Since we tabled our Access to State-Managed Adult Mental Health Services report, the data and the data warehouse have been provided to the Department of Health (DoH) as a proof of concept. WA health and the Mental Health Commission have expressed a keen desire to continue to develop the analysis and use it to inform their decision making around people-centred mental health service development.
Access to State-Managed Adult Mental Health Services
Building patient journeys with the data
To create a systematic view of people’s pathways, we requested data for all people who accessed State-managed mental health care. These people accessed at least 1 of the 3 care settings at least once in the 5 year period from 1 January 2013 to 31 December 2017.
How many people accessed care from 2013 to 2017
On an annual basis, the number of people accessing State-managed mental health services grew steadily over the 5 years from 65,341 in 2013 to 76,845 in 2017 (Figure 1). The biggest increase was in 2016 when 5,079 more people accessed care compared to the previous year, representing a 7.4% increase on 2015.
How much care people accessed, and how often
We also tested if it was possible to analyse how much care (by time) people accessed, and how often they accessed it. This type of analysis could provide insights into how people use the mental health system, and the degree to which services are meeting needs. After consultation with clinicians and DoH analysts we developed 4 access categories for our analysis across the 5 years. These types of categories could potentially prove useful in understanding the interplay between the intensity, severity and acuity of illness, need and service provision.
Patterns of people accessing care by service
Community treatment services
From 2013 to 2017, a total of 155,655 people accessed care from community treatment services.
From 2013 to 2017, a total of 58,620 people spent 1,595,182 days in mental health hospital beds across 117,615 stays.
A total of 118,532 people accessed mental health care in a public hospital ED from 2013 to 2017. Over the 5 years, the number of mental health ED events per year increased by 27%, from 43,965 in 2013 to 55,770 in 2017.
The analysis showed that the time spent in ED was very similar for people who were either not admitted into hospital or were admitted into a non-mental health bed (general hospital bed). People who were admitted from ED into either an open or secure mental health bed spent longer in ED.
Post discharge re-admission and follow-up rates
Re-admission to hospital within 28 days of discharge from acute specialised mental health units
The rate of readmission is higher than the percentage of people who are readmitted in any year, indicating that some people are readmitted to hospital, within 28 days of discharge, multiple times.
Percentage of contacts with community treatment services within 7 days post discharge from a dedicated mental health unit
The percentage of stays that are followed by a contact within 7 days has increased over the 5 years. Stays refers to the time a person spends in hospital from admission to discharge.