The trend in mental health-related mortality rates in Australia 1916-2004: Implications for policy

Doessel, Darrel P., Williams, Ruth F. G. and Whiteford, Harvey (2010) The trend in mental health-related mortality rates in Australia 1916-2004: Implications for policy. Australia and New Zealand Health Policy, 7 3: 1-10. doi:10.1186/1743-8462-7-3

Author Doessel, Darrel P.
Williams, Ruth F. G.
Whiteford, Harvey
Title The trend in mental health-related mortality rates in Australia 1916-2004: Implications for policy
Journal name Australia and New Zealand Health Policy   Check publisher's open access policy
ISSN 1743-8462
Publication date 2010-01-07
Sub-type Article (original research)
DOI 10.1186/1743-8462-7-3
Open Access Status DOI
Volume 7
Issue 3
Start page 1
End page 10
Total pages 10
Editor Hal Swerissen
Place of publication Clayton, VIC, Australia
Publisher CSIRO Publishing
Collection year 2011
Language eng
Formatted abstract
Background: This study determines the trend in mental health-related mortality (defined here as the aggregation of suicide and deaths coded as "mental/behavioural disorders"), and its relative numerical importance, and to argue that this has importance to policy-makers. Its results will have policy relevance because policy-makers have been predominantly concerned with cost-containment, but a re-appraisal of this issue is occurring, and the trade-off between health expenditures and valuable gains in longevity is being emphasised now. This study examines longevity gains from mental health-related interventions, or their absence, at the population level. The study sums mortality data for suicide and mental/behavioural disorders across the relevant ICD codes through time in Australia for the period 1916-2004. There are two measures applied to the mortality rates: the conventional age-standardised headcount; and the age-standardised Potential Years of Life Lost (PYLL), a measure of premature mortality. Mortality rates formed from these data are analysed via comparisons with mortality rates for All Causes, and with circulatory diseases, cancer and motor vehicle accidents, measured by both methods.

Results: This study finds the temporal trend in mental health-related mortality rates (which reflects the longevity of people with mental illness) has worsened through time. There are no gains. This trend contrasts with the (known) gains in longevity from All Causes, and the gains from decreases achieved in previously rising mortality rates from circulatory diseases and motor vehicle accidents. Also, PYLL calculation shows mental health-related mortality is a proportionately greater cause of death compared with applying headcount metrics.

Conclusions: There are several factors that could reverse this trend. First, improved access to interventions or therapies for mental disorders could decrease the mortality analysed here. Second, it is important also that new efficacious therapies for various mental disorders be developed. Furthermore, it is also important that suicide prevention strategies be implemented, particularly for at-risk groups. To bring the mental health sector into parity with many other parts of the health system will require knowledge of the causative factors that underlie mental disorders, which can, in turn, lead to efficacious therapies. As in any case of a knowledge deficit, what is needed are resources to address that knowledge gap. Conceiving the problem in this way, ie as a knowledge gap, indicates the crucial role of research and development activity. This term implies a concern, not simply with basic research, but also with applied research. It is commonplace in other sectors of the economy to emphasise the trichotomy of invention, innovation and diffusion of new products and processes. This three-fold conception is also relevant to addressing the knowledge gap in the mental health sector.
© 2010 Doessel et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons
Attribution License (, which permits unrestricted use, distribution, and reproduction in
any medium, provided the original work is properly cited.

Keyword Cause of death
Health care policy
Life expectancy
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2011 Collection
School of Public Health Publications
Version Filter Type
Citation counts: Scopus Citation Count Cited 4 times in Scopus Article | Citations
Google Scholar Search Google Scholar
Created: Wed, 09 Mar 2011, 15:23:05 EST by Geraldine Fitzgerald on behalf of School of Public Health