Mental Health – Health Needs Assessment

The Mental Health – Health Needs Assessment presents a systematic analysis of the mental health and care needs of the community in the North Western Melbourne Primary Health Network catchment. Its purpose is to facilitate discussions, nurture strategic partnerships, guide evidence-based planning and aid in the prioritisation of commissioning activity investment and advocacy work to ensure our community’s mental health and wellbeing.

Context

The Mental Health – Health Needs Assessment (MH HNA), conducted by NWMPHN in 2023 and published in 2024, is an evidence-based initiative that defines, identifies, and measures population health need in our region. Guided by the NWMPHN HNA Framework, it is tailored to mental health needs and provides key insights, informed through quantitative analyses based on population growth and social determinants, that influence mental health and wellbeing.

Integral to this project is the involvement of people with lived experience and mental health subject matter expertise. This is particularly evident in the third section of this report, titled Community and Health Service Provider Engagement, which imparts insights that contribute to a nuanced understanding of the complex social, cultural and economic factors and experiences related to mental health need in the NWMPHN region.

Method

This report used a mixed-methods approach guided by the Framework, combining quantitative analysis of population health data and mental health service mapping in the NWMPHN region, as well as a qualitative analysis of the consultations that were held with key stakeholders.

Comparative need analyses examined epidemiological data across 5 metrics: population; socio-demographics; risk factors; health service access and geographic environment; and mental health conditions and consequences. Quantitative data sources were used to generate insights about mental health needs, including in hospital and primary care settings. However, only those that met set selection criteria were then included in the quantitative model (Section 2.1).

Community and health provider consultations were guided by key lines of enquiry across online interviews and focus groups. There were 174 participants, comprising 20 consumers and 68 organisations. A deductive approach to qualitative analysis was used to categorise excerpts using the Social Ecological Model, across 7 priority populations which frequently experience poorer health outcomes and greater health disparities than the general population.

Examining comparative need through the analysis of population health data

Results from the quantitative population health need analyses identified Hume, Wyndham, and Brimbank LGAs as having the highest quantified mental health need when adjusted for the social determinants of health. The results across each of the 5 metrics are summarised below.

Metric 1. Projected population

By 2030, the NWMPHN region’s population is projected to grow by 28 per cent (amounting to 600,000 people) and surpass growth rates across all age cohorts in Victoria as a whole.

Our analysis indicates that Wyndham exhibits the highest level of need based on the projected 2025 population, with nearly half of the NWMPHN region’s residents residing there, Hume, Brimbank, and Melton.

Metric 2. Socio-demographic factors associated with mental health need

Brimbank had the highest level of need based on socioeconomic status. When the population was adjusted for socioeconomic factors, Wyndham, Hume, and Brimbank consistently displayed the highest need relative to other LGAs in the NWMPHN region.

With over 40 per cent of residents born in non-English speaking countries and speaking a language other than English at home, the NWMPHN region is more culturally and linguistically diverse than the rest of Victoria.

English proficiency across the region varied, with notably lower levels in Brimbank, Hume, and Maribyrnong.

The same 3 LGAs recorded ED presentation and hospital admission rates lower than the Victorian average.

Metric 3. Risk factors associated with mental health need

Brimbank presented the highest level of need based on risk factors influencing mental health and wellbeing, among LGAs in the NWMPHN region. The risk factors influencing poor mental health and wellbeing include child developmental vulnerability, family violence, obesity, and high levels of widowhood.

Adjusting for risk factors, Wyndham, Hume, and Brimbank continued to demonstrate the highest need.

Metric 4. Access and geographic environment

Access indicators showed that the most disadvantaged LGAs were marked by significant workforce shortages and less health infrastructure compared with Victoria overall.

These LGAs also had lower GP utilisation rates than others in the NWMPHN region – which collectively were higher than the state average. Psychiatry and psychology service utility were also lower in disadvantaged areas, as well as in Melbourne, Darebin, and Hobsons Bay.

Across the catchment, the GP workforce declined while the psychologist workforce grew.

Metric 5. Mental health conditions and consequences

Yarra, Melbourne, and Merribek demonstrated the highest need related to mental health conditions, with higher rates compared with Victoria of hospitalisations due to suicidal ideation or self-inflicted injury. Rates were disproportionately high among young females (10-19). ED presentation rates due to mental and behavioural disorders were also greater than most LGAs in the region.

