Mental health

Introduction

Mental health and wellbeing are more than the absence of mental illness or disorder. Mental wellbeing occurs along a continuum influenced by a complex interplay of social, psychological and biological factors.¹ People’s experience of wellbeing varies from person to person and across the lifespan. Mental wellbeing is supported by six different areas that strengthen the ability to perform daily activities, specifically:

• physical health
• mental growth
• bringing joy to others
• personal connection
• mindfulness
• connection with nature.²

Mental health burden

In 2022, mental health disorders, including substance use disorders, were the 3rd leading cause of healthy years of life lost (667,073) translating to an age-standardised rate (ASR or standardised rate) for mental health burden of 26.7 per 1,000 persons in Australia.³ Nationally, total disease expenditure on mental and substance use disorders was $10.850 billion in 2019–20.⁴

For selected mental disorders included in this section, the number and standardised rate for years of healthy life lost nationally in 2022 were:

• Anxiety disorders: 161,308 years (standardised rate 6.4 per 1,000 persons)
• Depressive disorders: 147,579 years (standardised rate 5.8 per 1,000 persons)
• Alcohol use disorders: 71,660 years (standardised rate 2.9 per 1,000 persons)
• Drug use disorders: 50,854 years (standardised rate 2.1 per 1,000 persons).⁴

Corresponding disease expenditure information for 2019–20 was $2.023 billion (anxiety disorders), $2.344 billion (depression disorders), $549.5 million (alcohol use disorders) and $716.9 million (drug use disorders).⁴

Terminology

Mental illness encompasses a range of clinically diagnosable disorders that impact a person’s cognitive, emotional or social abilities.⁵ A range of mental health and behavioural conditions including anxiety disorders, affective disorders and substance use disorders, can be described as a mental disorder. This section uses both terms to describe a range of mental health and behavioural conditions, and also uses other concepts such as psychological distress. In some contexts, substance use disorders are considered as separate to other mental disorders.

A person may be negatively affected by their mental health without meeting the criteria for a mental illness or mental disorder. Difficulties with mental health can occur at any stage of life and may be temporary or persist over a long period. Multiple socioeconomic factors may negatively affect a person’s mental health including:

• access to services
• living conditions
• employment status.⁶

This section uses a range of information sources to describe mental health and behavioural disorders as described below and under Additional information.

Suicide and self-harm statistics are available as a separate page in this report.

Mental disorders

The National Study of Mental Health and Wellbeing (NSMHW) was conducted in 2020–21. The NSMHW assesses the prevalence and impact of mental disorders, suicidality and self-harm behaviours as well as data on health service use. The previous NSMHW was conducted in 2007.⁷

Any mental disorder

In 2020–21, 43.7% of Australians 16 to 85 years had experienced a mental disorder at some time in their life. Anxiety disorders were the most reported mental disorder in the past 12 months (16.8%), followed by affective disorders (7.5%) and substance use disorders (3.3%).⁷

Mental disorders were disproportionately higher in:

• females (24.6%) compared to males (18.0%)
• younger age groups: 32.4% in 16 to 34 year olds, 19.0% in 35 to 64 year olds and 8.7% in 65 to 85 year olds.⁷

Figure 1: Mental disorder prevalence in Australian adults (age 18 to 85), 2021

Note: This dashboard is developed and maintained by the Australian Institute of Health and Welfare

Anxiety disorders

The higher prevalence of mental disorders in the past 12 months in females was largely driven by anxiety disorders—21.0% in females compared to 12.4% in males. The sex disparity differed by age group:

• 16 to 34 year olds: 1.8 times higher in females (33.3% in females compared to 18.0% in males)
• 35 to 64 year olds: 1.6 times higher in females (18.4% in females compared to 11.2% in males).⁷

Substance use disorders

This relationship reversed for substance use disorders with almost twice as many males reporting a substance use disorder compared to females.

• lifetime substance use disorder: 1.9 times higher in males (26.7% in males compared to 13.8% in females)
• past 12 months substance use disorder: 1.9 higher in males (4.4% in males compared to 2.3% in females).⁷

Medical care

Seeking health care for mental disorder was relatively uncommon—17.5% of people who reported a mental disorder in their lifetimes had at least one consultation with a health professional for mental health.

