It was clear at the outset of the National Mental Health Strategy that the structure and content of existing national health data did not provide the framework to guide data collection at the mental health service delivery level, nor to build a national picture of services and the consumers of those services. Little quantitative data were available to answer the question of '...who receives what services from whom'.
The main contributing factor was the isolation of mental health service delivery from mainstream health care. The emphasis on developing data standards and investments in information infrastructure that occurred in the acute health sector over the ten years preceding the Strategy largely bypassed mental health services. A critical step for the future was to translate the Strategy's emphasis on 'mainstreaming' to the information aspects of mental health reform and to ensure that any new developments were both tested and incorporated within the broader health information environment.
Consequently, an early priority agreed by all the jurisdictions was the development of a consistent set of data definitions and the establishment of national collections of agreed minimum datasets. Responsibility for this work has been carried by the Australian Institute of Health and Welfare, advised by the Information Strategy Committee of the AHMAC National Mental Health Working Group. Through its national role in health information management, the Institute was best placed to coordinate the development and implementation of mental health collections across both hospital and community settings.
Three 'patient level' national collections have been implemented that cover mental health care provided in hospitals, residential settings and the community:
- National Minimum Data Set – Admitted Patient Mental Health Care collects information at the national level on consumers admitted to public and private psychiatric hospitals or in designated psychiatric units in general hospitals. Commenced in 1996-97, the collection provides information on approximately 110,000 treatment episodes per year.
- National Minimum Data Set – Residential Mental Health Care reports on the care provided to consumers admitted to government-operated, 24-hour staffed residential units. This is a new collection, commencing in 2004-05.
- National Minimum Data Set – Community Mental Health Care is designed to collect information on the services provided by public sector mental health services to consumers who are living in the community, external to hospital and residential settings. Commenced in 2000-01, the collection gathers information on an estimated 5 million service contacts provided to approximately 300,000 consumers. It is the largest (and one of few) patient-level collections of community-based care in the Australian health system.
Together, the mental health national minimum data sets have advanced our understanding of mental health service delivery in Australia and established the building blocks for further work. Results from each collection are reported annually by the Australian Institute of Health and Welfare in its publication Mental Health Services in Australia.8