Executive summary and key findings

The second Australian national survey of psychotic illness was conducted in 2010. The aim was to provide updated information on the lives of people with psychotic illness who receive public specialised mental health services.

Psychotic disorders are a diverse group of illnesses that have their origins in abnormal brain function and are characterised by fundamental distortions of thinking, perception and emotional response. The most common of these disorders is schizophrenia.

• Two of the main symptoms are delusions and hallucinations.
• The onset for many psychotic disorders is in the late teens to early adulthood.
• Most people with psychotic illness will receive treatment, however, the stage and age at which this begins varies.

Psychotic illnesses are classified according to diagnostic criteria in the ICD-10 and include:

• Schizophrenia
• Schizoaffective disorders
• Mania with psychotic symptoms
• Bipolar affective disorder with psychotic symptoms
• Depression with psychotic symptoms
• Persistent delusional disorders
• Acute and transient psychotic disorders
• Other and unspecified non-organic psychotic disorder

The 2010 survey had four key aims to:

1. Estimate the prevalence of psychosis and age when symptoms were first experienced
2. Describe the profile of people with psychotic illness, including their personal, social and living circumstances, and mental and physical health
3. Determine the use of health and other services and
4. Assess the impact of psychotic illnesses on the lives of people with these disorders and identify factors related to better outcomes.

The main focus of the 2010 survey was on consumers of public specialised mental health services administered by state/ territory governments. It also included a sample of people who were only in contact with non-government organisations. It did not cover people with psychotic illness who were being treated only in the private sector or by their general practitioner.

This survey follows the first National Study of Psychotic Illness in 1997-98, which provided the first data on the prevalence of psychotic illness in the Australian population.

Public specialised mental health services and non-government organisations providing mental health services in seven catchment sites, participated in the survey. Together these sites cover 10% of the Australian population.

The sample for the survey was drawn from people receiving these services over the period from April 2009 to March 2010.

The survey methodology was based on a two-phase design:

1. All people seen by these services in the catchment sites over the period of the survey were screened, with 7,955 assessed as having psychosis and eligible for interview.
2. A random sample (1,825) of these people was interviewed over the period from April 2010 to March 2011.

The survey contained 32 modules and information was collected on over 1,500 items covering the following:

• socio-demographic characteristics, including income, education, housing, activities of daily life, employment, child and other caring responsibilities
• family contact, social participation, crime, offending and personal safety
• health and other services used for physical and mental health problems, covering hospital admissions, emergency department attendances, rehabilitation programs, contact with case managers, general practitioner visits and non-government organisation mental health services
• medications used for mental health problems and their side affects and
• physical conditions, smoking, alcohol and drug use, nutrition and exercise, as well as range of information collected through a physical examination and blood sample.

Scales were also included to determine the impact of psychotic illness on:

• overall functioning
• quality of life
• smoking, alcohol and drug use, and dependence
• cognitive functioning and
• perceived need for mental health and other support services.

Estimating the number of people with psychotic illness treated by public specialised mental health services

Demographic characteristics of people with psychotic illness

Nature of the illness, symptoms and functioning

Physical health and at-risk behaviours

Service and medication use

Non-government services and case management

General practitioner services

Employment and housing

Isolation, support and satisfaction with life

How things have changed since 1997-98