Mental health-related prescriptions
44.4 million mental health-related medications were dispensed in 2021–22.
4.7 million patients (18% of the Australian population) were dispensed a prescription for a mental health-related medication in 2021–22, with an average of 9 prescriptions per patient.
85% of mental health-related prescriptions dispensed were prescribed by GPs; 8% by psychiatrists; 5% by non-psychiatrist specialists in 2021–22.
74% of mental health-related prescriptions dispensed were for antidepressant medications in 2021–22.
This section presents information on the Pharmaceutical Benefits Scheme (PBS) information and Repatriation Pharmaceutical Benefits Scheme (RPBS) on prescriptions for mental health-related medications; both subsidised prescriptions and under co-payment prescriptions (that is, prescriptions that cost less than the threshold for subsidy under the PBS). Mental health‑related medications reported in this section comprise the broad groups Psycholeptics, Antipsychotics, Anxiolytics, Hypnotics and sedatives, Psychoanaleptics, Antidepressants, and Psychostimulants, agents used for Attention-deficit hyperactivity disorder (ADHD) and nootropics prescribed by all medical practitioners.
For further information on the PBS and RPBS and the medications covered by these schemes, refer to the data source section.
From February 2020, a range of restrictions on travel, business, social interaction and border controls were introduced to prevent and reduce the spread of SARS-CoV-2, the virus that causes COVID-19 disease. While this report explores the impact on mental health‑related prescriptions, the AIHW has published a report on the Impacts of COVID‑19 on Medicare Benefits Scheme and Pharmaceutical Benefits Scheme service use more broadly.
There were 44.4 million prescriptions dispensed for mental health-related medications (both subsidised and under co-payment) in Australia, to 4.7 million Australians in 2021–22. The majority of prescriptions were made by general practitoners (85%) and Antidepressants (74%) were the most common mental health-related prescriptions dispensed.
Unless otherwise stated in this report, prescriptions dispensed include total prescriptions, that is, both subsidised and under co-payment arrangements.
How many patients received a mental health-related prescription in 2021–22?
Interactive map and chart showing the number of patients who received a mental health related prescription and the number of prescriptions dispensed from 2014–15 to 2021–22 across state or territory, Primary Health Network and Statistical Area 3. Refer to tables PBS.2, PBS.20 and PBS.21. In 2021–22, 4,686,634 patients in total received a mental health-related prescription.
More than 1 in 6 Australians (18% of the population) were dispensed a mental health-related prescription in 2021–22. Tasmania had the highest proportion (23% of the population), while the Australian Capital Territory (17%) and New South Wales (17%) had the lowest (excluding the Northern Territory – see the Note accompanying Figure PBS.1).
Figure PBS.1: People (per cent of the population) dispensed one or more mental health-related prescriptions, by states and territories, 2021–22
Bar chart showing the per cent of patients filling mental health-related prescriptions (subsidised and subsidised and under co-payment) by states and territories in 2021–22. New South Wales had 10% of the population filling subsidised prescriptions, Vic (10%), Qld (11%), WA (10%), SA (12%), Tas (14%), ACT (7%), NT (5%), Australian total (10%). When considering subsidised and under co-payment prescriptions: NSW (17%), Vic (18%), Qld (20%), WA (18%), SA (19%), Tas (23%), ACT (17%), NT (10%), Australia total (18%). Refer to Table PBS.2.
Note: A proportion of the Australian Government subsidy on pharmaceuticals in remote Aboriginal communities (primarily the Northern Territory) is funded through the Aboriginal Health Services program, where drugs are supplied directly to patients and hence are not included in this data. Therefore, figures presented for the Northern Territory are considered to be an underestimate.
Source: PBS/RPBS data (sourced from Australian Government Department of Health and Aged Care): Table PBS.2.
The proportion of people receiving mental health-related prescriptions in 2021–22 was lowest for the youngest age groups and increased by age. A higher proportion of females (22%) were dispensed mental health-related prescriptions than males (15%). A greater proportion of people living in Inner regional areas were dispensed mental health-related medications (22%), than people living in other remoteness areas.
Figure PBS.2: People (per cent of the population) dispensed one or more mental health-related medications, by patient demographics, 2021–22
Horizontal bar chart showing the per cent of people filling mental health-related prescriptions (subsidised and under co-payment), by patient demographics for 2021–22. Proportions were lowest for people aged 0–4 years (less than 1%) gradually increasing to 41% for those 85 years and over. The proportion of females (22%) filling prescriptions was higher than males (15%). Proportions varied among patient area of usual residence: Major cities (17%), Inner regional (22%), Outer regional (20%), Remote (15%) and Very remote (9%). Refer to Table PBS. 4.
