10. Patient and Service Reporting

Population Demographics

Tasmania’s population is 495 354, with 247 461 (50 per cent) living in the South of Tasmania, 137 561(28 per cent) in the North and 109 147 (22 per cent) in the North West[1].

1185 people have no usual address. Males comprise 49 per cent of the population with females comprising 51per cent[2].

Four percent of the population (19 626) identify as being of Aboriginal, Torres Strait Islander or both Aboriginal and Torres Strait Islander origin[3]. The median age of Tasmania’s non-indigenous population is 40, with the median age of Tasmania’s indigenous population being 22[4].

The burden of disease with respect to mental health is extensive and is costly, both in social and monetary terms to the Tasmanian community.

Mental illness comprises a spectrum of disorders that vary in severity. Mental illness can have damaging effects on the individuals and families concerned, and its influence is far-reaching for society as a whole. Social problems commonly associated with mental illness include poverty, unemployment or reduced productivity and homelessness. Those with mental illness often experience problems such as isolation, discrimination and stigma[5].

Estimates from the 2007 National Survey of Mental Health and Wellbeing suggest that 7.3 million Australians (45 per cent of the population aged 16–85) will experience a common mental disorder (a mood disorder, such as depression; anxiety or a substance use disorder) over their lifetime. Each year, 20 per cent of the population in this age range, or three million Australians, are estimated to experience symptoms of a mental disorder.

The Report on the Second Australian National Survey of People Living with Psychotic Illness 2010 estimated that almost 64 000 people in Australia had a psychotic illness and were in contact with public specialised mental health services each year.

Over the 2011-12 period 15 per cent of the Tasmanian population were reported as having been diagnosed with a mental health or behavioural problem at some time in their life (compared with 13.6 per cent for Australia). Yet despite this, the proportion of Tasmanian adults who reported to have experienced high to very high levels of psychological distress in the four weeks prior to interview (8.9 per cent) was lower than for other jurisdictions and Australia as a whole (10.8 per cent)[6].

The high burden of disease with respect to mental disorders in Australia overall, and specifically in Tasmania, necessitates continued surveillance of the services provided to assist people with mental illness. The Chief Psychiatrists’ role in ensuring compliance with legislation affecting those who lack capacity to make their own decisions and in developing standing orders and clinical guidelines which promote appropriate management of mental illness is consistent with this need.

Mental Health Facilities and Services

During the 2014-15 year Tasmania’s health system was geographically based, with three Tasmanian Health Organisations (THOs) covering the North, North West and South of the state.

Mental Health Services (MHS) provides specialist clinical mental health services across the state targeted at the estimated three per cent of the Tasmanian community experiencing a severe mental illness. These services are primarily focussed on secondary and tertiary level care for people with serious mental disorders.

Community mental health services

Community mental health services are delivered over three service streams comprising:

  • Child and Adolescent Mental Health Services (CAMHS)
  • Adult Community Mental Health Services (ACMHS)
  • Older Persons Mental Health Services (OPMHS).

Crisis Assessment Treatment and Triage (CATT) services are delivered through community mental health services, providing a mental health crisis response including assessment and triage.

The Mental Health Services Helpline is a 24 hour, seven days a week statewide telephone triage service.

Inpatient and Extended Treatment Mental Health Services

Acute care inpatient units are located at the three public hospitals and offer 24 hour care and treatment. These facilities include Northside Mental Health Clinic (20 beds located at the Launceston General Hospital), Spencer Clinic (19 beds located at the North West Regional Hospital) and the Department of Psychological Medicine (33 bed unit at the Royal Hobart Hospital).

Specialist extended treatment facilities are located in the south and provide statewide services including Millbrook Rise Centre (27 beds), Roy Fagan Centre (32 beds), Mistral Place (10 beds) and Tolosa Street Units (12 beds).

Forensic Mental Health Services (FMHS)

Provide community and inpatient mental health care for people experiencing a mental health disorder, who are involved with or at risk of becoming involved with the criminal justice system.

Services are delivered across three streams:

Inpatient Forensic Mental Health Services

These services are provided at Tasmania’s secure mental health unit, the Wilfred Lopes Centre (WLC), which is located near but separate from the Risdon Prison complex.  WLC commenced operation in February 2006 and is a purpose built dedicated forensic facility, owned by the Department of Health and Human Services (DHHS), and managed on a statewide basis by the THO-South, and is Tasmania’s first secure mental health unit.

Patients admitted to WLC generally include those found not guilty by reason of insanity or unfit to plead, people with mental illnesses appearing in or remanded from the courts or sent by the courts for assessment, and prisoners with a mental illness or mental health issue that requires specialist mental health inpatient treatment.

WLC operates as a 23 bed facility, including high dependency and extended care beds.

Community Forensic Mental Health Services

Includes services provided to the Tasmanian Prison Service and the WLC and community case management across the state within the general community.

Court Liaison Services

Assist in the assessment and identification of people before the judiciary who may not be fit to plead and/or require diversion into a mental health setting through the Mental Health Diversion List (MHDL). FMHS works in partnership with the Department of Justice to facilitate the MHDL initiative.

Approved Facilities and Secure Mental Health Units

The Chief Civil Psychiatrist has a general and overall responsibility under and to the Minister, for ensuring that the objects of the Act are met regarding the running of approved facilities other than secure mental health units. The Chief Forensic Psychiatrist has a general and overall responsibility under and to the Minister, for ensuring that the objects of the Act are in relation to the running of secure mental health units.

The Chief Civil Psychiatrist also has a general overall responsibility, under and to the Minister to ensure that the objects of the Act are met in relation to patients other than forensic patients or those who are subject to supervision orders, with the Chief Forensic Psychiatrist being similarly responsible for forensic patients and those subject to supervision orders.


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Footnotes:

[1] Health Indicators Tasmania 2013, Population Health, Department of Health and Human Services

[2] Health Indicators Tasmania 2013, Population Health, Department of Health and Human Services

[3] Health Indicators Tasmania 2013, Population Health, Department of Health and Human Services

[4] Australian Bureau of Statistics – Census 2011

[5] Mental Health Services in Brief 2012, Australian Institute of Health and Welfare

[6] The State of Public Health 2013, Population Health, Department of Health and Human Services, Tasmania