Australia's mental health system

Overview

Mental health is a key component of overall health and wellbeing (WHO 2021). In any year in Australia, an estimated 1 in 5 people aged 16–85 will experience a mental disorder (ABS 2023). A person’s mental health affects and is affected by multiple factors, including access to services, living conditions and employment status, and impacts not only the individual but also their families and carers (Slade et al. 2009; WHO 2021). Mental health and physical health are inter-related and people with mental illnesses are more likely to develop physical illness and tend to die earlier than the general population (Lawrence et al. 2013).

The importance of good mental health, and its impact on Australians, has long been recognised by Australian governments. Over the last 3 decades governments have worked together to develop mental health programs and services to better address the needs of Australians.

Throughout this section, the terms ‘mental illness’ and ‘mental disorder’ are both used to describe a wide range of mental health and behavioural disorders, which can vary in both severity and duration.

Roles and responsibilities

A range of mental health services are funded in Australia by the different levels of government, insurers and/or individuals with services delivered by both government and non-government providers. For example, the Australian Government funds consultations with specialist medical practitioners, general practitioners (GPs), psychologists and other allied health practitioners through the Medicare Benefits Schedule (MBS), other primary mental health services through the Primary Health Networks, support for psychosocial disabilities through the National Disability Insurance Scheme and subsidised medication via the Pharmaceutical Benefits Scheme. Access to psychiatrists, psychologists and other allied health professionals may, dependent on eligibility, be subsidised through initiatives such as Better Access initiative.

State and territory governments fund and provide mental health services through residential mental health care, community mental health care, specialised mental health care facilities and public hospitals, including emergency departments.

In addition to services provided or subsidised by governments, services are also provided by the community sector, such as crisis and support services like Lifeline, Beyond Blue and Kids Helpline. Services delivered in private hospitals are funded via private health insurance, contracted care through state and territory governments and/or out-of-pocket payments.

The Australian Institute of Health and Welfare monitors and reports on a number of different mental health indicator sets that have been developed to measure the performance and progress in the delivery of services across the mental health sector. Performance indicators are generally developed for a specific purpose, for example, measuring changes after commitment to a national strategy.

Australian Government Expand

State and territory governments Expand

Private and community sectors Expand

2023–24

In July 2023, Treasury released the Measuring What Matters Framework, intended to measure and track various wellbeing themes, many of which, including psychological distress, are published by AIHW.

From 1 September 2023, Australians with an ongoing health condition who are stable on their current treatment were eligible to purchase 60-days’ worth of medication for the price of a single prescription (Department of Health and Aged Care 2023). This applies to more than 300 common medicines listed on the PBS and will be implemented in 3 stages over 12 months. Refer to the Mental health services activity monitoring section for more details.

The National Mental Health Workforce Strategy 2022–2032, released in October 2023, aims to address some of the challenges in attracting, training and retaining practitioners to provide the mental health services required by Australians over the next decade.

2022–23 Expand

A further $547 million was allocated to support the National Mental Health and Suicide Prevention Agreement 5 pillars in the 2022–23 Budget (DoH 2022b). Additionally, the 2023–24 Budget allocated $586.9 million to action and expand projects. These include:

Projects to provide psychosocial support services for those with severe mental illness not covered by the NDIS.
Opening and/or announcing more than 20 Head to Health and headspace centres since the previous budget, including services in remote, regional, and underserved communities and allocating resources to increase interpreting services across these services.
Rolling out programs targeting students, farmers, parents, and refugees which focus on wellbeing and suicide prevention (refer to National mental health policies and strategies below).

From January 2022, expanded telehealth services were made an ongoing feature of MBS arrangements (DoH 2022). As part of the October 2022–23 Federal Budget, $47.7 million was also allocated to restore MBS-subsidised bulk billing psychiatry services in rural and regional Australia that were previously removed in December 2021.

The National Mental Health and Suicide Prevention Agreements, struck with each state and territory, further detail roles, responsibilities and co-funding arrangements (Department of the Treasury 2022).

More recently, the Australian Government has implemented a number of initiatives. These include:

Funding of Medicare bulk billing services for allied health professionals including psychologists for mental health services in rural and remote areas facilitated by a new Memorandum of Understanding with all states and the Northern Territory.
Beginning rollout of 60-day dispensation of prescription medicines (following 2018 recommendations) subsidised through the PBS and further supporting electronic prescription infrastructure.
Shifting of approach to suicide prevention [DOCX, 1.6MB] from strictly mental health to a whole-of-life approach, including establishing the National Suicide Prevention Office Advisory Board comprised of experts, across academia, research, government, and peak bodies, and supported by the establishment of the National Suicide Prevention Office Lived Experience Partnership Group.
Elevating lived experience voices through funding for the establishment and operation of two independent national mental health lived experience peak bodies with one to represent consumers, and one to represent carers, family and kin.
Development of a new National Disaster Mental Health and Wellbeing Framework to provide guidance on mental health response following national disasters.
Commissioning an independent review into Health Practitioner Regulatory settings related to approval of overseas applications of health workforce to address workforce shortages.
Funding identified priority research areas such as loneliness and eating disorders.

2021–22 Expand

In the 2021–22 Federal Budget, $2.3 billion over 4 years was allocated to the National Mental Health and Suicide Prevention Plan (DoH 2018), responding to recommendations from the Productivity Commission’s Inquiry Report on Mental Health, the Royal Commission into Victoria’s Mental Health System and advice from the National Suicide Prevention Advisor (Department of the Treasury 2021). The majority of these recommendations require collaboration between the Australian Government and state and territory governments, including through the National Mental Health and Suicide Prevention Agreement. The plan included 5 pillars to this investment which address:

Prevention and early intervention
Suicide prevention
Treatment
Supporting the vulnerable
Workforce and governance.

