Australia's youth:

Mental illness

Web article

Last updated: 25 Jun 2021

Topic: Children & youth

Part of Australia's youth

AIHW

Australian Institute of Health and Welfare (2021) Mental illness, AIHW, Australian Government, accessed 26 April 2024.

APA

Australian Institute of Health and Welfare. (2021). Mental illness. Retrieved from https://pp.aihw.gov.au/reports/children-youth/mental-illness

MLA

Mental illness. Australian Institute of Health and Welfare, 25 June 2021, https://pp.aihw.gov.au/reports/children-youth/mental-illness

Vancouver

Australian Institute of Health and Welfare. Mental illness [Internet]. Canberra: Australian Institute of Health and Welfare, 2021 [cited 2024 Apr. 26]. Available from: https://pp.aihw.gov.au/reports/children-youth/mental-illness

Harvard

Australian Institute of Health and Welfare (AIHW) 2021, Mental illness, viewed 26 April 2024, https://pp.aihw.gov.au/reports/children-youth/mental-illness

Key findings

In 2013–14, 1 in 5 (20%) young people aged 11–17 had either high or very high levels of psychological distress (13% and 6.6%, respectively).
In 2017–18, an estimated 339,000 young people aged 18–24 (15%) experienced high or very high levels of psychological distress.
In 2013–14, an estimated 245,000 young people aged 12–17 (14%) experienced a mental disorder, with males more commonly affected than females (16% compared with 13%).
In 2019, there were 461 deaths by suicide among young people aged 15–24, a rate of 14 per 100,000 young people.

Most young people in Australia are happy, feel positive about the future and are satisfied with their lives overall (see also Subjective wellbeing). However, some young people suffer poor mental health.

Mental health is a state of wellbeing in which an individual realises their own abilities, can cope with the normal stresses of life, can work productively and can contribute to their community. Poor mental health can impact on the potential of young people to live fulfilling and productive lives (WHO 2018).

Psychological distress is an individual’s overall level of psychological strain or pain. It is evidenced by psychological states such as depression and anxiety (AIHW 2011). The Kessler 10 Psychological Distress Scale (K10) has been shown to be highly correlated with the presence of depressive or anxiety disorders (Lawrence et al. 2015).

Mental illnesses (also referred to as mental health disorders) are diagnosable health conditions. They are health problems that affect how a person feels, thinks, behaves and interacts with others (DoH 2007). Mental illness can vary in severity and duration and may be episodic (AIHW 2018). However, most mental disorders can be effectively treated, and earlier treatment leads to better outcomes (DoH 2007).

The National Children’s Mental Health and Wellbeing Strategy is being developed to ensure that mental illnesses are diagnosed and treated early to prevent lifelong disability (NMHC 2019). A range of mental health services are available in Australia; for detailed information, see Mental health services in Australia.

Poor mental health can be associated with suicidality (that is, suicidal ideation, suicide plans and suicide attempts). However, while suicidality is common in people with mental disorders, it is not confined to this group (Slade et al. 2009 in AIHW 2018). In 2015, suicide and self-inflicted injury was the leading cause of the total burden of disease for young people aged 15–24, followed by anxiety disorders and depressive disorders. Alcohol use disorders was the fifth leading cause (AIHW 2019) see Burden of disease.

Mental health concerns and rates of deaths by suicide among young people were raised as key challenges by young people during consultations by the Youth Taskforce in 2019 to assist in the development of the National Youth Policy Framework (the Framework) (DoH 2020).

Box 1: Data sources, definitions and limitations

Psychological distress

Data on psychological distress are sourced from Young Minds Matter survey (for ages 11–17) and the ABS National Health Survey 2017–18 (for ages 18–24). Both surveys use the K10. This scale consists of 10 questions about negative emotional states in the past 30 days (see ABS 2018b and Lawrence et al. 2015 for more details).

Mental illness

The latest national data on mental illness for young people aged 11–17 are sourced from the Second Australian Child and Adolescent Survey of Mental Health and Wellbeing (also known as, and hereafter referred to as, the Young Minds Matter survey), and the Young Minds Matter Survey Results Query Tool). This household survey was conducted in 2013–14 by the Telethon Kids Institute at the University of Western Australia, in partnership with Roy Morgan Research. A total of 6,310 parents and carers responded, as well as 2,967 young people aged 11–17 in those households where parents or carers had given permission for them to respond and also completed a questionnaire. Data relating to young people aged 12–17 in this section are based on parent and/or carer reported data; some self-reported data are included for young people aged 11–17.