Source: PBS/RPBS data (sourced from Australian Government Department of Health and Aged Care): Table PBS.4.
The population rate of people dispensed a mental health‑related prescriptions was higher for females aged 85 and over than all other age groups for all drug types, except for Psychostimulants, agents used for ADHD and nootropics where males aged 5–11 had the highest rate. A higher proportion of males were dispensed Psychostimulants, agents used for ADHD and nootropics than females, while females were dispensed more Anxiolytics, hypnotics and sedatives, and Antidepressants. The rates for Antipsychotics were the same for males and females.
The proportion of the population filling mental health-related prescriptions rose slightly over the past 9 years, from 16% in 2014–15 to 18% in 2021–22. The proportion of people filling subsidised prescriptions remained consistent over this time at 10%.
In 2021–22, Tasmania had the highest rate of mental health-related prescriptions dispensed for subsidised prescriptions (1,500 per 1,000 population) and total prescriptions (2,278).
The Australian Capital Territory had the lowest rate of subsidised prescriptions dispensed (722) and New South Wales had the lowest rate of total prescriptions (1,570) (excluding the Northern Territory – see the Note accompanying Figure PBS.3).
Figure PBS.3: Number of mental health-related prescriptions per 1,000 population, by states and territories, 2021–22
Bar chart showing rate of mental health-related prescriptions dispensed (subsidised and under co-payment) per 1,000 population by jurisdiction in 2021–22. Subsidised prescription rates: NSW (957), Vic (1,006), Qld (1,170), WA (1,000), SA (1,192), Tas (1,500), ACT (722), NT (395), National total (1,036). Subsidised and under co-payment prescription rates: NSW (1,570), Vic (1,709), Qld (1,911), WA (1,742), SA (1,847), Tas (2,279), ACT (1,612), and NT (818), National total (1,722). Refer to Table PBS.11.
Note: A proportion of the Australian Government subsidy of pharmaceuticals in remote Aboriginal communities (primarily the Northern Territory) is funded through the Aboriginal Health Services program, where drugs are supplied directly to patients and hence are not included in this data. Therefore, figures presented for the Northern Territory are considered to be an underestimate.
Source: PBS/RPBS data (sourced from Australian Government Department of Health and Aged Care): Table PBS.11.
Who prescribes mental health-related prescriptions?
In 2021–22 the majority of prescriptions were dispensed by general practitioners (GPs), except for Psychostimulants, agents used for ADHD and nootropics. Antidepressants (74%, or 32.7 million) was the most commonly dispensed medication in 2021–22, followed by Antipsychotics (10% or 4.3 million), Anxiolytics (7% or 3.0 million), Psychostimulants, agents used for ADHD and nootropics (6% or 2.6 million) and Hypnotics and sedatives (4% or 1.8 million) (Figure PBS.4). Similar patterns were observed for subsidised prescriptions.
Figure PBS.4: Number of mental health-related prescriptions, by type of medication and prescribing medical practitioner, 2021–22
Horizontal bar chart showing the number of mental health-related prescriptions dispensed (subsidised & under co-payment), by ATC group of medication and prescribing medical practitioner, 2021–22. Antidepressants were prescribed by: GPs (30 million), non-psychiatrist specialists (0.9 million), psychiatrists (1.7). Antipsychotics (3.2, 0.1, 0.7), Anxiolytics (3, 0.07, 0.1), Hypnotics and sedatives (1.6, 0.06, 0.04) and Psychostimulants, agents used for ADHD and nootropics (0.5, 1, 0.9). Refer to Table PBS.11.
Source: PBS/RPBS data (sourced from Australian Government Department of Health and Aged Care): Table PBS.11.
The highest average number of total prescriptions dispensed per patient was for Antidepressants and Antipsychotics (both at 9) in 2021–22. A similar pattern was observed for subsidised prescriptions.
Females had a higher rate of prescriptions dispensed (around 2,070 per 1,000 population) than males (around 1,350) in 2021–22. Males (9) and females (10) were dispensed a similar number of scripts per patient.
Has the rate of mental health-related prescriptions changed over time?
From 2017–18 to 2021–22, the rate (per 1,000 population) of total mental health-related prescriptions being dispensed increased at an average annual increase of 3%, to 1,722. The rate of subsidised prescriptions dispensed also increased over the same period but at a slower rate, partly due to price reductions on medications no longer under patent (Figure PBS.5). More information about this is available in Expenditure on mental health-related services.
