Since 1997-98 when the first national survey of psychotic illness was conducted, there have been major changes in mental health service delivery particularly affecting public specialised mental health services, which are key providers of services to people with psychotic illnesses. Both the 2010 and 1997-98 surveys collected information from people receiving these services in a census month and comparison of these data provides insights into the impact of these changes.
The one-month prevalence of psychotic illness in people receiving public mental health services in 2010 was 3.1 cases per 1,000 population. This is consistent with that found in 1997-98, which was estimated as 3.6 cases per 1,000 population.
There appear to be some changes in the course of disorder people experience (figure 25).
- The majority of people had multiple episodes of psychotic illness, but more people experienced periods of good recovery in between these (29.3% compared with 21.3% in 1997-98).
- The proportion of people experiencing deterioration due to chronic psychotic illness had halved since 1997-98 (11.3% compared to 23.6%).
- Hospital admissions for mental health reasons decreased by 35.9%.
- Involuntary admissions decreased by a third from 31.4% to 22.7%.
- There was a 60.7% increase in the use of community rehabilitation or day programs.
- One quarter (26.5%) of people received mental health services from non-government organisations compared with 18.9% in 1997-98.
- The proportion of people with a psychotic illness who had a case manager increased from 71.9% to 78.1%.
- General practitioners continue to be major providers of services, with the proportion visiting general practitioners increasing from 76.7% to 87.8%.
More people were in their own home or rented accommodation (68.4% compared with 49.0% in 1997-98) and the proportion in supported accommodation had doubled to 10.9%.
The proportion of people who had been homeless at some time in the previous 12 months more than halved (5.0% compared with 13.0% in 1997-98).
Smoking rates remained very high and lifetime alcohol and drug abuse or dependence increased markedly, both rising from around 30% to just over half having these disorders (figure 27).
Figure 25: Course of disorder, 1997-98 and 2010
Text version of figure 25
| Course | 2010 - proportion (%) | 1997-98 - proportion (%) | |
|---|---|---|---|
| Single episode | 7.6 | 8.0 | |
| Multiple episodes - good recovery in between | 29.3 | 21.3 | |
| Multiple episodes - partial recovery in between | 30.1 | 29.5 | |
| Continuous chronic illness | 21.7 | 17.6 | |
| Continuous chronic illness with deterioration | 11.3 | 23.6 | |
Figure 26: Health service use, 1997-98 and 2010
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Text version of figure 26
| Health service | 1997-98 - proportion (%) | 2010 - proportion (%) | ||
|---|---|---|---|---|
| Outpatient/ community clinic contact | 75.3 | 92.8 | ||
| General practitioner visits | 76.7 | 87.8 | ||
| Case manager | 71.9 | 78.1 | ||
| Inpatient - any admission | 62.9 | 45.6 | ||
| Emergency department attendance | 47.6 | 43.0 | ||
| Mental health | 58.7 | 37.6 | ||
| Community rehabilitation/ day program | 22.9 | 36.8 | ||
| Non-government organisation for mental health | 18.9 | 26.5 | ||
| Involuntary admission | 31.4 | 22.7 | ||
| Physical health | 7.9 | 12.6 | ||
Figure 27: Smoking, alcohol and drug abuse or dependence, 1997-98 and 2010
Text version of figure 28
| Behaviour | 2010 - proportion (%) | 1997-98 - proportion (%) | ||
|---|---|---|---|---|
| Current smoker | 67.2 | 68.9 | ||
| Lifetime alcohol abuse/ dependence | 50.5 | 29.0 | ||
| Lifetime drug abuse/ dependence | 56.4 | 30.4 | ||