The analysis also identified specific conditions that contribute to the mental health burden in our region. Anxiety and depression were the leading self-reported chronic mental health conditions across all LGAs, with depression being more prevalent in adults aged over 80 than any other age cohort.

Although less common, schizophrenia emerged as the leading cause of mental health related hospitalisations since 2019, with the highest rates in Brimbank, Moonee Valley, and Maribyrnong. Additionally, it was one of the top mental health conditions resulting in ED presentations.

Community and health provider consultations

Findings from consultations with community members and health service providers included:

• Mental health needs of the community are influenced by intersecting social, cultural, and economic factors, such as discrimination, housing, income, family violence, and trauma.
• Coordination between healthcare and social service providers was consistently identified as a challenge across interviewee types. Unsurprisingly, this was also a common theme when discussing solutions, such as streamline resource location, minimise duplication, and optimise the patient experience within an efficient system.
• Consumers emphasised the need to be included in mental health service development, to support the creation of safe and inclusive environments, particularly for marginalized groups.
• It was noted across interviewee types that providing person-centred care requires a culturally competent and diverse workforce.
• Lived experience consumers highlighted that trauma-informed approaches can facilitate the provision of sensitive mental health care; however, the workforce requires support and training to build capacity and competency to meet demand.
• There was broad recognition that social connection plays a vital role in promoting positive mental health and wellbeing.
• Consumers, carers, and health providers experience challenges navigating the health system.
• Carers play a crucial role in mental health support and improving outcomes, yet they often face unique unmet needs, such as insufficient follow-up care, health literacy gaps, and a lack of social recognition of their role.
• An increase in acuity and complexity of mental health conditions was reported by mental health service providers, including a growing number of patients diagnosed with more than one condition. There was also a reported trend towards more severe symptoms and an increase in incidences of self-harm and suicidality. The age of symptom onset was also reported to be decreasing.
• Interviewees also communicated that commissioning approaches which promote collaboration, sustainability, and innovation, should be prioritised.
• Interviews also highlighted issues with workforce, specifically that increasing workforce demands are not being met and there is service disparity between availability of services for low acuity cases versus people needing more intensive intervention and structured support.
• Flexible service delivery models with “multiple open doors” were perceived to help address service access inequities for diaspora communities and at-risk cohorts.
• Lack of vertical integration within the mental health sector was noted. As was a need for better collaboration between service providers in the public and private health sectors.

This report to provides a comprehensive understanding of the mental health and wellbeing needs of people in the NWMPHN catchment by combining quantitative findings from several large data sources with in-depth perspectives from consultations with community members, people with lived experience, and mental health service providers.

Service accessibility, availability, and mental health outcomes

• LGAs with lower levels of social disadvantage compared with the NWMPHN catchment as a whole demonstrated higher rates of new GP mental health related diagnoses. This indicates higher levels of access to, and utilisation of, mental health service providers.
• Social disadvantage, characterised by indicators such as low English proficiency and financial stress, contributes to access disparities in mental health services, creating cultural and financial barriers. This limitation was notable in LGAs with low socioeconomic status and in growth areas in the catchment.
• Disadvantaged postcodes within metropolitan areas have better access to service providers compared to those located in outer LGAs.
• Compared to less disadvantaged metropolitan areas, they also exhibit higher hospitalisation rates and ED presentations related to mental health conditions.

Underrepresentation of diversity in the health sector

• Consultation groups identified levels of cultural safety, competency, and responsiveness in health services as drivers influencing mental health outcomes for some cultural, ethnic, and language communities seeking care in the NWMPHN catchment.
• Several marginalised populations are under-represented or unidentified in key population health datasets. These include people with disability, LGBTIQ+ people, refugees, and asylum seekers. This entrenches health system inequity.

Mental health acuity and complexity is increasing

• Psychosocial issues, including social isolation exacerbated by the COVID-19 pandemic, were identified in consultations as drivers leading to increasing presentations to services by patients with acute or complex needs. This was particularly pronounced among young people.
• Better indicators are needed to measure complexity and treatment effectiveness in primary care.
• Analyses of GP information, commissioned service data and the Victorian Department of Health data ranked anxiety and depression as the common diagnoses of mental health condition. Schizophrenia is the leading cause of hospitalisations and fourth leading cause of ED presentations for mental health conditions in the NWMPHN catchment.
• Gaps in service as well as workforce competency and capacity amplify the challenges associated with managing complex mental health conditions.

