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Housing Circumstances of People Using Mental Health Services and Prescription Medications

This is an overview of selected housing circumstances of people using subsidised mental health-related services and prescription medications

Released
13/05/2016
Next release Unknown
First release

Introduction

Housing is most readily defined in terms of the physical structures used to provide shelter (Endnote 1). More broadly, places of residence serve other functions such as providing a place for privacy, to care for family members and friends, to socialise, entertain and spend time with others, and to relax, eat and sleep.

For some people their housing circumstances may reflect their preferences or desires, not just their needs. However, regardless of whether those circumstances are based on a need or want, housing should cater for different needs of people at different stages of life, their physical abilities and their cultural context. Appropriate housing can be an important determinant of health and subjective wellbeing, of building social connections and of access to jobs and public services.

This publication is the third in a series of analyses based on data from the Mental Health Services-Census Integrated Dataset. It explores use of Medicare Benefits Schedule (MBS) subsidised mental health-related services and Pharmaceutical Benefits Scheme (PBS) subsidised mental health-related medications in 2011 by people with different housing circumstances, building upon previous releases from the Integrated Dataset. These are:

MBS subsidised mental health-related services are those provided by psychiatrists, general practitioners (GPs), clinical psychologists, other psychologists, and other allied health professionals. PBS subsidised mental health-related medications comprise antipsychotics, anxiolytics/hypnotics and sedatives, antidepressants, and psychostimulants, agents used for ADHD and nootropics. See Appendix 1 and Appendix 2 respectively for more detail about mental health-related services and medications listed on the MBS and PBS.

Housing circumstances considered in this publication include:

  • Dwelling type (private dwellings and non-private dwellings);
  • Tenure type (home owner or renting);
  • Household type (family, group and lone person households);
  • Living arrangements; and
  • Overcrowding.
     

In the Integrated Dataset, the Census of Population and Housing provides insight into a range of socio-demographic characteristics including age, sex, remoteness, socio-economic disadvantage, household income, labour force status, educational attainment and others.

Data quality considerations

There are a number of factors that should be considered when interpreting information presented in this publication.

While MBS items included in scope of the Mental Health Services-Census Integrated Dataset include a range of subsidised mental health-related services provided in Australia, consultations with some medical practitioners such as paediatricians were not captured in the dataset, even if they were related to mental health. Consultations with GPs that may have involved discussion of mental health issues but were not recorded as mental-health related medications were also not captured.

The type of dwelling a person resides in is usually determined by the Census collector during enumeration. As well as being increasingly difficult to determine whether some dwellings are private or non-private, it is also becoming increasingly difficult to determine or distinguish between some types of non-private dwelling. For example, for nursing homes and accommodation for the retired or aged, accommodation is usually offered for both low and high level care which can be difficult to separately identify.

A person's use of mental health-related services or medications does not imply a diagnosis of a mental health condition. For information on people who reported having a mental or behavioural condition in Australia in 2014-15 (4.0 million people) see National Health Survey: First Results, 2014-15 (cat. no. 4364.0.55.001).

Endnotes

1. Australian Bureau of Statistics, 2015, Frameworks for Australian Social Statistics, Jun 2015, cat.no. 4160.0.55.001

Overview of housing circumstances of Australians

As people progress through different stages of life their housing preferences and needs may change as a result of factors such as changes in family structures, health and mental well-being and financial situations (Endnote 1). For example, a young adult might rent a small flat or unit or share a group house, and then progress to purchasing and owning their own home. People may partner and have children, while other people may live alone as a result of relationship breakdown, the death of a partner, or through personal preference. People requiring support with day-to-day tasks or health care may live in facilities such as nursing homes.

In 2011, the vast majority (around 98%) of Australians at home on Census night were members of households living in private dwellings such as houses, flats or units (including dwellings rented through state or territory housing authorities). A small proportion (2%) of Australians lived in non-private dwellings such as nursing homes, psychiatric hospitals or institutions, hostels, boarding schools/residential colleges and staff quarters.

People living in private dwellings had a range of different housing circumstances in 2011; most lived in a family household (84%), while 9% lived in a lone person household and 4% lived in a group household. Of all people living in a family household, over half (58%) were in a couple family with children, around one-quarter (25%) were in a couple family without children, and 14% were in a one parent family.

Across Australia, people with different housing circumstances had different socio-demographic characteristics. For example, people living in non-private dwellings were generally older than people living in private dwellings. In 2011, the median age of people in non-private dwellings was 59 years, compared with 37 years for people in private dwellings.

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  1. At home on Census night.