Among those who experienced symptoms of a mental disorder in the past 12 months, less than half (47.1%) received care from their GP, a mental health practitioner, or other health professional. Women were 1.5 times more likely to receive care (54.7% for females compared to 37.0% for males).⁷

Long term mental and behavioural problems

The National Health Survey (NHS) has included a general category of self-reported ‘mental or behavioural problems’ since 2001. Changes in survey design, however, limit the ability to assess changes over time (see Technical notes).

There was no evidence of an increase within either of two time periods (2001 to 2011–12, and 2014–15 to 2017–18). Additional years of data are needed to clarify patterns over time. For available years, prevalence was similar for Queensland and Australia.⁸

Psychological distress

The Kessler Psychological Distress Scale-10 (K10) measures psychological distress based on a person’s self-reported level of nervousness, agitation, psychological fatigue and depression in the past four weeks.⁹ The NHS has included the K10 since 2001.

In 2017–18 the standardised prevalence of high or very high psychological distress was 13.0% in Australia and 14.0% in Queensland. The prevalence was stable over time and did not differ between Queensland and Australia.¹⁰

Demographic differences

Psychological distress is consistently higher among females compared to males. Across all available surveys, the odds of reporting high or very high psychological distress was 50% higher in females than males.¹¹

In 2017–18, the standardised prevalence of high or very high psychological distress was higher in females in each age group:

• 18 to 24: 1.4 times higher (22.1% in females compared to 15.3% in males)
• for all other age groups: 1.3 times higher in females compared to males.¹¹

While females had a higher standardised prevalence of psychological distress, the rate of increase was similar between males and females for most age groups. Rates were stable over the period for both.

Remoteness and sociodemographic differences

Regional differences are assessed using area-based measures of remoteness¹² and the index of relative socioeconomic disadvantage.¹³

In 2017–18, adults in the most disadvantaged areas reported higher levels of psychological distress. The standardised prevalence of high or very high levels of psychological distress was:

• Australia: 2.5 times higher for those in the most disadvantaged areas compared to the least disadvantaged areas (20.5% compared to 8.3%, respectively)
• Queensland: 1.5 times higher for those in the most disadvantaged areas compared to the least disadvantaged areas (19.6% compared to 12.7%, respectively).¹⁴

International comparison

Globally, standardised rates of mental disorder burden were largely consistent between 1990 and 2019. Mental disorders are among the top ten leading causes of years of healthy life lost.¹⁵

In 2019, Australia had the highest standardised rate of healthy years of life lost due to mental disorders among high-income countries (2,399.5 per 100,000 persons). For comparison, New Zealand ranked 3rd (2,354.3 per 100,000 persons) and the United States ranked 9th (2,137.7 per 100,000 persons).¹⁵

Mental health, mental disorders and the COVID-19 pandemic

The effect of the COVID-19 pandemic on mental health in Australia is unclear. From early in the pandemic there were concerns that the virus itself, as well as the measures put in place to limit community spread, may negatively impact mental health.⁶ The AIHW reported a rise in the use of mental health services throughout the pandemic in 2020 and 2021.¹⁶ While young Australians (12 to 24 years) and females are experiencing higher levels of psychological distress,¹⁷ this pre-dates the COVID-19 pandemic. While larger population studies have not indicated a consistent relationship between mental health and the COVID-19 pandemic, effects have been shown in some areas and among more vulnerable groups such as those living in lower income households.⁶ A review of the wider mental health impacts of the COVID-19 pandemic is beyond the scope of this report.

Additional information

Data and statistics

More mental health information is available from the Australian Institute of Health and Welfare:

• Prevalence and impact of mental illness
• Australia’s mental health services
• Interactive data on disease burden from the Australian burden of disease study
• Mental health performance indicators
• Mental health expenditure

Strategies and general information

Mental health and wellbeing information from the Queensland Government is available from: Your Mental Wellbeing initiative

• Counselling and support services from Help lines, counselling and support groups
• Queensland Alcohol and other Drug Treatment Service Delivery Framework - QNADA

Section technical notes

Where presented, ratios were calculated using higher precision estimates than in text. Ratios calculated using estimates in text may differ.