Young people with mental health disorders are those who meet the criteria for a medical diagnosis of a mental disorder within the 12 months before the survey. Diagnoses were based on the DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, 4th edition).

Data on mental disorders for young people aged 16–24 are sourced from the Australian Bureau of Statistics (ABS) National Survey of Mental Health and Wellbeing 2007. The survey based its classification of mental disorders on existing diagnostic criteria to estimate prevalence (ABS 2008). Data on the prevalence of mental disorders from the 2007 survey are due to be updated from 2020–21 as part of the Intergenerational Health and Mental Health Study. This will consist of 4 surveys over 3 years. The survey will also include data on the impact of mental and behavioural and other chronic health conditions on Australians, and lived experiences of suicide (ABS 2021).

Self-reported mental and behavioural conditions

Data on mental and behavioural conditions for ages 15 to 24 are sourced from the ABS National Health Survey 2017–18, which provides data on a range of health conditions including mental and behavioural disorders. Estimates are based on self‑reported data, and record a participant as having a mental or behavioural condition during the collection period only if it was also reported as long term (that is, had lasted, or was expected to last, a minimum of 6 months) (ABS 2018b) (see also Technical notes).

Self-harm

Data on hospitalised injury cases for self-harm are sourced from the AIHW National Hospital Morbidity Database (NHMD). The NHMD is a collection of episode-level records from admitted patient morbidity data collection systems in Australian hospitals. It includes records for all episodes of admitted patient care from essentially all public and private hospitals in Australia.

Deaths by suicide

Data on deaths by suicide are sourced from the Australian Bureau of Statistics (ABS) Causes of Death. These data include information about causes of death and other characteristics of the person, such as sex, age at death, area of usual residence and Indigenous status. The cause of death data are compiled and coded by the ABS to the International Statistical Classification of Diseases and Related Health Problems (ICD).

The information is provided to the ABS by state and territory Registrars of Births, Deaths and Marriages for coding and compilation into aggregate statistics. Generally, most deaths due to external causes will be referred to a coroner for investigation; this includes those deaths that are possible instances of intentional self-harm (death by suicide) (ABS 2019). In addition, the ABS supplements these data with information from the National Coronial Information System (NCIS).

Ambulance attendances

Data on ambulance attendances are sourced from the National Ambulance Surveillance System (NASS), a partnership between Turning Point, Monash University and jurisdictional ambulance services across Australia (AIHW 2020b). The NASS collates and codes monthly ambulance attendances data for participating states and territories for self-harm behaviours (suicidal ideation, suicide attempt, death by suicide, self-injury) and mental health (AIHW 2020b).

Data limitations for deaths by suicide, intentional self-harm or suicidal ideation

This section draws on mortality, hospitals and survey data. Data from emergency departments (EDs) or primary health-care services cannot currently capture those presenting with intentional self-harm or suicidal ideation in most jurisdictions. Many others will not seek medical treatment.

The Australian Institute of Health and Welfare (AIHW) is currently working with key stakeholders, including the Mental Health Information Strategy Standing Committee and ED data custodians, to develop a nationally consistent method to identify and collect data on suicide-related ED presentations (AIHW 2020a).

A further difficulty in determining the incidence of suicidal and self-harming behaviours is that the International Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10) used to code cause of death data and International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, Australian Modification (ICD-10-AM) used to code hospital admission data cannot distinguish between the suicidal and non-suicidal intent of self-harm (AIHW 2020a).

In this report, deaths by suicide are presented according to year of registration, not necessarily the year in which the death occurred.

How many young people experience psychological distress?

As this section draws on different data sources for different age groups, data for age groups 11–17 and 18–24 are reported separately.

In 2013–14, based on self-reported data in the Young Minds Matter survey among young people aged 11–17:

1 in 5 (20%) had either high or very high levels of psychological distress (13% and 6.6%, respectively)
a higher proportion of females had high or very high levels of psychological distress (16% and 9.5%, respectively) compared with males (10% and 4.0%)
a higher proportion of those aged 16–17 had high or very high levels of psychological distress (11% and 16%) compared with those aged 11–15 (4.8% and 12%) (Figure 1).

Figure 1: Level of psychological distress among 11–17 year olds, by age group and sex, 2013–14

The bar chart shows that a larger proportion of females experienced high or very high psychological distress than males and a larger proportion of those aged 16–17 than those aged 11–15.