The Budget also allocated $117 million to establish a comprehensive evidence-base to support real time monitoring and data collection for our mental health and suicide prevention systems, enabling services to be delivered to those who need them, and improving mental health outcomes for Australians (Department of the Treasury 2021).

In March 2022, the National Mental Health and Suicide Prevention Agreement (National Agreement) came into effect, signed by the Australian and all states and territory governments. The National Agreement seeks to deliver a comprehensive, coordinated, consumer-focused mental health and suicide prevention system with joint accountability across all governments. Key priority areas under the National Agreement include regional planning and commissioning, priority populations, stigma reduction, safety and quality, gaps in the system of care, suicide prevention and response, psychosocial supports outside the NDIS, national consistency for initial assessment and referral, workforce, and data and evaluation.

The National Agreement is supported by bilateral agreements with all state and territory governments, which commit to joint investment from the Australian and states and territory governments in mental health and suicide prevention services. The bilateral agreements focus on providing community-based services to address gaps in the mental health and suicide prevention system, and include varying commitments such as adult, youth and child mental health services, perinatal measures and suicide prevention services.

Monitoring mental health consumer and carer experiences is a long-term goal of the National Mental Health Strategy. More information on consumer and carer experiences is progressively becoming available through the implementation of the Your Experience of Service (YES) survey, which is currently used in some jurisdictions in Australia. It is offered to consumers who interact with specialised state and territory mental health services and aims to help these services and mental health consumers to work together to build better services. More information on the YES survey can be found in the Consumer perspective of mental health care section. Information on the outcomes of mental health care is also reported to gauge the effectiveness of mental health services from the perspective of both clinicians and consumers. These data form part of the National Outcomes and Casemix Collection (NOCC). More information can be found in the Consumer outcomes of mental health care section.

In December 2022, the Australian Government released the Evaluation of the Better Access Initiative report. Better Access provides Medicare rebates to those with diagnosed mental illness to facilitate access to mental health services. It was found those who received treatment through Better Access tended to have positive outcomes. However, some groups were found to be better served than others with those in lower socioeconomic, regional, rural, and remote and aged care residents seeing fewer benefits (Pirkis et al. 2022).

The 10 additional psychological therapy sessions, initially provided during the COVID-19 pandemic, were discontinued as of 31 December 2022.

2020–21 Expand

2019–20 Expand

During the emergency phase of the COVID-19 pandemic, all Australian Governments progressively introduced measures to mitigate mental health impacts as the situation developed. While a more comprehensive overview of the mental health impacts of the pandemic can be found in the archived content of this website, some key events from the Australia Government response included:

March 2020 – Expanding Medicare-subsidised telehealth services, including new MBS items for providers to provide telehealth services (DoH 2020). Additional funding to crisis lines, digital and online services, and support for healthcare professionals including funding of a dedicated Coronavirus Mental Wellbeing Support Service for free 24/7 mental health support.
April 2020 – Conducting surveys into the adverse impacts of the pandemic on the mental health of Australians by the Australian National University, University of Melbourne and headspace.
May 2020 – Endorsement of the National mental Health and Wellbeing Pandemic Response Plan by the National cabinet (NMHC 2020) with an additional $48.1 million committed to support priority areas.
August 2020 – Expanding MBS-subsidised services under the Better Access initiative to provide 10 additional individual psychological therapy sections for those in areas subjected to lockdown restrictions, which were subsequently granted to all Australians as part of the October Budget. More information on the Australian Government Response to COVID-19 can be found in the Mental health services activity monitoring section.

Additionally, each state and territory government also introduced a range of mental health support packages to benefit their residents. More information on jurisdictional responses can be found on the websites of each state and territory health department.

Service access

The 2020–2022 National Study of Mental Health and Wellbeing collected data on mental health service access in the preceding 12 months. From this survey, it is estimated that 3.4 million Australians aged 16–85 saw a health professional for their mental health in the previous 12 months (ABS 2023).

Of persons with a lifetime mental disorder who experienced symptoms within the last 12 months:

36% consulted a general practitioner for mental health
21% consulted a psychologist
10% consulted a psychiatrist
13% consulted another health professional

An estimated 944,900 Australians aged 16–85 also accessed at least one service for mental health via digital technologies, such as crisis support, treatment programs or information from late 2020 to late 2022 (ABS 2023). Of those who did not access mental health services, the majority (89%) reported that they felt no need to access any mental health services (Figure 2).

In 2022–23, 49% of MBS mental health specific services were provided by psychologists (including clinical psychologists), 27% were provided by general practitioners (GPs) and 20% were provided by psychiatrists (AIHW 2024).

Figure 2: Which health professions did Australians consult for mental health?

Sex	General Practitioner	Psychiatrist	Psychologist	Other health professional	No consultations with a health professional for mental health	Crisis support or counselling services	Mental health support groups, forums or chat rooms	Information about mental illness, treatment options or services	No service for mental health accessed via digital technologies
Males	484200	170600	302500	175700	1124300	36900	56200	128200	1555300
Females	1028400	248600	603300	353800	1207400	149000	98600	182500	2080700

Source: Australian Bureau of Statistics, National Study of Mental Health and Wellbeing, 2020–2022; Tables 6.1, 7.1 | Data source overview

References Expand

Australia's mental health system

Overview

Roles and responsibilities

National developments since 2020

Figure 1: National developments

2023–24

Service access

Figure 2: Which health professions did Australians consult for mental health?

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Australia's mental health system Print this page

Overview

Roles and responsibilities

National developments since 2020

Figure 1: National developments

2023–24

Service access

Figure 2: Which health professions did Australians consult for mental health?

Australia's mental health system