Dementia and Alzheimer’s disease are included in burden of disease and expenditure reporting of mental health sourced from the Australian Institute of Health and Welfare.

Information has been derived from the National Health Survey (NHS) and The National Study of Mental Health and Wellbeing (NSMHWB), which determine mental disorders and level of psychological distress based on self-reported responses to validated questionnaires.

Information on long term mental health conditions collected as a component of the National Health Survey in 2014­–15 and 2017–18, was obtained through a Mental Health, Behavioural and Cognitive Conditions module, while in the previous years it was collected in the Other Long Term Conditions model.¹⁸

NHS and NSMHWB do not collect data in very remote areas; The outer regional category includes remote areas.

Age-standardised rates sourced from the Australian Government Productivity Commission were standardised to the Australian population as at 30 June 2001.

Age-standardised rates reported by Enticott et al. were directly age-standardised against the Australian population as at 30 June 2001. “When not stratified by age, data were directly age-standardized against the estimated resident population of Australia as at 30 June 2001. Using this direct age-adjustment approach, the 2001 age-structured population is used as the reference and each survey round is weighted to match this.”¹¹ This means that standardised rates will vary from those reported elsewhere.

References

1. World Health Organization. 2022. Mental health: strengthening our response. Accessed: 14 February 2023.
2. Queensland Government. 2020. Your mental wellbeing.
3. Australian Institute of Health and Welfare. 2022. Australian burden of disease study 2022. Accessed: 11 January 2023.
4. Australian Institute of Health and Welfare. 2022. Disease expenditure in Australia 2019-20. Accessed: 20 December 2022.
5. Council of Australian Government. 2017. The fifth national mental health and suicide prevention plan.
6. Australian Institute of Health and Welfare. 2022. Mental health: prevalence and impact. Accessed: 30 November 2022.
7. Australian Bureau of Statistics. 2022. National study of mental health and wellbeing. Accessed: 14 February 2023.
8. Australian Bureau of Statistics. 2018. National health survey: first results, 2017-18. Accessed: 1 February 2023.
9. Kessler R. C., Andrews G., Colpe L. J., Hiripi E., Mroczek D. K., Normand S.-L. T., Walters E. E. & Zaslavsky A. M. 2002. Short screening scales to monitor population prevalences and trends in non-specific psychological distress. Psychological Medicine. 32(6): 959–976. doi: 10.1017/S0033291702006074.
10. Australian Government Productivity Commission. 2022. Report on government services 2022. Services for mental health. Accessed: 14 February 2023.
11. Enticott J., Dawadi S., Shawyer F., Inder B., Fossey E., Teede H., Rosenberg S., Ozols AM I. & Meadows G. 2022. Mental health in Australia: psychological distress reported in six consecutive cross-sectional national surveys from 2001 to 2018. Frontiers in Psychiatry. 13: 815904. doi: 10.3389/fpsyt.2022.815904.
12. Hugo Centre for Population and Migration Studies. 2018. Accessibility/remoteness index of Australia (ARIA). Accessibility/Remoteness Index of Australia (ARIA). Accessed: 1 October 2022.
13. Australian Bureau of Statistics. 2018. Socio-economic indexes for areas (SEIFA) 2016. 2033.0.55.001 - Census of Population and Housing: Socio-Economic Indexes for Areas (SEIFA), Australia, 2016. Accessed: 1 October 2022.
14. Australian Government Productivity Commission. 2022. Report on government services 2022. Services for mental health. Accessed: 14 February 2023.
15. GBD 2019 Mental Disorders Collaborators. 2022. Global, regional, and national burden of 12 mental disorders in 204 countries and territories, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019. The Lancet. Psychiatry. 9(2): 137–150. doi: 10.1016/S2215-0366(21)00395-3.
16. Australian Institute of Health and Welfare. 2023. Suicide and self-harm monitoring: the use of mental health services, psychological distress, loneliness, suicide, ambulance attendances and COVID-19. Accessed: 15 February 2023.
17. National Mental Health Commission. 2022. Monitoring mental health and suicide prevention reform: national report 2021. Sydney, NSW: NHMRC.
18. Australian Bureau of Statistics. 2018. National health survey: first results, 2017-18. Accessed: 1 February 2023.