Source(s): The Mental Health Services-Census Integrated Dataset

Similarly, characteristics differed amongst people living in private dwellings. For example, the median age of people who owned their house/had a mortgage was 41 years in 2011, compared with 28 years for people renting through a real estate agent. Of lone person households, 55% were female (with a median age of 64 years) and 45% were male (with a median age of 52 years).

Amongst people living in non-private dwellings, those in nursing homes or accommodation for the retired or aged had a median age of 86 years in 2011, while people in boarding schools/residential colleges had a median age of 19 years.

Given the relationship between demographic characteristics such as age and sex and the use of MBS and PBS subsidised mental health-related treatments (Endnote 2), it is important to take these into consideration when interpreting data presented in this publication on the use of mental health-related treatments by people with different housing circumstances.

Endnotes

1. Australian Bureau of Statistics, 2010, Year Book Australia, No. 91, 2009-10 – Housing and Life Cycle Stages, cat. no. 1301.0

2. Australian Bureau of Statistics, 2014, Characteristics of People Using Mental Health Services and Prescription Medication, 2011, cat. no. 4329.0

In 2011, 7.2% of all Australians (1.5 million people) used at least one MBS subsidised mental health-related service such as a consultation with a psychologist. Rates of use differed among people in different housing circumstances.

People living in private dwellings

People living in private dwellings comprised 98% of Australians at home on Census night, with 7.3% accessing at least one MBS subsidised mental health-related service in 2011. Females living in private dwellings had higher rates of use than males (8.8% compared with 5.7%).

Download
  1. Living in private dwellings, at home on Census night.

Source(s): The Mental Health Services-Census Integrated Dataset

Tenure type

Of all people living in private dwellings, two-thirds (67%) lived in a dwelling that they owned outright/had a mortgage on, while around one-quarter (28%) were renting. Of people renting through a state or territory housing authority, 11.3% used at least one MBS subsidised mental health-related service in 2011, while people living in their own dwelling (owned or mortgaged) or in dwellings rented through real estate agents had similar rates of use (7.4% and 7.6% respectively).

Around one in five (20.2%) people aged 35-44 years who were renting through a state or territory housing authority used at least one MBS subsidised mental health-related service in 2011.

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  1. Living in private dwellings, at home on Census night.

Source(s): The Mental Health Services-Census Integrated Dataset

Living arrangements

In 2011, of all people living in private dwellings, most lived in a family household (84%), while 9% lived alone and 4% lived in a group household. Of people in family households, over half (58%) were members of a couple family with children, one-quarter (25%) were in couple families without children, and 14% were in one parent families.

Lone female parents had the highest rate of use of MBS subsidised mental health-related services (16.9%) in 2011, with more than one in five (20.6%) lone female parents aged 25-44 years accessing at least one MBS service in 2011. Around one in ten (9.5%) lone male parents used MBS mental health-related services in 2011. Of all couples with children, 8.5% used at least one MBS subsidised mental health-related service in 2011 compared with 6.2% of all couples without children.

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  1. Living in private dwellings, at home on Census night.

Source(s): The Mental Health Services-Census Integrated Dataset

Children living in one parent families had slightly higher rates of use of mental health-related services than children living in couple families (8.0% and 5.3% respectively).

Females living in lone person households were more likely to access MBS subsidised mental health-related services than males in 2011 (10.9% for females compared with 8.4% for males), while 7.8% of people living in group households used mental health-related services in 2011.

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  1. Living in private dwellings, at home on Census night.

Source(s): The Mental Health Services-Census Integrated Dataset

Overcrowding

Overcrowded households are defined as those requiring one or more extra bedrooms under the Canadian National Occupancy Standard. This standard takes into account household size and composition. In 2011, 6% (1.3 million people) of the Australian population living in private dwellings lived in an overcrowded household.

People living in overcrowded households had slightly lower rates of accessing MBS subsidised mental health-related services in 2011 than people in households that were not overcrowded (6.0% compared with 7.6%). This was consistent across all age groups.

Download
  1. Living in private dwellings, at home on Census night.

