Evidence base on mental health in remote Australia

  • Major Mitchell cockatoos, Tarcoola, outback South Australia.

[Image: Paula Algar]

Australian Institute of Health and Welfare
Dr Claire Reid
and Patrick Bell

According to the recent National Study of Mental Health and Wellbeing, in 2020–21 an estimated one in five Australians aged 16–85 experienced a mental disorder in the previous 12 months. While there is no significant difference in the rates of mental illness between major cities and the rest of Australia, for people living in remote and very remote areas, access to specialised mental health services may be limited. Due to their location, they may face challenges and experience poorer health outcomes than people living in metropolitan areas. Accessing services can be complex and issues may include long travel distances, limited workforce availability and poor telecommunications coverage.

Across Australia, mental health services are provided by psychiatrists, psychologists, general practitioners and other allied health professionals through private consultations, hospitals, home visits and telehealth. With few exceptions, the number of mental health professionals per 100,000 population working in remote and very remote areas tends to be much lower than in cities and regional areas.

It is perhaps unsurprising then that only three per cent of Australians living in very remote and six per cent in remote areas accessed Medicare-subsidised mental health services in 2020–21, compared with 12 per cent of people living in major cities. However, over the past five years, the proportion of people receiving Medicare-subsidised mental health services in remote and very remote areas has grown at almost twice the rate of those living in major cities.

People experiencing mental ill health can also receive care in community and hospital-based outpatient care services provided by state and territory governments. Collectively, these services are referred to as community mental health care (CMHC). In 2020–21 around two per cent of CMHC contacts were for people living in remote and very remote areas, and nine per cent were for people living in outer regional areas, compared with 69 per cent in major cities, in line with the Australian Bureau of Statistics estimated residential populations. However, CMHC engagement was more than double in very remote areas (38 patients per 1,000 population) than in major cities (16 per 1,000 population).

Furthermore, presentations to hospital emergency departments for mental-health-related conditions were more than twice the rate in remote and very remote areas (235 per 10,000 population) compared with people living in major cities (107 per 10,000 population).

Rates of suicide and intentional self-harm are higher in regional and remote areas than in major cities. In 2021, the suicide rate for residents of very remote areas (24 deaths per 100,000 population) was twice the rate for residents of major cities (10 deaths per 100,000 population), but the numbers of deaths were comparatively small (43 deaths in very remote areas and 1,900 in major cities).

For hospitalisations due to intentional self-harm, residents of very remote areas recorded a rate of 178 hospitalisations per 100,000 population, compared to 107 in major cities. Young adults aged 15–19 years living in remote areas were the most hospitalised group for intentional self-harm (724 hospitalisations per 100,000 population), followed by the same age group in outer regional areas (542 hospitalisations per 100,000 population).

The Australian Institute of Health and Welfare publishes data relating to Australian’s mental health service use, providing a strong evidence base for policymakers and service providers to make decisions that lead to better mental health outcomes for all Australians, regardless of where they live.

This article uses the Australian Statistical Geography Standard Remoteness Structure, 2016.

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