Coverage/Scope:

State/territory public specialised mental health services.

Methodology:

Reference period for 2020 performance reporting: 2018–19

• Tracking the client's service use back from the date of first contact in the reference period should be calculated as the 5 years preceding the date of first contact rather than on a calendar or financial year basis.
• Client counts should be unique at the state/territory level.

Requires a count of individuals receiving services provided by state/territory mental health services within the reference period. The preferred standard for reporting this data is for person counts to be based on unique enumeration of individuals receiving care within the year. That is, consumers who received services in the reference period in more than one service setting, or by more than one specialised mental health service organisation, should only be counted once.  However, in developing specifications for this indicator, it has been recognised that states and territories vary significantly in the extent to which persons can be counted uniquely at the jurisdiction level, the details of which are explored in the data quality statement for this indicator.

No additional service utilisation thresholds have been set for this indicator.  This approach has been taken to allow:

• ‘assessment only’ cases to be included (i.e. individuals receiving only one service contact) because these are a regarded as a significant and valid service provided by specialist mental health services; and
• all service contacts to be included in defining whether a person receives a service, including those delivered ‘on behalf’ of the consumer i.e. where the consumer does not directly participate.  This approach has been taken to ensure that the role of state and territory mental health services in providing back up as tertiary specialist services to other health providers is recognised.

(Numerator ÷ Denominator) x 100

Number of new consumers who received services from state/territory public specialised mental health services within the reference period.

Number of individuals recorded on jurisdictional mental health information systems as receiving one or more service events from state/territory public mental health services (including admitted patient, ambulatory and residential services) within the reference period.

Service variables: nil.

Consumer attributes: age, sex, Socio-Economic Indexes for Areas (SEIFA) decile, remoteness area, Indigenous status.

Disaggregated data excludes missing or not reported data.

All disaggregated data are to be calculated as at the first service event for the reporting period, that is, any in-scope admission, residential episode or service contact, even if an ongoing event is underway at the start of the reporting period. In cases where a null value is returned, the first valid result is to be used.

N[NN].N

State/territory level

This indicator cannot be accurately constructed using the mental health National minimum data sets because they do not include unique patient identifiers that allow links across data sets and financial reporting years.

There is no proxy solution available. Construction of this indicator at a national level requires separate indicator data to be provided individually by states and territories.

Development of state-wide unique patient identifiers within all mental health NMDSs is needed to improve this capacity.

• This indicator presents complexities at the analysis stage. For example, there are several approaches to defining ‘new client’ that depend on how the following issues are resolved:
  * Level of the mental health system at which ‘newness’ is defined—consumers new to a particular organisation may be existing consumers of other organisations. Counts of new consumers at the state/territory level would certainly yield lower estimates than those derived from organisation-level counts.
  * Diagnosis criteria for defining ‘newness’—a consumer may present with a new condition, although they have received previous treatment for a different condition.
• To date, the approach has been to specify an initial measure for implementation with a view to further refinement following detailed work to address the complexities associated with the definition of a new clients and the possible implementation of unique state-wide patient identifiers within all jurisdictions.
• This work does not take into account the activities of private mental health services, primary mental health care or the specialist private mental health sector.

When data for this indicator are requested, jurisdictions are required to answer whether a state-wide unique client identifier system is in place, or some comparable approach has been used in the data analysis to allow tracking of service utilisation by an individual consumer across all public specialised mental health services in the jurisdiction. Collection of this information is aimed at assessing the degree of consistency between jurisdictions in data reported, the result of which are explored in the data quality statement.

Australian Institute of Health and Welfare on behalf of the National Mental Health Performance Subcommittee

National Mental Health Performance Subcommittee (NMHPSC) 2013. Key Performance Indicators for Australian Public Mental Health Services, 3rd edn. Canberra: NMHPSC.