Chart: AIHW.
Source: AIHW analysis of the Young Minds Matter Survey Results Query Tool.

In 2017–18, based on self-reported data in the ABS National Health Survey among young people aged 18–24:

an estimated 15% (or 339,000) had high or very high levels of psychological distress – 29% reported moderate levels and 49% had low levels
a higher proportion of females than males reported high or very high levels of psychological distress (18% and 12%, respectively).

Has there been a change over time?

Among young people aged 18–24, the rate of high or very high psychological distress increased from 12% to 15% between 2011–12 and 2014–15. However, there was little change between 2014–15 and 2017–18.

For females aged 18–24, the rate of high or very high psychological distress also rose between 2011–12 and 2014–15, from 13% to 20%. However, there was little change between 2014–15 and 2017–18 (Figure 2).

Levels of psychological distress for females aged 18–24 were higher than all other age groups in 2014–15, and higher than those aged 35–44, 65–74 and 75 years and over in 2017–18 (ABS 2015, ABS 2018a).

Figure 2: Psychological distress among 18–24 year olds, by sex, 2011–12 to 2017–18

The column chart shows that the rate of high or very high psychological distress increased over time for young males and varied for young females, with the lowest in 2011–12 (13%25). The rate of high or very high psychological distress has been consistently higher for females than males (18%25 compared with 12%25 in 2017–18).

Note: The data for females 2011–12 have a relative standard error (RSE) of 25% to 50% and should be treated with caution.
Chart: AIHW.
Sources: ABS 2012, 2015, 2018a.

How many young people have mental illness?

In 2013–14, based on information collected from parents/carers in the Young Minds Matter survey, among young people aged 12–17:

an estimated 245,000 (around 14%) experienced a mental disorder in the 12 months before the survey, with a higher proportion of males than females (16% compared with 13%) (AIHW analysis of the Young Minds Matter Survey Results Query Tool; Lawrence et al. 2015)
anxiety and attention-deficit/hyperactivity disorder (ADHD) were the most common disorders (7.0% and 6.3%, respectively). Anxiety was the most common disorder among girls (7.7%) and ADHD the most common disorder among boys (9.8%) (Figure 3).

In relation to major depressive disorder, the survey collected information from young people (aged 11–17) themselves, as well as information from their parents/carers. The prevalence of major depressive order among 11–17 year olds was higher (7.7%) based on adolescent-reported information than on information reported by parents/carers (4.7%) (Lawrence et al. 2015). When considering information provided by parents/carers together with information provided by young people themselves, the prevalence was higher again, with 11% of 11–17 year olds meeting the diagnostic criteria for major depressive disorder (Lawrence et al. 2015).

Young people rated how much their parents or carers knew about how they were feeling. The proportion who reported that their parent/carers know ‘not at all’ how they are feeling was:

7.4% among those who did not have major depressive disorder
15% among those where both the parent/carer report and young person report indicated that the young person had major depressive disorder
30% among those where only the young person report indicated major depressive disorder (Lawrence et al. 2015).

Figure 3: Mental disorders among 12–17 year olds^(a), by sex, 2013–14

The column chart shows that the most common disorders among girls was anxiety disorders (7.7%25) and major depressive disorders (5.8%25) and among boys was attention-deficit/hyperactivity disorder (9.8%25) and anxiety disorders (6.3%25).

(a) In the 12 months before the survey.
Note: Findings are based on parent and/or carer-reported data for young people.
Chart: AIHW.
Source: AIHW analysis of the Young Minds Matter Survey Results Query Tool.

Among young people aged 12–17 with mental disorders, the severity of the impact was:

mild for more than 4 in 10 (44%) young people
moderate for more than 3 in 10 (33%) young people
severe for more than 2 in 10 (23%) young people.

There was little difference in the proportions of males and females at each level of impact (Lawrence et al. 2015). However, the proportion of 12–17 year olds with severe impact was almost 3 times as high as that for 4–11 year olds (23% and 8.2%, respectively) (Lawrence et al. 2015).

In 2007, based on the ABS 2007 National Survey of Mental Health and Wellbeing, among young people aged 16–24:

an estimated 1 in 4 (26% or 671,100) experienced at least 1 mental disorder in the preceding 12 months
anxiety disorders were the most commonly reported disorder for all young people overall (15%) followed by substance use disorders (13%) and affective disorders (6%). For more information, see Young Australians: their health and wellbeing 2011.