Workforce capacity and capability

• Consultations conveyed heightened concerns among mental health professionals regarding inadequate workforce capacity to meet the increasing community demand and complexity.
• Workforce burnout and shortages of GPs, psychologists and psychiatrists further compound the issue.
• The majority of mental health and wellbeing services available to NWMPHN residents offer services with a low to moderate intensity level of care (as defined by the Initial Assessment and Referral (IAR) – Decision Support Tool (DST). NWMPHN commissioned services and Head to Health data reflects a greater proportion of need for higher intensity level mental health care, suggesting there may be a service gap related to more intensive or complex care needs.

Mental health service multidisciplinary care coordination, navigation, and integration

In the context of challenges around workforce capability and capacity to manage increasing mental health acuity and complexity, there are opportunities to streamline cross-sector coordination and collaboration, including prioritising integrated services such as multidisciplinary health hubs.

Directions

The analyses presented in this MH HNA and its supplementary document offer comprehensive contextual information into our region’s current state of mental health need. It serves as a reference for NWMPHN, its commissioned partners and other mental health stakeholders.

It reveals the complexity of social determinants on individual mental health, and offers insights into potential gaps, challenges, and areas for further focus and exploration to address unmet mental health needs in the NWMPHN region.

Plans for disseminating the report to build awareness and contribute towards a collective understanding of the mental health landscape in our community are in place.

This health needs assessment explores the mental health needs in the NWMPHN catchment to support evidence-informed commissioning. Several key lines of enquiry informed our approach, while taking care to balance delving deeply into specific aspects and capturing a broad overview of the complex issues within the diverse population of the region.

A key benefit of using ‘the Framework’ to inform our approach to analysis includes the triangulation of a range of quantitative and qualitative data sources to provide a comprehensive and nuanced understanding of mental health needs. This approach enhances the reliability and validity of our findings, allowing for a more robust and evidence-based analysis that can better inform targeted interventions and initiatives within the community. The broad stakeholder representation involved in this HNA also enabled the identification of improvement ideas based on lived experience and subject matter expertise. Application of the social-ecological model to organise and interpret findings is another strength.

On a qualitative level, we consulted widely with health service providers, subject matter experts and people with lived experience of mental health challenges.

We relied in part on large datasets gathered by bodies such as the Victorian Department of Health, the Public Health Information Development Unit (PHIDU), and the Australian Bureau of Statistics (ABS). These were augmented by de-identified data provided by hundreds of general practices across the NWMPHN catchment. All datasets have limitations. These are summarised in Table 4 and in Appendix B.

There are also some important limitations that must be acknowledged. As outlined throughout the relevant sections of the report, there are specific data limitations that affect the generalisability of some of the analyses.

For example, whilst we use the term ‘CALD’ in several sections of the report to capture diversity, we acknowledge that collectively grouping cultural and linguistic subpopulations can mask invisible and underserved communities given the term is large and heterogeneous.

Furthermore, other population groups are also largely absent from data collection mechanisms, such as LGBTIQ+ people, people with a disability, asylum-seekers and refugees, and people living in prisons.

Many datasets use a strict male-female binary, which does not reveal non-binary, trans or intersex people. Equally, there is a notable absence of data related to intersectionality.

It is also likely that our region’s Aboriginal and Torres Strait Islander population is under-represented. Incomplete and inaccurate identification of the Aboriginal and Torres Strait Islander population is commonplace in administrative and clinical information systems in health service organisations across Australia (Australian Commission on Safety and Quality in Health Care, 2021).

We acknowledge that data collection needs to better capture quality indicators of diversity in order to improve investment decisions in multicultural health and other high-risk populations in order to improve the health and wellbeing of all residents on the NWMPHN region.

This section comprises a summary of mental health need across each of the local government areas in the NWMPHN region. Refer to Section 2 of the report for more detailed information.

