Mental Health Establishments NMDS 2020–21: National Mental Health Establishments Database, 2023; Quality Statement
Data Quality Statement Attributes
Identifying and definitional attributes | |
Metadata item type: | Data Quality Statement |
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METEOR identifier: | 764465 |
Registration status: | AIHW Data Quality Statements, Superseded 14/02/2024 |
Data quality | |
Data quality statement summary: | Description The National Mental Health Establishments Database (NMHED) contains data on specialised mental health care services managed or funded by state or territory health authorities in Australia. The NMHED is specified by the Mental Health Establishments (MHE) National Minimum Data Set (NMDS) (see link). The NMHED includes data from 1992–93 to 2020–21. Since 2005–06 data have been compiled as specified by the MHE NMDS. Prior to this (1992–92 to 2004–05), data were collected through the National Survey of Mental Health Services, managed by the Australian Government Department of Health and Aged Care, and the Community Mental Health Establishments NMDS. The NMHED includes information on the characteristics of specialised mental health services (for example, program type and target populations) and summary information on their expenditure, staffing and activity (for example, patient days, available beds, separations, service contacts and episodes). The MHE NMDS is associated with the Community Mental Health Care NMDS, Residential Mental Health Care NMDS, Admitted Patient NMDS and the Mental Health National Outcomes and Casemix Collection, which are used to collect data about clients and care provided by specialised mental health services. Summary of key issues
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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/our-vision-and-strategic-goals). Mental health services may be required to provide data to state and territory health authorities 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 NMHED under the terms of the National Health Information Agreement, as specified by the MHE NMDS (see ‘Interpretability’ section below). The services that report to MHE NMDS may also report client level data in accordance with the Community Mental Health Care NMDS (METeOR ID 722221), Residential Mental Health Care NMDS (METeOR ID 722224), Admitted Patient Care Care NMDS (METeOR ID 713850) and Mental Health National Outcomes and Casemix Collection. |
Timeliness: | States and territories are required to supply data annually in accordance with the MHE NMDS specifications. The reference period for this data set is 2020–21, that is, services that were operational between 1 July 2020 and 30 June 2021, or part thereof. Data for the 2019–20 reference period were first supplied to the AIHW in April (Tas, Qld, NT, WA), May (Vic, NSW, SA), and July (ACT) 2021. The AIHW publishes data from the NMHED in its online product Mental health services in Australia annually. |
Accessibility: | The AIHW produces the annual series Mental health services in Australia, primarily as an online publication at https://www.aihw.gov.au/mhsa. 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 MHE NMDS is published in the AIHW’s online metadata repository—METEOR. METEOR can be accessed on the AIHW website: Data published annually in Mental health services in Australia include additional important caveat 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 NMHED is to collect national data to provide a system-wide view of all specialised mental health services, managed or funded by state or territory health authorities. Specialised psychiatric care (and associated costs) provided to patients admitted to wards/units that are not specialised public mental health inpatient units is not in scope. Coverage of specialised mental health services, managed or funded by state and territory health authorities, is considered complete by states and territories, subject to any specific caveats in the Coherence section. |
Accuracy: | States and territories are primarily responsible for the quality of the data they provide. The AIHW undertakes extensive validation after files are submitted for review. Validation is conducted in two stages: (1) The compliance stage is managed by the AIHW and is concerned with ensuring that the file is structurally compliant. (2) The data validation stage is managed by the AIHW and is primarily concerned with identifying and explaining or fixing inconsistent, anomalous, and exceptional issues, including invalid values, missing data and historical inconsistency. Although there are national standards for the reporting of mental health services data, differences in financial accounting, counting and classification practices may affect the comparability of these data. Data are subject to ongoing historical validation. Due to this ongoing validation, published 2005–06 to 2020–21 data could differ from previously published data. New South Wales 2018–19 FTE figures are under-reported for NSW due to data on FTE staffing not being provided by the Northern Beaches Hospital. This is a new, privately-operated hospital that provides public mental health services under a public-private partnership agreement with NSW Health. The hospital opened in late October 2018. Northern Territory Domestic staffing FTE figures are routinely unavailable for the Northern Territory. |
Coherence: | Data are reported for each year from 1992–93 to 2020–21. Data should be consistent across most jurisdictions and across years within most jurisdictions, with the following exceptions. Impact of the COVID-19 pandemic Since 2020, the COVID-19 pandemic has affected the delivery of care in health systems and health expenditure. The approach to the reporting of pandemic-related expenditure differed between jurisdictions. For example, some jurisdictions have included the expenditure for COVID screening measures, COVID tests for staff and patients, and the purchase of Personal Protective Equipment and other consumables in the reporting to NMHED, while for others, these costs were not allocated into health portfolios. Restrictions on movement and social distancing requirements may have also had an impact on expenditure, particularly in 2020–21. Caution should be exercised when making jurisdictional comparisons and time series analysis that include the 2020–21 period. Youth admitted beds Prior to 2014–15, Youth beds were aggregated into the General category, due to small numbers. From 2014–15 these beds have been reported separately. Patient days, and patient day costs relating to Youth units are aggregated into the General category, for all years. Admitted patient cost per bed day comparisons Costs per inpatient bed day by target population and program type may not be comparable across jurisdictions. Classification of expenditure into target populations and program type is based on the classification of services in accordance with the MHE NMDS rather than the characteristics of their patient populations. For a service to be classified as providing a Child and adolescent, Youth, Older persons’ or Forensic mental health service for example, it must be recognised by the relevant state or territory funding authority as having a corresponding specialised function and is specifically funded to provide such specialty services. It is likely that the cost per patient day for General services in a