Data on the prevalence of mental disorders from the 2007 survey are due to be updated from 2020–21 as part of the Intergenerational Health and Mental Health Study (see Box 1 for details).

More recent data on self-reported long-term mental and behavioural conditions is available from the National Health Survey 2017–18. Results show that among young people aged 15–24:

26% reported having any long-term mental or behavioural condition, with the proportion higher among females (30%) than males (21%) (ABS 2018a)
the most common conditions were anxiety disorders/feeling anxious, nervous or tense (17%) and depression/feeling depressed (12%) (ABS 2018a).

Between 2014–15 and 2017–18, the proportion of young people reporting having any long-term mental or behavioural condition increased from 19% to 26% (ABS 2018a) (see also Technical notes regarding comparisons over time).

Has there been a change over time?

Between 1998 and 2013–14, comparisons of 3 disorders (major depressive disorder, ADHD and conduct disorder) reported in the Young Minds Matters surveys showed that among young people aged 12–17, the proportion:

of those who had any of the 3 disorders remained stable (10% in 1998 and 11% in 2013–14)
with major depressive disorder increased from 2.9% to 5.0%
with ADHD was similar (7.1% in 1998 and 6.3% in 2013–14).
with conduct disorder showed little change (2.2% to 2.1%) (Lawrence et al. 2015).

Box 2: How many young people use mental health services?

A wide variety of support services are available to assist young people with emotional and behavioural problems.

While comprising 12% of the Australian population, in 2019–20, young people aged 12–24 made up 22% (587,000) of all people receiving Medicare-subsidised services specific to mental health, and accounted for:

20% (85,800) of people receiving services from psychiatrists
22% (496,000) of people receiving services from general practitioners
23% (127,000) of people receiving services from clinical psychologists
24% (176,000) of people receiving services from other psychologists
24% (27,600) of people receiving services from other allied health providers (AIHW 2021b).

In 2019–20, young people aged 12–24 also made up 25% (76,100) of ED presentations for mental-health-related care (AIHW 2021c).

In 2018–19, young people aged 12–24 accounted for:

28% (124,900) of community mental health care service patients (AIHW 2021a)
22% (4,100) of same-day admitted mental health-related separations from public hospitals with specialised psychiatric care and 17% (6,800) of those without specialised psychiatric care (AIHW 2021e)
20% (34,200) of overnight admitted mental health-related hospital separations from public hospitals with specialised psychiatric care and 11% (10,600) of those without specialised psychiatric care (AIHW 2021d).

For more information on mental health service use in Australia, see Mental health services in Australia.

Monitoring data on deaths by suicide and self-harm

Please carefully consider your needs when reading the following information about suicide and self-harm. If this report raises any issues for you, these services can help:

Lifeline 13 11 14
Suicide Call Back Service 1300 659 467
Kids Helpline 1800 55 1800
MensLine Australia 1300 78 99 78
Beyond Blue 1300 22 4636.

Crisis support services can be reached 24 hours a day.

The AIHW supports the use of the Mindframe guidelines on responsible, accurate and safe reporting of suicide and self-harm. Please consider these guidelines when communicating about suicide and self-harm.

How many young people self-harm and engage in suicidal behaviour?

Based on self-reported data in the Young Minds Matter survey, in 2013–14, among young people aged 12–17:

around 1 in 10 (11% or an estimated 186,000) reported ever having deliberately injured themselves. Around 7.5% reported that they preferred not to say, indicating that the proportion may be higher. The proportion was:
- almost twice as high among females as males (15% compared with 6.8%)
- almost twice as high among those aged 16–17 (16%) as among those aged 12–15 (8.2%)
5.9% of young people (or 100,000) had self-harmed 4 or more times over their lifetime, with the proportion:
- more than 3 times as high for females (9.2%) as males (2.8%)
- 2.6 times as high for those aged 16–17 (9.8%) as for those aged 12–15 (3.8%)
8.0% of young people (or 137,000) had self-harmed in the past 12 months, with the proportion:
- more than 3 times as high for females (12%) as males (4.0%)
- nearly twice as high for those aged 16–17 (12%) as for those aged 12–15 (6.2%)
around 128,000 or 7.5% had seriously considered attempting suicide in the previous 12 months. The proportion was over twice as high for females as for males (11% and 4.5% respectively) (Lawrence et al. 2015).

Over half (56%) of young people aged 13–17 who had self-harmed in the past 12 months had used services for emotional or behavioural problems. The proportion of females (61%) was higher than that for males (40%) (Lawrence et al. 2015).