Figure PBS.5: Number of mental health-related prescriptions per 1,000 population, 2006–07 to 2021–22
Line chart showing the rate of mental health-related prescriptions dispensed (subsidised and subsidised and co-payment) per 1,000 population between 2006–07 and 2021–22. Rates of subsidised prescriptions: the lowest rate was 973 in 2007–08 and 2018–19 and the highest was 1,046 in 2012–13. Rates for subsidised and co-payment prescriptions: the lowest rate was 1,378 in 2012–13 and the highest was 1,722 in 2020–21. Refer to Table PBS.12.
Source: PBS/RPBS data (sourced from Australian Government Department of Health): Table PBS.12.
Between 2017–18 and 2021–22, the rate (per 1,000 population) of mental health-related prescriptions dispensed decreased to 83 for Anxiolytics and to 50 for Hypnotics and sedatives, average annual decreases of 6% and 8% respectively. Prescription rates increased over the same period of time to 674 for Antidepressants and to 81 for Psychostimulants, agents used for ADHD and nootropics, average annual increases of 3% and 16% respectively. Prescription rates did not change for Antipsychotics (148).
Information on mental health-related prescriptions can also be reported at the sub-jurisdictional level, within state and territory boundaries. See also Figure PBS.1.
Sub-jurisdictional data for 2021–22 shows variation in the number and rate of prescriptions and patients across Australia’s 31 Primary Health Network (PHN) areas, as well as at the Statistical Area 3 (SA3) region level. For the analysis presented here, geographical area is based on the patient's residential address, or, if the patient’s address is unknown, the location of the supplying pharmacy is used.
The South Australian Adelaide City SA3 region had the highest rate of mental health-related medications dispensed in 2021–22 (3,222 per 1,000 of the population), followed by the Queensland Redcliffe SA3 region (2,801). East Arnhem and Katherine SA3 regions in the Northern Territory had the lowest rate (276 and 329 of the respective populations).
The Queensland Bribie-Beachmere and Maryborough SA3 regions had the highest patient rates in 2021–22 (28% of the population), while East Arnhem and Daly-Tiwi-West Arnhem SA3 regions in the Northern Territory had the lowest rates (4% of the population).
Pharmaceutical Benefits Scheme and Repatriation Pharmaceutical Benefits Scheme data
The Australian Government subsidises the cost of prescription medicines through two schemes, the Pharmaceutical Benefits Scheme (PBS) and the Repatriation Pharmaceutical Benefits Scheme (RPBS) for eligible veterans and their dependants.
People fall into two broad classes: general and concessional. Concessional beneficiaries include pensioners, Health Care card holders, Commonwealth Seniors Health card holders and Veterans card holders. Under the PBS/RPBS, the patient is required to contribute a co-payment which is indexed annually; $42.50 for general patients and $6.80 for those with a concession card as of 1 July 2022. If a medicine is priced below the relevant co-payment threshold the consumer pays the full price and the prescription is classified as ‘under co-payment’. If a medicine is not listed in the PBS Schedule of Pharmaceutical Benefits, the consumer pays the full price as a private prescription, and the data is not included in the presented tables.
The collection of under co-payment prescription data for the PBS and RPBS commenced on 1 April 2012. The data collected is identical to that collected for subsidised prescriptions. Prior to 2012 the only source of under co-payment data was a survey of pharmacies funded by the Australian Government Department of Health and Aged Care (DHAC) (see the information on the Drug Utilisation Sub-Committee (DUSC) below). Time series presentation of survey data with the under co-payment data is not possible prior to 2012–13 as the DUSC data may have been an underestimate of prescription volumes.
Most prescriptions for General Schedule medicines (Section 85) are dispensed through community pharmacies, but PBS is also available in private hospitals and through eligible public hospitals to patients on discharge and day patients. In addition, a number of drugs are distributed under alternative arrangements where these are considered more appropriate (Section 100). Examples are the Highly Specialised Drugs program and General Schedule medicines that are supplied directly to Indigenous patients via Aboriginal Health Services in remote areas of Australia (AHS program). Causing the Northern Territory’s PBS/RPBS statistics to be recognised as an underestimate.
PBS/RPBS does not include the following:
- Private prescriptions,
- Over the counter medicines, and
- Medicines supplied to public hospital inpatients.
