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Low-income earners more likely to use emergency mental health services

By Kenneth Young | 22 May 2019
5 min read

Mental illness affects people from many walks of life, with 4.2 million Australians receiving prescriptions to treat mental health conditions in 2017-18.[1] However, a recent report from the Australian Institute of Health and Welfare (AIHW) suggests that people in lower income areas run a higher risk of emergency hospitalisation due to mental illness.

Measured in five segments – from most to least disadvantaged – the data shows that emergency department presentations for mental health issues were almost double for the most disadvantaged people (139.9 per 10,000) compared to those who were least disadvantaged (76.3 per 10,000).[1] What’s more, the report illustrates how the number of visits gradually decreases the higher someone’s socioeconomic standing is.

Australians needing these services may also be surprised by emergency transportation fees. A study commissioned by Compare the Market found that almost half (49%) of the 1,500 respondents surveyed thought ambulance rides were free.[2]

While this is the case in states like Queensland and Tasmania, Australians living in other states and territories can pay more than $900 for their emergency transportation.[2]

Overall, mental health-related presentations made up 3.6% of all emergency department instances in Australia in 2017-18.[1]

Although socioeconomic influences may play a significant role in mental health emergency hospitalisations, it isn’t the only cultural factor. Let’s have a look at other contributing aspects to mental health-related emergency presentations in 2017-18 (as per the AIHW report).

Emergency mental health services for Indigenous Australians

The AIHW study suggests that Australians of Aboriginal and Torres Strait Island descent are also more likely to visit the emergency department for mental health issues. In fact, per 10,000 people, Indigenous Australians (455.9) were four times more likely to need emergency health services than other Australians (106.8) in 2017-18.[1]

There are several mental health resources specific to the Aboriginal and Torres Strait Islander community, which are accessible through Beyond Blue.

Major cities vs remote areas

Another significant contributor to mental health hospitalisations was the patient’s location. While Australians living in major cities made up almost two in three mental health-related visits to the emergency department, people in areas characterised as “remote” or “very remote” were more likely to need emergency care. For every 10,000 people, Aussies in remote or very remote areas (203.6) required twice as many emergency department visits for mental illness as their major city counterparts (101.3).[1]

The most common mental illnesses

In 2018, one of the main concerns for GPs in Australia was drug addiction – and it’s not hard to see why. More than one in four (27.2%) cases of emergency visits for mental health in 2017-18 were related to substance abuse.[1]

The AIHW has previously found links between alcohol and drug consumption and mental illness. According to the Alcohol, tobacco and other drugs in Australia report, regular smokers were two times more likely to need treatment for a mental health disorder, while those who drank more than four standard drinks per day were also at a higher risk of psychological distress.[3]

Stress-related disorders such as anxiety saw a similar percentage in terms of emergency department instances (26.2%), while schizotypal and delusional illnesses (11.6%) and mood disorders (11%) also made up a significant portion of mental health-related hospital visits.

Anxiety, in particular, is a condition many Australians have struggled to get medical treatment for. In a survey conducted in 2017, Beyond Blue found that over a third (37%) of participants experienced anxiety symptoms for more than 12 months before seeking help.[4]

How to get help through the Better Access to Mental Care initiative

Patient consulting with their GP.

Although the AIHW study suggests that people from lower socioeconomic backgrounds are more likely to need emergency care for mental illness, anyone with a Medicare card can access mental health treatment to help prevent these instances. In fact, around 10.2% of Australians used these services in 2017-18.[1]

Australians diagnosed with mental health disorders can receive Medicare rebates for up to 10 individual or group sessions with allied mental health professionals every year.[5] This is known as the Better Access to Mental Care initiative. Conditions that are treatable under this scheme include issues with alcohol, anxiety, depression, eating disorders and other problems that can significantly affect a patient’s mental wellbeing.[6]

To access this service, Australians need to visit a GP, who will determine if a patient has a mental disorder that requires specialist treatment. From there, the doctor may develop a GP Mental Health Treatment Plan or refer the patient to a psychiatrist who can either run further assessments or devise a management plan of their own.

Initially, doctors can refer patients for six allied mental health services (individual or group), but if more specialist consultations are required, GPs may refer their patients for an additional four services in the calendar year.

Mental health services through hospital insurance

Hospital psychiatric services are available in every hospital policy, and the health insurance reforms that began their rollout in 2018 won’t change that requirement. This is usually in the form of restricted (partial) or unrestricted (full) cover.

However, under the tiered system, policies labelled “Gold” must include unrestricted cover for these mental health services to comply with the new regulations.

The hospital psychiatric services category includes cover for patients who require treatment for mental and behavioural conditions, along with eating disorders, addiction and various other ailments.

For more information on these costs, read our eight tips that can save you on mental health services.

If you or someone you know are struggling with mental health issues, visit Beyond Blue or Lifeline for additional help and resources.

Sources

[1] Australian Institute of Health and Welfare. Mental health services in Australia.

[2] Compare the Market. The most expensive taxi they’ll ever take: Aussies ignorant about ambulance costs.

[3] Australian Institute of Health and Welfare. Alcohol, tobacco & other drugs in Australia.

[4] Beyond Blue. Can you name the most common mental health issue in Australia?

[5] The Department of Health. Better access to mental health care: fact sheet for patients.

[6] Australian Psychological Society. Better Access to Mental Health Care: Medicare funded services.

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Written by Kenneth Young

Known in the writing team as "that guy who likes pineapple on pizza", Kenneth prides himself on being a little different. He studied Creative and Professional Writing and Marketing at QUT and enjoys watching live music of most varieties, playing video games and can talk for hours about basketball.

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