Self-harm and mental disorders

In 2013–14 among young people aged 12–17:

the highest rates of self-harm in the 12 months prior to the survey were among those with major depressive disorders (47% based on self-report and 33% based on parent/carer report)
the rate was lower (11%) for those with an ‘other’ disorder based on parent or carer report, but still more than twice as high as for those for whom no disorder was reported (4.2%) (Lawrence et al. 2015).

Box 3: How many hospitalisations are for self-harm?

Suicidal ideation or suicide attempts may result in admission to hospital for specialised mental health care. National admitted patient hospital data cannot be used to distinguish between non-suicidal intentional self-harm and suicide attempts, so activity relating to these types of presentations is collectively reported as intentional self-harm.

In 2018–19, among young people aged 15–24:

there were 9,600 hospitalised cases for intentional self-harm – a rate of 297 per 100,000, and 13% of all hospitalised cases for injuries among this age group
the rate for females was 2.7 times as high as that for males (437 compared with 164 per 100,000). For 15–19 year olds, the female rate was 3.5 times as high as that for males; for 20–24 year olds, the female rate was twice as high as that for males.

While data on 15–24 year olds are presented here, self-harm can start at younger ages. In 2017–18, there were 1,100 hospital separations for intentional self‑harm for children aged 10–14 – a rate of 76 per 100,000 children. The rate for girls was 7 times as high as that for boys (136 and 19 per 100,000, respectively) (AIHW: Pointer SC 2021).

Due to a break in series in 2017–18, time-series analysis is presented only for 2007–08 to 2016–17 (see Technical notes for more details).

Between 2007–08 and 2016–17:

cases of self-harm increased from 227 per 100,000 in 2007–08 to 344 per 100,000 in 2016–17
the greatest increase was for females aged 15–19, which rose from 359 per 100,000 in 2007–08 to 686 per 100,000 in 2016–17 (Figure 4).

Figure 4: Hospitalised cases of self-harm for young people aged 15–24, 2007–08 to 2016–17

The line chart shows that since 2007–08, cases of hospitalised self-harm increased for all young people, with the largest increase for females aged 15–19 and consistently higher rates among females irrespective of age.

Chart: AIHW.
Source: AIHW NHMD.

In 2018–19, among young people aged 15-24, the rate of hospitalised cases for intentional self-harm varied across remoteness areas. It was highest in Remote areas (535 per 100,000), followed by Outer regional areas (479 per 100,000), Very remote areas (442 per 100,000) and Inner regional areas (369 per 100,000). It was lowest in Major cities (251 per 100,000).

In 2016–17, the rate of hospitalised cases for intentional self-harm was 1.4 times as high for young people living in the lowest socioeconomic areas as for those in the highest areas (394 and 276 per 100,000, respectively) (see Technical notes).

It should be noted that the complete extent of non-fatal suicidal and self-harming behaviours in the community is unknown in Australia. Although, data on hospitalisations due to intentional self-harm provide an indication of the incidence of these behaviours in the community, only data on those with serious physical or mental health issues admitted for further treatment are included (AIHW: Pointer 2021).

Information on hospitalisations for intentional self-harm reported here may differ from that in other publications. The differences are small and may reflect differences in the inclusion criteria (for example, Y87.0 is included here) and/or exclusion criteria. See also Technical notes for methodological issues.

How many deaths are due to suicide?

In 2019, based on ABS Causes of Death data, among young people aged 15–24:

there were 461 deaths due to suicide, a rate of 14 per 100,000 young people
the rate was much higher among males than females (20 and 7.6 per 100,000, respectively)
for both males and females, the rate was higher among those aged 20–24 (24 and 8.5 per 100,000, respectively) than among those aged 15–19 (16 and 6.6 per 100,000, respectively).

Has there been a change over time?

Between 2010 and 2019, based on ABS Causes of Death data, among young people aged 15–24:

the rate of death by suicide increased from 10 per 100,000 young people to 14 per 100,000, with rates consistently higher for males than females (Figure 5)
based on rate differences for 2010 and 2019, the largest percentage increases were for females aged 15–19 (from 3.7 to 6.6 per 100,000) and for males 20–24 (from 16 to 24 per 100,000) (Figure 5).

Caution should be exercised when analysing trends in deaths by suicide by young people (especially with regard to year-to-year changes) due to the small numbers of deaths by suicide each year. Deaths of young people attributed to suicide can also be influenced by reporting practices.