Services Australia processes all prescriptions dispensed under the PBS/RPBS and provides this data to the DHAC. The PBS/RPBS data maintained by the DHAC has been used to produce this report. Information collected includes the characteristics of the person who is provided with the prescription, the medication prescribed (for example, type and cost), the prescribing practitioner and the supplying pharmacy (for example, location). The figures reported relate to the number of mental health-related prescriptions supplied by pharmacies and processed by Services Australia in the reporting period, the number of people provided with the prescriptions and their characteristics, as well as the prescription costs funded by the PBS and RPBS (further information can be found in the Expenditure section).
Analyses of prescriptions for mental health‑related medications by financial year quarter have been included to show seasonal variations in medications dispensed, and provide more insight into the impact of events, such as the COVID-19 pandemic. These include prescription and person counts disaggregated by medication type, age group and sex (Tables PBS.8‑9, PBS.18‑19).
Although the PBS and RPBS data capture most of the prescribed medicines dispensed in Australia, these data have the following limitations:
- The number of patients dispensed under co-payment prescriptions cannot be derived by subtracting the number of patients receiving subsidised prescriptions from the total number of patients shown in the tables. Patients may receive both subsidised and under co-payment prescriptions which means there is duplication of some people the subsidised and total prescription categories in tables PBS.2–8.
- Programs funded by the PBS/RPBS that do not use the Services Australia online processing system include:
- Public hospitals,
- Aboriginal health services program, and
- Opiate Dependence Treatment Program.
Only one of these has a bearing on the mental health-related prescriptions data published in the Prescriptions and Expenditure sections: the Aboriginal health services program. Most affected are the data for Remote and Very remote areas and the data for the Northern Territory. Consequently, the mental health-related prescriptions data in these sections will not fully reflect Australian Government expenditure on mental health-related medications.
- All data is presented by the date of supply, that is, when the prescription was dispensed to the patient. For demographic tables, patient characteristics are determined at a single point in each year, ensuring each person is only counted once in the year.
- State and territory are determined according to the patient’s residential address as recorded on the Medicare Enrolment file. If the patient’s state or territory is unknown, then the state or territory of the pharmacy supplying the item is reported.
The Anatomical Therapeutic Chemical (ATC) classification version used is the primary classification as it appears in the PBS Schedule of Pharmaceutical Benefits. This can differ slightly from the World Health Organization (WHO) version (WHO 2022). There are 3 differences between the WHO ATC classification and the PBS Schedule classification that have a bearing on mental health data:
- Prochlorperazine is regarded as an antiemetic (A04A) in the PBS Schedule while it is an antipsychotic (N05A) according to the WHO classification. This means that information on prochlorperazine will not appear in the data provided as it is not listed as a mental health drug in the PBS Schedule.
- Bupropion is listed as an anti-smoking drug (N07B) in the PBS Schedule while it is an antidepressant (N06A) according to the WHO classification. This means that bupropion will not appear in the data as it is not listed as a mental health drug in the PBS schedule.
- Lithium carbonate is classified as an antidepressant (N06A) in the PBS Schedule while it is an antipsychotic (N05A) according to the WHO classification. This means that lithium carbonate will appear in the data as an antidepressant rather than an antipsychotic.
Clozapine (N05A) historical data incomplete
Clozapine is PBS listed under the Highly Specialised Drugs (HSD) program, and prior to 2015 was only available through public and private hospital pharmacies. Due to differing HSD funding arrangements over time, historical prescription/patient data is incomplete:
- Prior to 1 July 2010 – no data available.
- 1 July 2010 to 31 December 2013 - partial data available - gradual transition to prescription based payments increasing over time, transition complete by December 2013.
- 1 January 2014 onwards – complete data available.
Complete data available.
Drug Utilisation Sub-Committee (DUSC) database
Previous Mental health services in Australia prescription data products included data sourced from the DUSC database. From 1 April 2012, following the implementation of the under co-payment data collection, the DUSC-sponsored Pharmacy Guild survey ceased to be the source of under co-payment prescription data. As a result, time series data prior to 2012–13 for under co-payment data has been removed from the tables as the previous survey methodology may be an underestimate of the volumes of under co-payment prescriptions.
AIHW (Australian Institute of Health and Welfare) 2020. Impacts of COVID-19 on Medicare Benefits Scheme and Pharmaceutical Benefits Scheme service use. Cat. no. HPF 65, AIHW, Australian Government, accessed 6 February 2023.
WHO (World Health Organisation) 2022. ATC: Structure and principles. Oslo: WHO Collaborating Centre for Drug Statistics Methodology, accessed 6 February 2023.
This section was last updated in April 2023.