Melbourne (inner city area)

• Melbourne is a highly populated LGA with some localised disadvantages relating to high levels of housing stress. These are key determinants that can exacerbate mental health needs. In addition, there is a large proportion of the population born in non-English speaking countries, indicating the need for culturally safe and appropriate services for this community.
• GP workforce shortages and high avoidable ED presentation rates driven by mental health are indicative of potential barriers to seeking care and may be contributing factors to the low utilisation of Medicare-subsidised GP services.
• High family violence rates and high ED presentations driven by alcohol use and complex conditions (including bipolar and psychotic disorders) indicate a need for targeted support to address intricate challenges associated with complex mental health needs.

Maribyrnong (inner city area)

• Maribyrnong experiences localised social disadvantages, in particular, housing stress and food insecurity, which significantly impact mental health. In addition, approximately a third of the population born in a non-English speaking country and a proportion of the population with low English proficiency higher than the Victorian average, indicates a demand for services accommodated for specific cultural needs.
• Low utilisation rates of Medicare-subsidised mental health services and avoidable ED presentation rates due to mental health above the state average highlight there may be some barriers for people living in Maribyrnong to accessing services for their mental health.
• A high rate of hospitalisations driven by schizophrenia and depressive episodes coupled with elevated ED presentation rates due to suicidal ideation indicates significant and complex mental health needs within this population, that require tailored care.

Yarra (inner city area)

• The greatest identified area of need related to mental health within Yarra is driven by alcohol use. The proportion of Yarra’s population who consume alcohol daily above recommended standards was second highest in the NWMPHN region, and higher than the Victorian average, potentially contributing to the increased rates of ED presentations and hospitalisations due to alcohol.
• In addition, high ED presentation rates are driven by a multitude of mental health conditions, namely alcohol, anxiety, psychotic disorders, schizophrenia. Despite being a LGA of relatively less social disadvantage compared to others in the region, there are pockets of disadvantage in postcodes 3065 and 3066 that had the highest hospitalisation and ED presentation rates.
• These drivers of need highlight the impact of financial and risk factor determinants on mental health outcomes and indicate a need for targeted services to address specific and complex mental health needs.

Brimbank (suburban area)

• A highly populated area, Brimbank stands out as the LGA in our region with the greatest level of social disadvantage. It also has a high level of need related to risk factors that research shows have negative effects on mental health and wellbeing. These include low income, food insecurity, low English proficiency, developmental vulnerability, family violence and high rates of adult obesity.
• A relatively low liveability index in Brimbank indicates there is insufficient public transport access, health infrastructure or access to healthy food.
• These factors could be impacting the mental health and wellbeing of residents. A high proportion of residents in Brimbank report high or very high psychological distress.
• Barriers to accessing care are further exacerbated by psychologist workforce shortages in this LGA.
• High hospitalisation rates due to mental health in Brimbank are driven by schizophrenia, depressive episodes, and delirium. These, coupled with high hospitalisation and ED presentation rates due to suicidal ideation, indicate complex mental health needs in the population and underscore the critical importance of targeted mental health support.
• Brimbank is the third highest ranked LGA for percentage of population with 2 or more chronic health conditions. However, this is lower than Victorian average. Brimbank also exhibited higher hospitalization rates but lower ED presentations than Vic average. Except for Brimbank’s Aboriginal and Torres Strait Islander peoples who exhibited higher hospitalisation and ED presentation rates, when compared to the Victorian average.

Darebin (suburban area)

• There is some localised disadvantage in Darebin, in particular relating to low household income, a social determinant that can exacerbate mental health needs. In addition, Darebin has the largest LGBTIQ+ population in our region, emphasising the importance of having inclusive services that cater to varying needs.
• Darebin ranks first with the highest proportion of the population experiencing high psychological distress, suggesting that there could be a higher risk or prevalence of mental health in the community.
• Although a larger proportion of mental health related services were identified to be available in Darebin, schizophrenia and alcohol use are large drivers of ED presentations and hospitalisations indicating there still may be an unmet need of services that cater for these conditions.

Hobsons Bay (suburban area)

• Hobsons Bay experiences healthcare workforce shortages for GPs, psychologists, nurses and midwives. In addition, out of pocket costs for Medicare-subsidised mental health services are above the national average, indicating there may be some barriers to seeking care in the community. Compared with other LGAs, residents of Hobsons Bay have low utilisation rates of Head to Health and CareInMind services as well as low utilisation of Medicare-subsidised nursing, and Aboriginal health services.
• High ED presentations due to suicidal ideation and high mortality rates by suicide highlight the need for tailored interventions to address severe mental health outcomes.

