An accurate estimate of the community's need for mental health care was recognised as critical to planning services, allocating resources and evaluating the overall effectiveness of the Strategy. Estimates made prior to the Strategy pointed to a substantial level of unmet need. However, these estimates were based on a small number of local studies and overseas evidence. A more direct measure was deemed to be required as a base for future planning.
Commencing in 1995, a specific population study was planned to gauge the level of need. Known as the National Survey of Mental Health and Wellbeing, the study was the first major survey of the Australian population aimed at gathering direct measures of mental disorders in Australia. The survey sought to:
- estimate the prevalence of the main categories of mental disorder and of significant psychological symptoms in the Australian population;
- determine the amount of disablement associated with those disorders; and
- determine service utilisation by persons with mental disorders, including an estimation of unmet need.
The adult survey, conducted by the Australian Bureau of Statistics in 1997, highlighted significant unmet need:
- almost one in five (18%) of Australians experienced a mental disorder at some time in the twelve months prior to the survey; and
- of these, only 38% used a health service over the same period, with about half of this group seeing a mental health professional.
The low prevalence survey was conducted by the University of Western Australia in 1998. The study examined specified catchment areas in four jurisdictions and provided estimates of one-month and one year prevalence of severe mental illness in the community. The study also assessed the personal and social circumstances and the extent of service utilisation of persons with a 'low-prevalence' mental illness. Results highlighted the extensive disability experienced by people affected by such disorders. Despite the fact that specialist mental health services were targeting this group as a priority for treatment and care, the survey found that the health and disability-related needs of many people with a psychotic illness remained unmet.
Overall, the National Survey of Mental Health and Wellbeing was instrumental in highlighting that potential demand for mental health care is high. In particular, it has highlighted the need to take a broader 'whole of community' approach to mental health than was envisaged when the Strategy was drafted in the early 1990s and raised the priority assigned to the Strategy's promotion and prevention themes.