jurisdiction that has separate Child and adolescent and Older persons services (for example, New South Wales and Victoria), may not be comparable to the average cost in a jurisdiction that has General services only (for example, Northern Territory). Residential service beds Beds for Child and adolescent and Forensic units are reported separately. Patient days for these services are rolled up into the General category for all years. In Western Australian data, several residential services reported as 24-hour staffed services in 2009–10 transitioned to a non-24-hour staffed model of care as of 1 July 2010. In addition, data prior to 2010–11 include a small number of emergency department observation beds in one hospital. In 2014–15, Tasmania reclassified 27 non-acute admitted beds to residential beds, reflecting a change in function of the unit. Full-time-equivalent (FTE) staffing Data collected for specific professional categories are only available from 1994–95. Data prior to 2005–06 may exclude small numbers of staff employed by specialised mental health service organisations. In 2012–13, the Organisational overhead setting was introduced. The category includes FTE staff not directly involved in the delivery of patient care services in the admitted patient, residential or community mental health care service settings, or in the operations of those settings. This does not imply that these roles do not have an impact on service delivery. The introduction of this new category may have resulted in an observed decreased FTE in the other service setting categories for some jurisdictions and may not have been consistently applied both within and between jurisdictions. FTE data for a small number of residential services reported as Child and adolescent by New South Wales and the Australian Capital Territory; Forensic by Victoria, South Australia, and Northern Territory; and Youth by Victoria Western Australia and the Australian Capital Territory, were included in the General category at the request of those jurisdictions. Aboriginal and Torres Strait Islander Mental Health Workers was added as a new staffing category in 2020–21. Queensland previously reported this FTE under Other Personal Care FTE. New South Wales, Western Australia and South Australia previously reported Aboriginal and Torres Strait Islander Mental Health Worker FTE under the Other Diagnostic and Health Professionals staffing category. Prior to and in 2020-21, Western Australia captured Aboriginal and Torres Strait Islander Mental Health Workers FTE as part of the Diagnostic and allied health professionals staffing category at the setting level. Primary Health Network (PHN)-funded state managed services PHN funded state managed mental health services are reported in the Community Mental Health Care (CMHC) and MHE NMDSs by Victoria and South Australia; Western Australia reports these services in CMHC only. Other states and territories do not currently report on these services to either NMDS. National Mental Health Service Standards accreditation Services for several jurisdictions were assessed under service accreditation standards that differ from the National Standards for Mental Health Services (NSMHS) as specified in the MHE NMDS.
New South Wales In 2020–21, changes in reporting methodology have resulted in an increase in Consumer Workers FTE in New South Wales. Victoria For Victoria, 70% of the expenditure reported by Prevention and Recovery Care (PARC) units were deemed to be Non-Government Organisation expenditure, contrasting with data presented in the Facilities section, where beds, mental health care days, etc. were shown as government operated services. Data between November 2020 and November 2021 may have been affected by protected industrial activity, impacting the collection of non-clinical and administrative data and recording of ambulatory mental health service activity and consumer outcome measures. Affected data reported during this period should be interpreted with caution. Queensland Long term analysis of admitted and residential services in Queensland must take the following reporting changes into consideration:
Queensland provides Older persons’ mental health inpatient services using a number of different service models; however, the majority of Older persons’ acute care is reported through General units, which limits comparability with jurisdictions that report these services differently. Queensland does not report any Forensic services; however, forensic patients can and do access acute care through General units. In 2013–14, a review of services resulting in the reclassification of beds from non-acute Older persons admitted services to non-mental health care. From 2018–19 onwards, the number of supported housing places reported by Queensland reflects changes resulting from the transition of clients to the National Disability Insurance Scheme (NDIS). Western Australia A review of services resulted in the reclassification of beds between the acute and non-acute categories for the 2010–11 collection to more accurately reflect the function of these services. FTE staff data has been unavailable for one service in Western Australia since 2015–16, impacting time series staffing figures. Direct care FTE staff for the service are estimated to be about 70 FTE in 2015–16, about 120 FTE in 2016–17, and about 125 FTE in 2017–18 to 2020–21. Comparisons between staffing and expenditure should be made with caution. South Australia In 2019–20, South Australia advised that the decrease in non-24 hour, non-government organisation operated residential mental health care beds are related to the transition to these beds to funding under the NDIS, which are considered out-of-scope for reporting to the MHE NMDS. Australian Capital Territory (ACT) In 2016–17, ACT advised that a number of non-24 hour residential services are now funded under the NDIS, which ACT now consider out-of-scope for reporting to the MHE NMDS. This has resulted in a significant reduction in non-24 hours staffed residential beds (from 45 to 5), and small decreases in patient days and residential FTE. Therefore, time-series comparisons and comparisons between jurisdictions should be made with caution. From 2017–18 the ACT made a number of changes to its supported housing program resulting in the jurisdiction reporting zero places. This number may be revised or increased in the future. Northern Territory In 2019–20, the Northern Territory advised that the decrease in residential expenditure is due to the gradual transition of clients to NDIS funding. In 2020–21, a residential service in the Northern Territory transitioned to PHN funding, resulting in a decrease in Other personal care FTE for residential mental health care services. |
Data products | |
Implementation start date: | 01/07/2020 |
Source and reference attributes | |
Submitting organisation: | Australian Institute of Health and Welfare |
Relational attributes | |
Related metadata references: | Supersedes Mental Health Establishments NMDS 2019–20: National Mental Health Establishments Database, 2022; Quality Statement AIHW Data Quality Statements, Superseded 28/03/2023 Has been superseded by Mental Health Establishments NMDS 2021–22: National Mental Health Establishments Database, 2024; Quality Statement AIHW Data Quality Statements, Standard 14/02/2024 See also Mental health establishments NMDS 2020–21 Health, Superseded 20/01/2021 |