Moonee Valley (suburban area)

• Moonee Valley has a greater proportion of older adults relative to other LGAs in the region. Being an LGA with a relatively higher socio-economic status, there is some localised disadvantage related to food insecurity.
• Moonee Valley has the higher proportions of consumers assessed in Head to Health referrals as requiring high or specialist-level care and has high rates of avoidable ED presentations. Suicidal ideation leading to hospitalisations is also prevalent in Moonee Valley, indicating a need for a more targeted and higher intensity level of care.

Merri-bek (suburban area)

• Merri-bek has a large LGBTIQ+ population, highlighting a need for appropriate and varying services to accommodate for this cohort.
• Although there are no workforce shortages relative to other LGAs and Victoria, there are above-average out-of-pocket costs for GP and mental health services and increased avoidable ED presentation rates attributed to mental health, indicating there may be some barriers to seeking care in the community.
• A high prevalence of individuals with 2 or more chronic conditions and high psychological distress suggests that there could be higher risk or prevalence of mental health in Merri-bek. This can be seen with above average hospitalisation and ED presentation rates due to mental health. The hospitalisation rate due to suicidal ideation was also noted, surpassing the Victorian average.

Hume (growth area)

• Hume is one of the most populated areas in NWMPHN and experiences social disadvantage across multiple indicators – specifically housing stress and low individual and household income – that can have negative consequences for mental health and wellbeing.
• Being a highly disadvantaged area coupled with a younger age profile and more cultural diversity, including a higher proportion with low English proficiency, than most other LGAs, emphasises the importance of having targeted services that cater to varying and unique needs.
• Hume also benchmarks below Victorian state averages in multiple risk factors that can affect mental health and increase need. Specifically, there are a high proportion of children who are developmentally vulnerable, high levels of family violence and a large proportion of adults who are living with obesity.
• A low liveability index in Hume is driven by insufficient public transport access, low health infrastructure and access to healthy food. Barriers to accessing care for mental health and wellbeing needs are further exacerbated by GP and psychologist workforce shortages.
• Above average rates of ED presentations and hospitalisations due to suicidal ideation highlight there are complex mental health needs in the population requiring tailored intervention.

Melton (growth area)

• Relative to Victoria, Melton has higher rates of social disadvantage across multiple indicators that can affect mental health and wellbeing, specifically, housing stress and food insecurity.
• Melton also has one of the highest populations of young people and Aboriginal and/or Torres Strait Islander across the region indicating there are unique and varied needs within the population necessitating tailored services to address the specific challenges faced by these communities.
• Melton has a high level of need related to risk factors associated with poor mental health, in particular, developmental vulnerability, family violence and high rates of children living with obesity highlighting a need for support specified towards childhood development and family.
• Melton experiences significant shortages in the healthcare workforce, particularly in the availability of GPs and psychologists. The low liveability index, reflecting deficiencies in public transport and overall health infrastructure, in combination with workforce shortages poses environmental barriers that may contribute to low utilisation of essential services, including mental health services.

Wyndham (growth area)

• Wyndham is NWMPHN region’s fastest growing and most populous LGA, but also experiences high levels of social disadvantage; in particular, high levels of housing stress and low individual income are key health determinants that exacerbate mental health need. A younger demographic and notable cultural diversity, including a higher percentage with low English proficiency highlight the importance of tailoring services/programs to address unique needs.
• Wyndham contends with various mental health risk factors, including high rates of babies born with a low birth weight, higher proportion of children developmentally vulnerability, and high rates of adult obesity compared with the Victorian average which indicate a need for interventions targeted to families and early childhood.
• Wyndham’s low liveability index highlights deficiencies in public transport, easy access to fresh food, and overall availability of health infrastructure. Wyndham also has a shortage of health professionals, particularly psychologists.
• Compared with other LGAs and with the Victorian average residents of Wyndham have low utilisation rates of Directline and Online counselling, as well as low utilisation of essential services such as Medicare-subsidised mental health, nursing, and Aboriginal health services.
• Although Wyndham has a lower prevalence of individuals with two or more chronic conditions relative to Victoria, the ED presentation rate due to chronic conditions was higher than the Victorian average.

