Who uses mental health services in Australia? An analysis of data from the National Survey of Mental Health and Wellbeing

Objective: This study sought to identify sociodemographic and psychological measures associated with utilisation of mental health services in Australia, using information collected through the 1997 National Survey of Mental Health and Wellbeing. Method: Twenty-one potential predictor variables were selected from the National Survey. Predisposing and enabling factors included age, sex, marital status, labour force status, geographical location and level of education. Predictor variables measuring need for services included the General Health Questionnaire score, a neuroticism scale, diagnoses of affective, anxiety and substance-abuse disorders from the Composite International Diagnostic interview, and self-identified depression, anxiety and substance abuse. Simple and multiple logistic regressions were undertaken to identify predictor variables associated with use of mental health services from general practitioners, psychiatrists, psychologists and other health professionals. Results: General practitioners were the most commonly reported providers of mental health services with 76% of those receiving any mental health care reporting using this type of service. Using multiple logistic regression, the predictor variables most associated with use of mental health services were measures of the need for such services, such as psychological distress and mental disorder. After controlling for need variables, the sociodemographic variables associated with using services provided by any health professional were being female, level of education and being separated. Living in a remote area was associated with lower use of specialist services, but not with general practitioner services. Older age was associated with less use of psychologists and other health professionals. income and having a usual language other than English did not affect service use. Conclusions: The factors most strongly related to Australians' use of mental health services are their having a diagnosed affective, anxiety or substance-abuse disorder and their self-identifying as having depression or anxiety. Although there are regional inequalities in levels of utilisation of mental health services, these are seen more with specialist services than with those provided by general practitioners.