore Medical Journal. 2015;56(6):306-309. https://doi.org./10.11622/smedj.2015087
Hawton K, Zahl D, & Weatherall R. Suicide following deliberate self-harm: Long-term follow-up of patients who presented to a general hospital. British Journal of Psychiatry. 2003; 182(6), 537-542. https://doi.org/10.1192/bjp.182.6.537
Data source:
Compiled by UWA and Telethon Kids Institute based on Emergency Department Data Collection, Department of Health Western Australia; ABS Estimated Residential Population estimates.
Numerator:
Number of presentations to public and private Emergency Departments with a primary presenting self-inflicted injury for selected age group
Denominator:
Total ERP for selected age group
Unit of measure:
Per 10,000 population
Geography:
SA2, SA3, LGA, HR, RDC
Data confidentiality:
Areas with count values 1 to 4 and where population is less than 50 have been suppressed.
Prior moving averages combine a sequence of 3 or 5 years of data prior to, and including, the selected year. The series are presented as overlapping sequences until the most recent year is included. Moving averages make it possible to combine more years of data to maximize sample size at each point while maintaining data confidentiality.
Notes:
The EDDC captures data relating to services provided to patients within public hospital emergency departments, contracted health entities and emergency services provided in smaller hospitals without a designated ED.
The collection excludes episodes of non-admitted patient care provided in outpatient clinics or hospital inpatient departments.
Presentation deemed to be deliberate self-harm if any of the following ICD codes were recorded
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Indicator:
Community mental health service contacts for selected age group (excluding not present)
Data source:
Compiled by UWA and Telethon Kids Institute based on Hospital Morbidity Data Collection, Department of Health Western Australia; ABS Estimated Residential Population estimates
Numerator:
Community mental health service contacts for selected age group (excluding not present)
Denominator:
Total ERP for selected age group
Unit of measure:
Per 1,000 population
Geography:
SA2, SA3, LGA, HR, RDC
Data confidentiality:
Areas with count values 1 to 4 and where population is less than 50 have been suppressed.
Prior moving averages combine a sequence of 3 or 5 years of data prior to, and including, the selected year. The series are presented as overlapping sequences until the most recent year is included. Moving averages make it possible to combine more years of data to maximize sample size at each point while maintaining data confidentiality.
Notes:
The MIND collects demographic and clinical information on patients who have:
Community mental health episodes or service contacts
Admitted episodes with specialised mental health inpatient services
National Outcome Casemix Collection (NOCC) data for patients who have community, admitted or residential episodes in public specialised mental health services