4.8.1 RationaleA population health approach is important across all areas of activity in mental health and all key themes of the National Mental Health Plan 2003-2008. The National Survey of Mental Health and Wellbeing, conducted during 1997 and 1998, provided the first comprehensive source of information on the distribution and type of mental health problems in the Australian population. The work produced vital information about population mental health needs that has guided the planning and development of many new initiatives under the Strategy.
The 1997-98 surveys set the baseline but regular surveillance will be needed to assess changes over time, and provide current information about mental health needs and service utilisation in the community that can inform future policy and planning. Refinements in surveying methodology are also needed to identify common risk factors that may act as determinants of mental health and wellbeing.
Several developments in population surveying have added to Australia's capacity to monitor mental health trends in the community:
- The Australian Bureau of Statistics has incorporated a mental health component in its general National Health Survey. The survey, conducted at three-yearly intervals, now includes a brief measure of psychological distress (the Kessler 1028). This is also used in similar population surveys in Canada and the United States, and enables time series information on the adult population.
- A number of individual States and Territories have established their own population health surveillance approaches, based on the Computer Assisted Telephone Interview (CATI) method, that complement information derived from national surveys. The Kessler 10 measure has been included in New South Wales, Western Australia and South Australia and has potential to be used in others. Possible approaches to national pooling of data are being progressed through the National Public Health Information Working Group.
- The Australian Bureau of Statistics Indigenous Health Survey, undertaken over 2004-05, incorporates aspects of social and emotional wellbeing that recognises the importance of including mental health in understanding the health status of Indigenous Australians.
From the perspective of national information priorities, the main tasks ahead are to develop a coordinating framework that:
- makes best use of the opportunities created by existing national and state-level general health population surveys to ensure that a basic mental health screening measure is included; and
- resolves how often these general collections should be supplemented by further specific national surveys of population mental health.
4.8.2 Consolidation activities
Continuation of a mental health component in general and specialist National Health SurveysAction will be taken to maintain and build on the mental health component of the National Health Survey and Indigenous Health Survey conducted by the Australian Bureau of Statistics. This will give basic time series information on population mental health status and risk factors.
4.8.3 New initiatives
Strategic framework for population mental health surveillanceA strategy will be developed in consultation with stakeholders that maps out a coordinated and long term approach to the monitoring of population mental health and encompasses national and state-level surveying approaches. Particular attention will be given to opportunities for linkage and common methodologies between related surveys conducted by individual States and Territories, the Australian Bureau of Statistics and the Australian Institute of Health and Welfare. Ongoing collaboration will be pursued through the National Public Health Partnerships to develop a common agenda between mental health and public/population health.
Further national survey of mental health and wellbeingAs a component of this overall strategic framework, planning will be undertaken to conduct a second specialist epidemiological survey of mental health and wellbeing. Specific mental health surveys aim to add detail on risk factors, chronicity and service utilisation that are not possible through general surveys. The future survey will take account of the learnings from the 1997 survey and more recent international work as well as take into consideration how to best address specific age groups and sub populations. It is expected that the survey will be conducted approximately 10 years following the original 1997 survey, to give timely information that will guide the priorities for the National Mental Health Strategy beyond the current National Mental Health Plan.
28 Kessler RC, Andrews G, Colpe LJ, Hiripi E, Mroczek DK, Normand S-LT, Walters EE and Zaslavsky A (2002). Short screening scales to monitor population prevalences and trends in nonspecific psychological distress. Psychological Medicine, 32(6): 959-976.