Figure 5: Deaths by suicide among young people aged 15–24, by age and sex, 2010–2019

The line chart shows that the rate of death by suicide for young people has increased since 2010, with rates consistently higher for males than females and highest for males aged 15–19.

Note: These data have been adjusted for Victorian additional death registrations in 2019. See Technical notes for more details.
Chart: AIHW.
Source: ABS Causes of Death, Australia, 2020.

Box 4: Ambulance attendances for suicidal behaviour and mental health

In 2019, based on the AIHW’s 2019 Quarterly Snapshot in selected jurisdictions (see Technical notes for details), ambulances attended the following incidents for young people aged 15–24:

5,300 incidents involving suicidal behaviours (suicidal ideation – 3,200; suicide attempt – 2,100)
1,200 incidents involving self-harm (without suicidal intent)
4,700 incidents involving mental health.

Due to the low number of ambulance attendances for deaths by suicide, these data cannot be reported by age and sex (AIHW 2020b).

The number of incidents involving suicidal behaviours was higher among those aged 15–19 than among those aged 20–24. For both age groups, the number was consistently higher for females than males (Figure 6).

The number of incidents involving mental health was lower among those aged 15–19 than among those aged 20–24. For both age groups, the number was higher for females than males (Figure 6).

Figure 6: Number of ambulance attendances for self-harm behaviours and mental health in selected jurisdictions and months for young people aged 15–24, by age and sex, 2019

Note: National totals include data from New South Wales, Victoria, Tasmania and the Australian Capital Territory. Data were collected during March, June, September and December 2019 for ambulance attendances in Victoria, Tasmania and the Australian Capital Territory. Data for incidents in New South Wales were collected during June, September and December 2019.
Chart: AIHW.
Source: AIHW 2020b.

Are rates of mental illness the same for everyone?

In 2013–14, based on the Young Minds Matter survey, the prevalence of mental health disorders among young people aged 12–17 was:

2.5 times as high among those born in Australia as among those born overseas (16% and 6.2%, respectively) (Figure 7).
1.6 times as high in Outer regional areas as in Major cities (21% and 13%, respectively)
2.3 times as high among young people living in areas of lowest socioeconomic status as among those living in areas of highest socioeconomic status (23% and 9.9%, respectively).

Figure 7: Mental illness among young people aged 12–17(a), by selected population groups, 2013–14

The bar chart shows that the proportion of young people aged 12–17 experiencing mental illness varied by country of birth, with 16%25 among those born in Australia and 6.2%25 of those born overseas, by remoteness, with the highest in Outer regional areas (21%25) compared with lowest in Major cities (13%25), and by socioeconomic area, with 23%25 in the lowest and 9.9%25 the highest.

(a) In the 12 months before the survey.
Note: Data are based on parent and/or carer-report.
Chart: AIHW.
Source: AIHW analysis of the Young Minds Matter Survey Results Query Tool.

In 2017–18, based on the ABS National Health Survey, among young people aged 15–24, there was no statistically significant difference in the prevalence of mental or behavioural conditions across remoteness areas, or between the highest and lowest socioeconomic areas.

Where do I find more information?

For information on topics related to mental health in Australia’s young people, see:

For information on Indigenous young people and mental health, see:

Indigenous young people and mental health: Section 7.5 of Aboriginal and Torres Strait Islander adolescent and youth health and wellbeing 2018
Measure 1.18, Social & emotional wellbeing of the Aboriginal and Torres Strait Islander Health Performance Framework (HPF) report 2020
mental health disorders: The Mental Health of Young people and Adolescents: Report on the second Australian Child and Adolescent Survey of Mental Health and Wellbeing and The Young Minds Matter Survey Results Query Tool
mental health-care services and support, including presentations to EDs, hospitalisations and prescriptions related to mental health: Mental health services in Australia
death by suicide and self-harm: AIHW’s Suicide and self-harm monitoring
whole-of-population injury hospitalisations and deaths (including disaggregations for young people aged 15–24): Injury in Australia, 2017–18.

References Expand

Technical notes Expand

Burden of disease

Burden of disease measures how many years of life Australia loses to diseases either due to people dying early or living with ill health.