Macedon Ranges–part a (peri-urban area)

• Macedon Ranges has a diverse population with both a younger and older demographic and a higher proportion of LGBTIQ+ relative to other LGAs in the region.
• Macedon Ranges experiences some risk factors related to poorer mental health, in particular, greater daily alcohol consumption and obese adults. Coupled with the high prevalence of individuals with comorbid chronic conditions, the population could be at greater risk of mental health conditions.
• There are disadvantages across a range of liveability indicators including deficiencies in health infrastructure, public transport access and access to healthy food. Macedon Ranges also contends with barriers to seeking mental health-related care due to psychologist shortages and higher than average out-of-pocket costs, which may explain the low utilisation rates of Medicare subsidised services.
• Bipolar disorder is a notable condition of concern in Macedon Ranges with high rates of GP diagnoses and hospitalisations. The mortality rate of suicide and self-inflicted injury was also noted, surpassing the Victorian average indicating a need for tailored support for complex and severe mental health outcomes.

Moorabool–part a (peri-urban area)

• Moorabool stands out as an LGA in our region with greater socio-economic disadvantages (in particular, low income and housing stress) that exacerbate mental health need.
• There is also a high level of need related to various risk factors associated with poor mental health (including greater alcohol consumption, obese adults and childhood developmental vulnerability). The prevalence of these risk factors may contribute to the higher proportion of the population with comorbid chronic health conditions.
• Moorabool contends with liveability disadvantages due to lower health infrastructure, public transport access and greater distance to bulk-billing GP clinics. These environmental barriers combined with workforce psychologist shortages result in low utilisation of essential Medicare-subsidised services (including mental health and nursing).
• Moorabool has the highest proportion of Aboriginal and/or Torres Strait Islander people and the highest GP diagnoses of mental health conditions for this population, reflecting the importance of culturally appropriate and tailored services to address unique needs.

This section comprises a summary of the mental health needs of identified population groups. Refer to Section 2 of the report for more detailed information.

Children and adolescents (aged 0 to 19)

• Children aged 0 to 9 show high rates of developmental vulnerability. A larger proportion of this cohort than any other represent avoidable mental health-related ED presentations. These factors indicate a need for interventions targeted to early childhood.
• Although there are more mental health and wellbeing services targeted at children and young people compared to other target populations in the NWMPHN catchment, there is a lack of high intensity care and specialised services. Coupled with the high ED presentation rates for suicidal ideation in young people aged 10-29 years, this highlights the urgent need for more specialised mental health support for adolescents.
• The highest proportion of mental health community service referrals in the LGA post-ED discharge are in children aged 0 to 9 and young people aged 10 to 19, indicating the need for continued care after presenting to the ED.
• In 2022, more than half of mental health services clients were teenagers and adults aged 15 to 44. There were higher mental health diagnoses rates in females, aged 10 to 19, than males. Available data do not adequately identify non-binary patients.
• Anxiety followed by depression are the most common mental health diagnoses.

Older people (aged 65+)

• Adults aged 80 and over had the highest rates of mental health-related hospitalisations and ED presentations. These were mostly driven by delirium not due to alcohol or other psychoactive substances.
• Females aged 70 to 79 were more likely to be hospitalised than males of the same age, with admissions driven by delirium and depression. This underscores the pressing need for targeted mental health services for older women, addressing the existing gap in resources available to meet their needs.
• Adults aged 80 and over had the lowest referral rates to GPs and mental health community services upon discharge to home from the ED.
• More than 80 per cent of ED presentations in this age cohort resulted in admission to the ward.
• Older adults had the highest referral rates to GPs after discharge from hospital (in contrast to ED as above).

Women

• Hospitalisation rates and ED presentation rates due to suicidal ideation are significantly higher in females aged 10 to 29 compared to males and other age cohorts.
• In 2021, the average rate of having either anxiety or depression across the region was higher for females, at 10 per cent, compared with 6.3 per cent in males. It was most prevalent in females aged 20 to 30.
• Compared to males, females had a higher number and rate of mental health conditions diagnosed by a GP across all age groups. Young females, aged 20 to 29, had the highest rate of mental health diagnoses and females aged 10 to 19 had more than double the number of diagnoses recorded by males the same age.
• Females aged 10 to 29 had high ED presentation rates due to mental health conditions driven by anxiety, alcohol use and acute and transient psychotic disorders.
• Hospitalisation rates due to mental health were also high in young adult females aged 20 to 29. The top conditions attributed to hospitalisations in young females were depression and schizophrenia.
• Available data do not adequately identify nonbinary patients.