Source(s): The Mental Health Services-Census Integrated Dataset

     2011 Census countsPeople who accessed at least one MBS subsidised mental health-related service in 2011
    Persons '000Median age yearsSex ratio(b) ratioNumber ‘000Proportion %
Tenure and landlord type
 Owned outright/with a mortgage
13 407.8
41
96.1
992.4
7.4
 Renting
  Real estate agent
3 119.0
28
98.8
236.6
7.6
  State or territory housing authority
690.1
37
81.8
78.3
11.3
  Total persons renting(c)
5 533.9
29
96.6
441.0
8.0
Household type and living arrangements
 Family households
  Couple family
   Husband, wife or partner in couple family with children
4 932.5
43
96.9
420.1
8.5
   Child in couple family(d)
4 759.1
11
111.5
252.5
5.3
  Husband, wife or partner in couple family without children
4 190.9
58
99.3
259.1
6.2
  One parent family
   Male parent
158.7
50
. .
15.0
9.5
   Female parent
742.9
45
. .
125.7
16.9
   Child in one parent family(d)
1 379.4
14
117.3
110.3
8.0
  Total persons in family households(e)
16 832.5
35
96.5
1 226.1
7.3
 Group households
716.3
28
126.4
55.9
7.8
 Lone person households
  Male
859.1
52
. .
72.1
8.4
  Female
1 029.6
64
. .
112.6
10.9
  Total persons in lone person households
1 888.7
58
83.4
184.7
9.8
Canadian National Occupancy Standard
 Overcrowded
1 276.2
23
98.4
76.1
6.0
 Not overcrowded
17 231.8
38
95.9
1 314.3
7.6
Total persons in private dwellings(a)
20 098.1
37
96.6
1 466.9
7.3
. . not applicable
a. People living in private dwellings, at home on Census night.
b. Males per 100 females.
c. Includes other rental arrangements.
d. Includes dependent and non-dependent adult children.
e. Includes unrelated individuals in family households, and people in Other families.
   

People living in non-private dwellings

Non-private dwellings are establishments which provide a communal type of accommodation (Endnote 1), and include facilities such as nursing homes, psychiatric hospitals or institutions, hostels, boarding schools/residential colleges and staff quarters.

There were 381,800 people living in non-private dwellings on Census night in 2011, with 2.9% accessing at least one MBS subsidised mental health-related service in 2011. Rates of use of MBS subsidised mental health-related services varied among people living in different types of non-private dwellings.

In 2011 there were 126,000 people living in nursing homes, most of whom (86%) were aged 75 years or over. Of all people living in nursing homes, 1.9% accessed at least one MBS subsidised mental health-related service in 2011, compared with 3.2% of all people in Australia aged 75 years and over. A further 48,500 people lived in accommodation for the retired or aged, with 3.4% accessing MBS mental health-related services in 2011.

There were 9,100 people living in hostels for the disabled in 2011. Of these people, 16.7% accessed at least one MBS subsidised mental health-related service in 2011.

There were 3,700 people living in psychiatric hospitals or institutions in 2011, 10.4% of whom accessed at least one MBS subsidised mental health-related service in 2011. Mental health-related services provided in hospitals (and other facilities) and not subsidised through the MBS were not captured in the Mental Health Services-Census Integrated Dataset on which this data are based.

  2011 Census countsPeople who accessed at least one MBS subsidised mental health-related service in 2011
 Persons no.Median age yearsSex ratio(b) ratioNumber no.Proportion %
Public or private hospital
8 100
74
79.6
100
1.6
Psychiatric hospital or institution
3 700
47
170.4
400
10.4
Hostel for the disabled
9 100
50
155.3
1 500
16.7
Nursing home
126 000
86
44.2
2 400
1.9
Accommodation for the retired or aged (not self-contained)
48 500
86
41.8
1 600
3.4
Hostel for homeless, night shelter, refuge
3 000
36
189.4
300
9.0
Hotel, motel, bed and breakfast
26 000
39
190.4
600
2.5
Staff quarters
38 100
31
495.5
200
0.6
Boarding school/residential college
56 100
19
104.2
1 000
1.7
Total persons in non-private dwellings(a)
381 800
59
103.9
10 900
2.9
. . not applicable
a. People living in non-private dwellings, at home on Census night.
b. Males per 100 females.
   

Endnotes

1. Australian Bureau of Statistics, 2012, Census Data Quality Statements: Type of Non-Private Dwelling

In 2011, 10.9% (2.4 million people) of all Australians had at least one script filled for a PBS subsidised mental health-related prescription medication such as an antidepressant. Rates of use differed among people in different housing circumstances.

People living in private dwellings

Of all people living in private dwellings on Census night, 10.8% accessed at least one PBS subsidised mental health-related medication in 2011. Females living in private dwellings had higher rates of use than males (13.0% compared with 8.5%).

Download
  1. Living in private dwellings, at home on Census night.

Source(s): The Mental Health Services-Census Integrated Dataset

Tenure type

Around one in four (26.1%) people renting through a state or territory housing authority accessed at least one PBS subsidised mental health-related medication in 2011. This was more than twice the rate of people living in their own dwelling (owned or mortgaged; 11.0%) and more than triple that of people living in dwellings rented through a real estate agent (7.7%).