ABS National Health Survey

Mental, behavioural and cognitive conditions
- In 2014–15 a new module was created in the ABS National Health Survey (NHS) to collect information specifically about mental, behavioural and cognitive conditions. This module was used in 2017–18.
- Mental, behavioural and cognitive conditions are a broad and diverse range of health conditions including relatively mild conditions of short duration, episodic/recurring conditions, and severe and disabling conditions. This collection of conditions is often experienced simultaneously.
- For details on the mental health, behavioural and/or cognitive conditions included see National Health Survey: Users' Guide, 2017–18.
- More than one response was allowed and up to three 'Other mental or behavioural conditions' could be recorded.
- Respondents who reported one or more mental health, behavioural and/or cognitive conditions, were then asked:
  - whether the condition had lasted, or was expected to last, for 6 months or more (that is, was long-term) and, if so, which one(s).
  - whether they had been told by a doctor or nurse that they had each of the conditions reported (that is, diagnosed) (see National Health Survey: Users' Guide, 2017-18).
- Note that estimates of people with mental or behavioural conditions from the NHS will differ from those obtained from a diagnostic tool such as that used in the 2007 National Survey of Mental Health and Wellbeing.
Mental and behavioural conditions—comparison over time
- In 2014–15 and 2017–18, a module specifically dedicated to mental and behavioural conditions was included in the NHS to collection information on cognitive, organic and behavioural conditions. In previous NHS cycles, mental and behavioural conditions were collected in a module that included a wide range of long-term health conditions. The number of persons who reported having a mental and behavioural condition in 2014–15 increased from the 2011–12 NHS, potentially due to the greater prominence of mental and behavioural conditions in the new module. Data on mental and behavioural conditions for 2014–15 and 2017–18 are therefore not comparable with data in previous National Health Surveys.

AIHW National Hospital Morbidity Database

Hospitalised injury cases for self-harm:
- Estimating incident cases: Each record in the NHMD refers to a single episode of care in a hospital. Some injuries result in more than 1 episode in hospital and, hence, more than 1 NHMD record. This can occur in 2 main ways:
  - a person is admitted to 1 hospital, then transferred to another or has a change in care type (for example, acute to rehabilitation) within the 1 hospital
  - a person has an episode of care in hospital, is discharged home (or to another place of residence) and is then admitted for further treatment for the same injury, to the same hospital or another one.
- The NHMD does not include information designed to enable the set of records belonging to an injury case to be recognised as such. Hence, there is potential for some incident injury cases to be counted more than once, which occurs when a single incident injury case results in 2 or more NHMD records being generated, all of which satisfy the selection criteria being used.
- Information in the NHMD enables this problem to be reduced, though not eliminated. The approach used for this report makes use of the ‘Mode of admission’ variable, which indicates whether the current episode began with a transfer from another acute care hospital. Episodes of this type are likely to have been preceded by another episode that also met the case selection criteria for injury cases, so are omitted from our estimated case counts.
- This procedure should largely correct for over-estimation of cases due to transfers but will not correct for over-estimation due to re-admissions.
Case selection criteria:
- principal diagnosis in the ICD-10-AM range S00–T75 & T79 using ICD-10-AM, but excluding any with Z50 Care involving use of rehabilitation procedures appearing in any additional diagnosis field, and
- mode of admission was not a transfer from another acute hospital. (to reduce multiple counting of cases), and
- external cause codes for intentional self-harm: X60–X84
Adjusting for changes to rehabilitation coding:
- A change in coding practice for ICD-10-AM Z50 Care involving the use of rehabilitation procedures has necessitated a change to the standard record inclusion criteria for NISU reports of hospital admitted injury cases. The change applies to episodes that ended on 1 July 2015, or later. For details of the change see ‘Box 4.2’ in Admitted patient care 2015–16: Australian hospital statistics (AIHW 2017).
- Due to the change in coding practice, an increase in the numbers of separations in 2015–16 with a principal diagnosis in the ICD-10-AM Chapter 19 Injury, poisoning and certain other consequences of external causes (S00–T98) range occurred (approximately, an additional 60,000 records).
- In order to minimise the effect of the coding change on the estimation of injury occurrence and trends, a change to the case estimation method used by NISU was required. Records with Z50 either as Principal Diagnosis or as Additional Diagnosis are now omitted by NISU in data-years both before and after the coding change. The change to data prior to 2015–16 amounts to an adjustment of less than 0.1% of records. Where injury trends are presented by principal diagnosis for years prior to 2015–16, data will not be directly comparable for previous reporting periods.
Break in series: changes to NHMD inclusions for 2017–18
- The emergency department admission policy was changed for New South Wales hospitals in 2017–18. Episodes of care delivered entirely within a designated emergency department or urgent care centre are no longer categorised as an admission regardless of the amount of time spent in the hospital. This narrowing of the categorisation has had the effect of reducing the number of admissions recorded in NSW for the 2017–18 financial year. For New South Wales the effects was a significant decrease (3.7%) in all public hospital admissions in 2017–18 compared to 2016–17. The impact of the change was felt disproportionately among hospitalisations for injury and poisoning. According to NSW Health the number of hospitalisations for injury and poisoning in NSW decreased by 7.6% between 2016–17 and 2017–18, compared to a usual yearly increase of 2.8% (Centre for Epidemiology and Evidence 2019).
- The change in NSW’s emergency department admission policy may have had different effects on case numbers within different external cause categories. This is because different types of injury have a different likelihood of requiring prolonged care in an emergency department, but without an admission to a hospital ward.
- Consequently, fewer injury separations are reported than would have been seen had the NSW policy not changed, for most analyses.
- Due to the size of the contribution of NSW data to the national total, Australian data from 2017–18 should therefore not be compared with data from previous years.
Hospitalised unintentional injury cases and socioeconomic status
- Due to possible data quality concerns affecting 2017-18 and 2018-19 hospitalised unintentional injury data by socioeconomic areas, results for 2016-17 are presented in this section.

