Search

The Australian mental health system is weathering a deep crisis that places us at a critical juncture. The decisions to be made in the coming months could have adverse impact for decades. The Allison et al. (2020) paper tackles two critical issues in this process, though largely based on arguable premises: (a) the number of psychiatric hospital beds needed, and (b) the role of the National Mental Health Services Planning Framework (NMHSPF) as a planning tool for the public resourcing of mental health services. Local estimates based on the Atlases of Integrated Mental Health Care (Romero-López-Alberca et al., 2019) partially support Allison’s claim. The number of acute beds in Western Europe is broadly similar to that in Australia, but the number of subacute and non-acute hospital beds and the number of community residential beds are fewer in Australia. However, there is a substantial difference between stating that ‘the total availability of non-acute psychiatric beds in Australia is lower than in country “X”’, and inferring from this that ‘psychiatric non-acute beds should be increased by N% in the health district “Y”’. Such national figures provide no useful indication of a local mental health system’s need for hospital beds or effective community alternatives.

Objective: Access to services and workforce shortages are major challenges in rural areas worldwide. In order to improve access to mental health care, it is imperative to understand what services are available, what their capacity is and where existing funds might be spent to increase availability and accessibility. The aim of this study is to investigate mental health service provision in a selection of rural and remote areas across Australia by analysing service availability, placement capacity and diversity. Method: This research studies the health regions of Western New South Wales and Country Western Australia and their nine health areas. Service provision was analysed using the DESDE-LTC system for long-term care service description and classification that allows international comparison. Rates per 100,000 inhabitants were calculated to compare the care availability and placement capacity for children and adolescents, adults and older adults. Results: The lowest diversity was found in northern Western Australia. Overall, Western New South Wales had a higher availability of non-acute outpatient services for adults, but hardly any acute outpatient services. In Country Western Australia, substantially fewer non-acute outpatient services were found, while acute services were much more common. Acute inpatient care services were more common in Western New South Wales, while sub-acute inpatient services and non-acute day care services were only found in Western New South Wales.Conclusion: The number and span of services in the two regions showed discrepancies both within and between regions, raising issues on the equity of access to mental health care in Australia. The standard description of the local pattern of rural mental health care and its comparison across jurisdictions is critical for evidence-informed policy planning and resource allocation