Community mental health care NMDS 2021–22: National Community Mental Health Care Database, 2023; Quality Statement
Data Quality Statement Attributes
Identifying and definitional attributes | |
Metadata item type: | Data Quality Statement |
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METEOR identifier: | 780645 |
Registration status: | AIHW Data Quality Statements, Standard 08/12/2023 |
Data quality | |
Data quality statement summary: |
Description The NCMHCD contains data on community (also sometimes termed "ambulatory") mental health service contacts provided by government-funded community mental health care services as specified by the Community mental health care (CMHC) National Minimum Data Set (NMDS). The NCMHCD includes data for each year from 2000–01 to 2021–22. The NCMHCD includes information relating to each individual service contact provided by an in-scope mental health service. Examples of data elements included in the collection are demographic characteristics of patients, such as age and sex, clinical information, such as principal diagnosis and mental health legal status, and service provision information, such as contact duration and session type. The CMHC NMDS is associated with the Mental Health Establishments (MHE) NMDS, which is used to collect data about the services that provide service contacts. |
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Institutional environment: | The Australian Institute of Health and Welfare (AIHW) is an independent corporate Commonwealth entity under the Australian Institute of Health and Welfare Act 1987 (AIHW Act), governed by a management board, and accountable to the Australian Parliament through the Health portfolio. The AIHW is a nationally recognised information management agency. Its purpose is to create authoritative and accessible information and statistics that inform decisions and improve the health and welfare of all Australians. Compliance with the confidentiality requirements in the AIHW Act, the Privacy Principles in the Privacy Act 1988 (Cth), and AIHW's data governance arrangements ensures that the AIHW is well positioned to release information for public benefit while protecting the identity of individuals and organisations. For further information see the AIHW website www.aihw.gov.au/about-us, which includes details about the AIHW's governance (www.aihw.gov.au/about-us/our-governance) and our role and strategic goals (www.aihw.gov.au/about-us/what-we-do).
Community mental health services may be required to provide data to states and territories through a variety of administrative arrangements, contractual requirements or legislation. States and territories use these data for service planning, monitoring and internal and public reporting. In addition, state and territory health authorities supply data for the NCMHCD under the terms of the National Health Information Agreement, as specified by the CMHC NMDS. Expenditure and resource information for community mental health services reporting to the NCMHCD are reported through the associated MHE NMDS. |
Timeliness: | Data for the NCMHCD were first collected in 2000–01. States and territories are required to supply data annually in accordance with the CMHC NMDS specifications. The reference period for this data set is 2021–22, that is, service contacts provided between 1 July 2021 and 30 June 2022. Data for the 2021–22 reference period were supplied to the AIHW at the end of January 2023. The AIHW publishes data from the NCMHCD in Mental health online report annually. |
Accessibility: | The AIHW produces the Mental health online report as an online publication. This includes PDF documents of all sections in the publication, as well as data workbooks and an interactive data portal. |
Interpretability: | Metadata information for the CMHC NMDS is published in the AIHW’s online metadata repository — METEOR. METEOR can be accessed on the AIHW website: Data published annually in the Mental health online report includes caveated information to ensure appropriate interpretation of the analyses presented by the AIHW. Readers are advised to take note of footnotes and caveats specific to individual data tables that influence interpretability of specific data. |
Relevance: | The purpose of the NCMHCD is to collect information on all mental health service contacts provided by community mental health care services, as specified by the CMHC NMDS. The scope for this collection is all government-funded and operated community mental health care services in Australia. A mental health service contact, for the purposes of this collection, is defined as the provision of a clinically significant service by a specialised mental health service provider for patients/clients. There are two exceptions:
Any one patient can have one or more service contacts over the reporting period (that is, 2021–22). Service contacts are not restricted to face-to-face communication, and can include telephone, video link or other forms of direct communication. Service contacts can also be either with the patient or with a third party, such as a carer or family member, or other professional or mental health workers or other service providers. |
Accuracy: | States and territories are primarily responsible for the quality of the data they provide. However, the AIHW undertakes extensive validation on receipt of data. Data are checked for valid values, logical consistency and historical consistency. Potential errors are queried with jurisdictions, and corrections and resubmissions to the data may be made in response to these queries. The AIHW does not adjust data to account for possible data errors or missing or incorrect values. At the time of publication, the Australian Capital Territory was unable to verify the coverage of services and contact data, the quality of Indigenous status data, and edition of ICD-10-AM used for reporting Principal Diagnosis. Therefore, general statements referring to ‘all states and territories’ regarding coverage and data quality do not include the Australian Capital Territory. All states estimate that 85–100% of in-scope community mental health care services provided contact data to the collection. Overall service contact data coverage for jurisdictions was estimated to be between 86–100%.
