Service and medication use

Mental health care in Australia is provided through hospital-based and public specialised mental health services managed by states and territories, private sector services delivered by general practitioners, psychiatrists and psychologists and non-government organisations.

Service utilisation

The majority of people with psychotic illness used a wide variety of health services both for their mental and physical health problems (figure 11). Almost all (95.3%) had used services for their mental health problems and 81.0% had used services for their physical health problems.

• Most people (88.2%) had visited a general practitioner in the past year.
• Most (86.3%) had used outpatient or community clinics and ambulatory health care services in the past year.
• Two-fifths (41.0%) presented to an emergency department and one quarter (26.4%) had done so for a psychiatric problem. In addition, 17.2% had telephone contact and 16.3% had face-to-face contact with a psychiatric emergency service.
• One in five people (20.7%) had at least one involuntary inpatient admission and one-fifth (19.2%) were under a community treatment order in the past year.

One third (34.8%) of people with psychotic illness had one or more psychiatric inpatient admissions in the past year, with an average of 40 days in hospital (figure 12).

• Two-fifths (43.0%) spent from four to thirteen weeks in psychiatric inpatient treatment.

Medication use

Most (91.6%) people were taking prescribed medications in the previous four weeks, with four-fifths (81.6%) taking antipsychotics.

• The majority of people were on atypical psychotics (74.0%) (figure 13).

Newer 'atypicals' better control delusions and hallucinations, however, they do not alleviate other symptoms for which people may receive a variety of medications.

• 37.4% were on antidepressants.
• 26.7% were on mood stabilisers.

Medication side effects were common, with 44.7% experiencing drowsiness, 39.5% dry or watery mouths and 37.5% weight gain.

• People reported that the impact of the side effects on their daily lives was moderate or severe for 29.9%.

Two-fifths (41.1%) were also using medications for physical health conditions. The most common medications were cardiovascular (18.2%), followed by endocrine (14.7%). Top of page

Figure 11: Service use in the past year

Text version of figure 11

Service use		Any health (%)	Mental health (%)	Physical health (%)
General practitioner		88.2	49.3	76.3
Outpatient/ community clinic		86.3	82.2	23.2
Emergency department		41.0	26.4	21.3
Involuntary admission		-	20.7	-
Inpatient admission		43.7	34.8	13.3

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Figure 12: Psychiatric inpatient treatment in the past year

Text version of figure 12

Psychiatric inpatient treatment in the past year:

• Less than 2 weeks - 25.4%
• 2 to <4 weeks - 22.1%
• 4 to <13 weeks - 43%
• 13 to <26 weeks - 6.7%
• 26 to <52 weeks - 2.7%
• Full year - 0%

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Figure 13: Medication use in the past year

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Text version of figure 13

Medication use in the past year for mental health problems:

• Antipsychotic
  • Atypical antipsychotics: all - 74%
  • Clozapine - 16.4%
  • Typical antipsychotics - 15.2%
• Other
  • Antidepressants - 37.4%
  • Mood stabilisers - 26.7%
  • Anxiolytics, hypnotics, sedatives - 17.8%
  • Anticholinergics - 4.2%
  • Alcohol, nicotine or opioid dependence related - 3.5%
• Total on medication for mental health - 91.6%
• Supplements for mental health - 21.9%

Medication use in the past year for physical conditions:

• Cardiovascular - 18.2%
• Endocrine (any) - 14.7%
• Gastrointestinal - 12.8%
• Respiratory - 6%
• Blood and electrolytes - 4%
• Neurological - 3.8%
• Musculoskeletal - 3.7%
• Genitourinary - 0.8%
• Total on medication for physical health - 41.1%

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