Of people renting through a state or territory housing authority who were aged 35 years or older, around 40% accessed at least one mental health-related medication in 2011. Additionally, more than half (53.7%) of people renting through a state or territory housing authority with a need for assistance with core activities (for example, those relating to self-care, communication and mobility) accessed mental health-related medications in 2011.

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  1. Living in private dwellings, at home on Census night.

Source(s): The Mental Health Services-Census Integrated Dataset

Living arrangements

In 2011, 26.3% of female lone parents and 15.1% of male lone parents accessed at least one PBS subsidised mental health-related medication. Of all couples with children, 8.9% accessed mental health-related medications in 2011 compared with 15.8% of couples without children.

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  1. Living in private dwellings, at home on Census night.

Source(s): The Mental Health Services-Census Integrated Dataset

Children living in one parent families also had higher rates of accessing mental health-related medications than children living in couple families (7.1% compared with 3.3%).

In 2011, almost one-quarter (23.2%) of people living alone accessed at least one PBS subsidised mental health-related medication (16.3% of males and 29.0% of females living alone). Of all people living in family households, 9.8% accessed mental health-related medications in 2011, the same rate as for people living in group households (9.8%). 

The higher rate for people living alone was related to their older age structure (a median age of 58 years compared with 35 years for people in family households and 28 years for people in group households). Across age, rates of use were generally similar for people living in lone person and group households, but lower for people in family households in some age groups. In 2011, around 19% of people aged 45-54 years living in lone person and group households accessed mental health-related medications, compared with 10.8% of people of the same age in family households.

Download
  1. Living in private dwellings, at home on Census night.

Source(s): The Mental Health Services-Census Integrated Dataset

Overcrowding

Overcrowded households are defined as those requiring one or more extra bedrooms under the Canadian National Occupancy Standard. This standard takes into account household size and composition. In 2011, 6% (1.3 million people) of the Australian population living in private dwellings lived in an overcrowded household.

Overall, people living in overcrowded households had lower rates of accessing PBS subsidised mental health-related medications in 2011 than people in households that were not overcrowded (7.1% compared with 11.4%).

Download
  1. Living in private dwellings, at home on Census night.

Source(s): The Mental Health Services-Census Integrated Dataset

     2011 Census countsPeople who accessed at least one PBS subsidised mental health-related medication in 2011
    Persons '000Median age yearsSex ratio(b) ratioNumber ‘000Proportion %
Tenure and landlord type
 Owned outright/with a mortgage
13 407.8
41
96.1
1 472.3
11.0
 Renting     
  Real estate agent
3 119.0
28
98.8
240.2
7.7
  State or territory housing authority
690.1
37
81.8
180.0
26.1
  Total persons renting(c)
5 533.9
29
96.6
600.3
10.8
Household type and living arrangements
 Family households
  Couple family
   Husband, wife or partner in couple family with children
4 932.5
43
96.9
439.6
8.9
   Child in couple family(d)
4 759.1
11
111.5
159.1
3.3
  Husband, wife or partner in couple family without children
4 190.9
58
99.3
664.0
15.8
  One parent family
   Male parent
158.7
50
. .
23.9
15.1
   Female parent
742.9
45
. .
195.6
26.3
   Child in one parent family(d)
1 379.4
14
117.3
98.3
7.1
  Total persons in family households(e)
16 832.5
35
96.5
1 657.5
9.8
 Group households
716.3
28
126.4
70.0
9.8
 Lone person households
  Male
859.1
52
. .
140.0
16.3
  Female
1 029.6
64
. .
298.8
29.0
  Total persons in lone person households
1 888.7
58
83.4
438.9
23.2
Canadian National Occupancy Standard
 Overcrowded
1 276.2
23
98.4
91.2
7.1
 Not overcrowded
17 231.8
38
95.9
1 967.5
11.4
Total persons in private dwellings(a)
20 098.1
37
96.6
2 166.5
10.8
. . not applicable
a. People living in private dwellings, at home on Census night.
b. Males per 100 females.
c. Includes other rental arrangements.
d. Includes dependent and non-dependent adult children.
e. Includes unrelated individuals in family households, and people in Other families.
   

People living in non-private dwellings

Non-private dwellings are establishments which provide a communal type of accommodation (Endnote 1), and include facilities such as nursing homes, psychiatric hospitals or institutions, hostels, boarding schools/residential colleges and staff quarters.

There were 381,800 people living in non-private dwellings on Census night in 2011, with around one in five (20.6%) accessing at least one PBS subsidised mental health-related medication in 2011. Rates of accessing PBS subsidised mental health-related medications varied among people living in different types of non-private dwellings. 