Indigenous status Data from the NCMHCD on Indigenous status should be interpreted with caution. Jurisdictional advice is that the methodology for Indigenous identification varies. The methodology for the identification of Indigenous status varies both between jurisdictions and between services within a jurisdiction. Subsequently, the identification process may result in a different status being recorded among multiple service contacts or between service providers. Indigenous status is missing for 4.5% of contacts in the 2021–22 NCMHCD. States and territories provided additional information on the quality of the Indigenous status data for 2021–22 as follows:
Remoteness area and socioeconomic status Numerators for remoteness area and socioeconomic status are based on the reported area of usual residence of the patient, regardless of the location or jurisdiction of the service provider. This may be relevant if significant numbers of one jurisdiction’s residents are treated in another jurisdiction. Therefore, comparisons of service contact rates for jurisdictions require consideration of cross-border flows, particularly for the Australian Capital Territory. South Australia noted that technical limitations mean that the area of usual residence for the consumer is based on the consumer’s current address at the time data are reported to the AIHW, rather than when the actual contact was recorded. Mental health legal status Data on involuntary treatment of consumers is collected in the NCMHCD, however the quality of the data is unknown and should be treated with caution. |
Coherence: | Metadata specified in the CMHC NMDS may change from year to year. The following definitional changes occurred to the 2021–22 metadata specifications:
There are variations across jurisdictions in the scope and definition of a service contact. For example, most jurisdictions may include consultation and liaison services as service contacts while some consultation-liaison type services provided by Tasmania are not included. Queensland and the Northern Territory do not include contacts for unregistered clients. Mental health legal status Reporting of service events with a Mental health legal status of involuntary differs from reporting of treatment orders in the community by state and territory Chief Psychiatrists due to differences in statistical unit, collection scope and jurisdictional data systems. Legislation governing the use of treatment orders differs between jurisdictions and comparisons should be made with caution. Principal diagnosis The most recent classification scheme is the 10th Edition of the International Statistical Classification of Diseases and Relate Health Problems, Australian Modification (ICD-10-AM), Eleventh Revision. The quality of Principal diagnosis data in the NCMHCD may be affected by the variability in collection and coding practices across jurisdictions. In particular, there are: 1. Differences in the edition used for classification, as follows:
2. Differences in the availability of appropriately qualified clinicians to assign and record principal diagnoses (diagnoses are generally to be made by psychiatrists, whereas service contacts are mainly provided by non-psychiatrists). 3. Differences according to whether the principal diagnosis is applied to an individual service contact or to a period of care.
4. Differences in the technology for recording principal diagnosis (for example, data systems using short lists may impact the use of specific diagnosis codes, such as F99 Mental disorder, not otherwise specified). Comparability over time Comparability of NCMHCD data over time can be variable. Changes to reporting practices, upgrades to information systems and revisions to data mean comparison between years should be made with caution. For 2019–20, New South Wales reported reduced data coverage due to the introduction of a new system in the Justice Health network. Tasmania experienced industrial action which impacted the 2018–19 and part of the 2019–20 reporting periods. Victoria noted that industrial action in 2020–21 affected the recording of some contacts, with 10% of contacts appearing in two consecutive months. In 2021–22, states and territories provided additional information as follows:
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Data products | |
Implementation start date: | 01/07/2021 |
Source and reference attributes | |
Submitting organisation: | Australian Institute of Health and Welfare |
Steward: | Australian Institute of Health and Welfare |
Relational attributes | |
Related metadata references: | Supersedes Community mental health care NMDS 2020–21: National Community Mental Health Care Database, 2022; Quality Statement AIHW Data Quality Statements, Superseded 08/12/2023 See also Community mental health care NMDS 2021–22 Health, Superseded 17/12/2021 |