For more information on hospitals admitted patient care data quality for 2018–19, see Appendix A in Admitted patient care 2018–19 Appendixes.

Population data

Denominators for hospitalised injury cases are estimated resident population (ERP) values as at 31 December of the relevant year from the Australian Bureau of Statistics (ABS). For analysis by remoteness and socioeconomic areas, population denominators were calculated as the average of 30 June estimates for adjacent years.

Australian Bureau of Statistics (ABS) Causes of Death

Additional Victorian registrations:
- Care needs to be taken when interpreting data derived from deaths registered in Victoria. As a result of joint investigations between the ABS and the Victorian Registry 2,739 death registrations from 2017 and 2018 were identified that had not previously been provided to the ABS, and which were in scope of the 2019 reference year. An issue associated with the Registry's previous processing system (replaced in 2019) resulted in delays to the provision of some death registrations to the ABS. Whilst these are included in overall total numbers of all cause deaths for 2019 in line with ABS scope rules, a time series adjustment has been applied to deaths due to suicide, assault and accidental drug overdose to enable a more accurate comparison of mortality over time for these causes. When the time series adjustment is applied, affected deaths are presented in the year in which they were registered (that is, removed from 2019 and added to 2017 or 2018). As a result, some totals may not equal the sum of their components. See Technical note: Victorian additional registrations and time series adjustments for detailed information on this issue.
- See the Data quality section of the methodology in ABS Causes of Death, Australia publication for further information on specific issues related to interpreting time–series and 2019 data.
The deaths data presented for intentional self-harm (X60–X84) includes ICD–10 code Y87.0 (Sequelae of intentional self-harm). See the Deaths due to intentional self-harm (suicide) section of the methodology of ABS Causes of Death, Australia.
All coroner-certified deaths registered 2006 onward are subject to a revisions process - once data for a reference year are 'final', they are no longer revised. Affected data in this report are: 2010 -2016 (final), 2017 (revised), 2018 and 2019 public (preliminary). See the Data quality section of the methodology in ABS Causes of Death, Australia publication, and Causes of Death Revisions, 2016 Final Data (Technical Note) and 2017 Revised Data (Technical Note) in Causes of Death, Australia, 2018 (cat. no. 3303.0).
In addition to the revisions process, new coding guidelines have been applied to deaths registered from 2007 onward. These guidelines allow for deaths to be coded to suicide if evidence available on the NCIS indicates the death was from intentional self-harm. Under the new coding guidelines, cases that remain open at the time of processing or closed cases where the coroner has not made a finding on intent may also be coded to suicide following further investigation of information on the NCIS. See the Deaths due to intentional self-harm (suicide) section of the methodology of ABS Causes of Death, Australia.
Changes in coding processes have been applied to 2019 data. See the Classifications and Mortality coding sections of the methodology for further information.

National Ambulance Surveillance System (NASS)

The 2019 Quarterly snapshot data includes 1 month per quarter data for the months of March, June, September and December 2019 for Victoria, Tasmania and the ACT and for June, September and December 2019 for NSW. For more information see AIHW’s Suicide and self-harm monitoring, data sources section.

Mental illness