Aboriginal and Torres Strait Islander people

• For Aboriginal and Torres Strait Islander people, 61.5 per cent of mental health-related hospital admissions and 23.8 per cent of ED presentation rates across LGAs in the NWMPHN region were above the Victorian average.
• In Yarra, hospitalisations and ED presentation rates due to mental health conditions are more than 4 times higher than the Victorian average.
• Aboriginal and Torres Strait Islander males aged 40 to 49, and females aged 30 to 39, have the highest ED presentation and hospitalisation rates due to mental health conditions in the NWMPHN region.
• Alcohol use and schizophrenia were the leading causes of hospitalisations in Aboriginal and Torres Strait Islander people in 2022- 23. Multiple drug use, acute and transient psychotic disorders and alcohol use were the top reasons attributed to ED presentations between 2019-20 and 2022-23.
• There are relatively few services that self-identified as specialising in treating Aboriginal and Torres Strait Islanders. Of these, most offer low and moderate levels of care.
• Addressing the complexities of mental health need in the First Nations population requires more specialised and culturally appropriate support.

Culturally and linguistically diverse communities

• Brimbank and Wyndham have higher numbers of non-English speaking residents than other LGAs in the region. They also have lower than average hospital admission rates. It is unclear if there is any causative relationship between these 2 findings.
• Yarra had the highest hospitalisation and ED presentation rates in people from culturally and linguistically diverse backgrounds.
• For people from culturally and linguistically diverse backgrounds, hospitalisation numbers were highest in females aged 60 and older.

This section comprises a summary of health conditions identified as areas of need. Refer to Section 2 of the report for more detailed information.

Anxiety

• Anxiety has ranked as the leading condition attributed to avoidable ED presentations since 2019-20.
• Anxiety is the leading diagnosis at NWMPHN-commissioned mental health services.
• Anxiety is the top GP mental health diagnosis across all ages under 80 in all LGAs within the NWMPHN catchment. Rates of anxiety diagnoses are highest in patients aged 20 to 49.
• Of all mental health conditions, “other anxiety disorders” has been one of the top 2 conditions driving ED presentations since 2019-20.
• Anxiety is ranked in the top 3 mental health-related conditions driving ED presentations in people aged between 0 and 39, and those over 60.
• Yarra, followed by Melbourne and Merri-bek, had the highest rate for ED presentations due to anxiety.

Depression

• Depression is the top mental health condition diagnosed by GPs in adults aged 80 and over, and the second highest diagnosis across all other age groups. This holds across all LGAs in the NWMPHN catchment in 2022- 23.
• Of all mental health conditions, depressive episodes have been in the top 3 conditions attributed to hospitalisations since 2019-20.
• The highest rates of hospitalisation due to depression were in Brimbank, Moorabool-part a and Maribyrnong; all 3 LGAs also had high GP diagnosis rates of depression.
• Depression is ranked in the top 3 mental health-related conditions driving ED presentations in people aged 10 to 29 and over 60.

Schizophrenia

• Of all mental health conditions, schizophrenia has been the leading cause of hospitalisations since 2019-20.
• In 2022-23, rates of hospitalisations due to schizophrenia were highest in Brimbank, Moonee Valley and Maribyrnong. GP diagnoses rates are also high in Brimbank and Maribyrnong.
• In 2022, schizophrenia was the top mental health condition attributed to hospitalisations in people aged 20 to 69.
• It was the fourth leading cause of mental health-related ED presentations in 2022-23.
• It was also the second highest condition driving ED presentations in people aged 40 to 59. GP diagnoses rates of schizophrenia were highest in people aged 40 to 59.

Alcohol and other drugs

• Alcohol use was consistently one of the top drivers of hospitalisations and ED presentations between 2019-20 and 2022-23.
• Alcohol use was the leading cause of ED presentations in adults aged 30 to 59 and the second highest leading cause of hospitalisations in adults aged 30 to 69.
• Of all LGAs, Yarra had the highest hospitalisation and ED presentation rates due to alcohol use in 2022-23. Additionally, for people who consume more than 2 standard drinks a day, Yarra ranks second of the LGAs in NWMPHN region.