In 2011 there were 126,000 people living in nursing homes, 35.6% of whom accessed at least one PBS subsidised mental health-related medication in 2011. A further 48,500 people lived in accommodation for the retired or aged, with a similar proportion (39.9%) accessing PBS mental health-related medications in 2011.

There were 9,100 people living in hostels for the disabled in 2011. Of these people, almost half (47.9%) accessed at least one PBS subsidised mental health-related medication in 2011. 

There were 3,700 people living in psychiatric hospitals or institutions in 2011, 28.8% of whom accessed at least one PBS subsidised mental health-related medication in 2011. Mental health-related medications provided in hospitals (and other facilities) and not subsidised through the PBS were not captured in the Mental Health Services-Census Integrated Dataset on which this data are based.

Unlike the general population, amongst whom the proportion of people accessing mental health-related medications increases with increasing age, for people living in the above mentioned non-private dwellings, rates of accessing mental health-related medications were consistently high across age. It should however be noted that numbers of people living in these types of dwellings for some age groups are relatively small. For example, across Australia there were 1,900 people aged 35-44 years living in a hostel for the disabled in 2011, with 50.1% accessing at least one PBS mental health-related medications in 2011.

Download
  1. Living in non-private dwellings, at home on Census night.

Source(s): The Mental Health Services-Census Integrated Dataset

  2011 Census countsPeople who accessed at least one PBS subsidised mental health-related medication in 2011
 Persons no.Median age yearsSex ratio(b) ratioNumber no.Proportion %
Public or private hospital
8 100
74
79.6
1 600
19.8
Psychiatric hospital or institution
3 700
47
170.4
1 100
28.8
Hostel for the disabled
9 100
50
155.3
4 400
47.9
Nursing home
126 000
86
44.2
44 800
35.6
Accommodation for the retired or aged (not self-contained)
48 500
86
41.8
19 300
39.9
Hostel for homeless, night shelter, refuge
3 000
36
189.4
400
14.9
Hotel, motel, bed and breakfast
26 000
39
190.4
1 000
3.8
Staff quarters
38 100
31
495.5
300
0.8
Boarding school/residential college
56 100
19
104.2
700
1.2
Total persons in non-private dwellings(a)
381 800
59
103.9
78 700
20.6
. . not applicable
a. People living in private dwellings, at home on Census night.
b. Males per 100 females.
   

Endnotes

1. Australian Bureau of Statistics, 2012, Census Data Quality Statements: Type of Non-Private Dwelling

About the Mental Health Services-Census Integrated Dataset

The Mental Health Services-Census Data Integration project brings together the breadth of 2011 Census of Population and Housing (Census) data with administrative information on people accessing MBS subsidised mental health-related services and PBS subsidised mental health-related prescription medications. The project was initiated on behalf of the National Mental Health Commission (NMHC) with the aim of informing the National Review of Mental Health Services and Programmes.

Integrating a selected subset of data items from the MBS, PBS and 2011 Census has greatly increased the power of the data to support analysis of the circumstances and characteristics of people experiencing mental ill-health as they interact with the health care system. The Mental Health Services-Census Integrated Dataset includes people who responded to the 2011 Census and those who accessed subsidised mental health-related items listed on the MBS or PBS in 2011.

The Integrated Dataset contributes significantly to the pool of mental health-related data available in Australia to assist in the development and evaluation of mental health programs and support services now and into the future. Questions can be answered about people accessing subsidised mental health-related services and medications with evidence that up until now has not been available. For example, analysis of the integrated data answers questions about the relationship between mental health-related services, medication use and key socio-economic information such as education, employment and housing.

The confidentiality of these data are protected by the Census and Statistics Act (1905) and the Privacy Act (1988). MBS and PBS information provided by the Department of Health and the Department of Human Services to the ABS is treated in the strictest confidence as is required by the National Health Act (1953) and the Health Insurance Act (1973).

Data downloads

Table 1: Persons accessing MBS mental health-related services in 2011, housing circumstances

Table 2: Persons accessing PBS mental health-related medications in 2011, housing circumstances

Table 3: Persons accessing MBS or PBS mental health-related services and/or medications in 2011, housing circumstances

Table 4: Persons accessing MBS subsidised mental health-related services in 2011, type of service and selected housing and family characteristics

Table 5: Persons accessing PBS subsidised mental health-related prescription medications in 2011, type of medication and selected housing and family characteristics

History of changes

Show all

27/06/2016 - Additional data about the Housing Circumstances of People Using Mental Health Services and Prescription Medications