*Population in 2020，GNI and life expectancy are updated based on UN's 2019 data.

*Medical information is based on WHO's report of 2017 Mental Health Atlas-country profile.

I.      Overview

　　Australia located the smallest and oldest continent in the world, and the only major country in the world that occupies a single continent. It is the largest country in Oceania, the second largest (second only to Brazil) in the southern hemisphere, and the sixth largest in the world. It is also the biggest island nation in the world. The country includes the entire Australian mainland, and several overseas islands like Tasmania and Christmas Island, with a total area of 7,692,300 square kilometers.

　　Australia is a parliamentary and constitutional monarchy, Administratively, it is divided into six states (South Australia, Tasmania, New South Wales, Victoria, Western Australia and Queensland), There are two territories, one is Australian Capital Territory (ACT) and the capital Canberra is at the north, while another is Northern Territory, the total population is only about 25.49 million, and near 4.6 million people are concentrated in Sydney, of which is the biggest city. The proportion of the population under the age of 18 is 22%, while that of the age 60 or over is 13%. The population is dominated by the descendants of immigrants, of whom 76% are from Europe and 17% of Asians, and some minorities. The Australian indigenous people only account for less than 3% of its total population.

　　According to United Nations data, Australia's life expectancy at birth is 83.04 years. The gross national income per capita is about US$5,5100, which is a high-income country. The total medical expenditure accounts for 8.51% of the total GDP production. The government's per capita health care is US$2,113, and the total expenditure on mental health as percent of the overall medical expense is a high ratio of 7.81%. The suicide rates per 100,000 population for men and women are 16.7 and 4.4, respectively. According to World Health Organization (WHO) estimates, Australia's mental illness accounts for 29.4% of the global disease burden.

　　The federal government in charge of health is the Ministry of Health (hereinafter called MoH) which is responsible for providing information on Australian government health policies, plans and regulations to the public and the health care workers for the elderly.

II.      Mental health policy and system

　　The Australian government promotes the National Mental Health Strategy, which aims to enhance the mental health of the community, prevent mental illness, reduce the impact of disease on individuals, families and communities, and ensure the rights and interests of patients with mental problems The strategy was unanimously adopted by the supervisors of health in each states and the local governments in 1992, putting Australia's mental health reform on the national agenda and determining the direction and basic framework for the country. The said Strategy is derived from four documents, including National Mental Health Policy, Mental Health Statement Of Rights and Obligations, National Mental Health Plan and the Medicare Agreements, 1993-1998 .

　　The fifth phase National Mental Health and Suicide Prevention Plan is an integral part of the National Mental Health Strategy.

For the first time, the plan requires all levels of governments to work together to achieve the integration of planning and service provision at the local regions. In addition, the plan recognizes the tragic impact of suicide on the lives of so many Australians and sets a clear direction for the governments at all levels to take coordinated action to solve this important public issue effectively. In order to address the social and emotional well-being, mental issues and suicide problems of the aboriginal people and Torres Strait Islanders as the priority items, it is to improve the health needs of the residents with mental illness, and reduce the stigmatization and discrimination associated with the mental illness.

　　The fifth phase of the plan was formulated during a period of major changes in Australian social policy. The most important thing is the establishment of the National Disability Insurance Plan, which provides a lot of protection for people with psychosocial disabilities. In addition, the Primary Health Network has been built up as a new entity to provide primary and specialty mental health care, and several state governments have founded mental health committees to focus on the government’s overall approaches to mental care and suicide prevention.

Highlights include:

(1). Integrate regional planning and service provision

(2). Effective suicide prevention

(3). Coordinate treatment and support services for patients with severe and complex mental illness

(4). To improve the mental health and suicide prevention of Aboriginal and Torres Strait Islands residents

(5). To improve physical health for the patients with mental illness, and to  reduce the mortality rate.

(6). Safety and quality are the core of mental health services

(7). Ensure the effectiveness in the operation of the mental health system and appropriate improvements

　　In the next five years (2017-2022), the fifth phase of the plan will establish a national government cooperative action to improve the provision of better comprehensive mental health and related services in Australia.

　　It is based on the foundations of the previous four national mental health plans, the existing state and territory mental health and suicide prevention plans, and the reforms for the national health and mental health measures.

　　The Mental Health Act (MHA) enables people with acute mental illness to receive the compulsory treatment. Each jurisdiction of the state and territory government in Australia has its own MHA, and attempts to strike a balance between civil rights, the prevention of serious injuries and the need of nursing cares.

　　Medicare is the publicly-funded universal health care insurance scheme in Australia, operated by Services Australia. It is the main way that the Australian citizens and permanent residents can access health care in Australia, either partially or fully covering the cost of most primary health care services in the public and private health care system. International visitors from 11 countries have access to necessary medical treatment under the mutual beneficial agreements. All Australian citizens and permanent residents can have the complete covered health care in public hospitals and clinics. Most specialties and partial allied health services are underwritten by Medicare, including psychological and psychiatric illnesses, ophthalmological problems, physiotherapy and audiological diagnosis, etc., with the exception of dental services.

III.   Human Resources

　　There are 3,369 psychiatrists in Australia, it is 13.53 out of 100,000 people which should be one of the highest data in the world, and the average weekly working hours in remote and metropolitan areas are 40 and 38.7, respectively. There are 22,159 psychiatric nurses, of whom about 70% are women. Compared with 14,959 in 2007, it is an increase of 48%. Nearly 60% of nurses are over 45 years old. There are 26,311 psychologists, that is, 66.5 full-time clinical psychologists per 100,000 populations.

　　There are several potential problems in the human resources of mental health working in Australia:

(1). There are relatively few psychologists serving in Australia's existing mental health institutions, and they often serve part time as general case managers. Therefore, for patients with mental health problems, their professional contribution to providing expertise psychotherapy is insufficient.

(2). The distribution of psychiatric medical personnel is uneven, and most of  them are allocated in metropolitan areas. Many psychiatric consultations are in private practice and cannot support primary care and consultation services in rural and remote areas.

(3). The existing nursing manpower is gradually showing an aging labor force, and the supplement of it is greatly limited, it is foreseeable that in the future, there will be a serious shortage of professional nursing staff to maintain mental health services.

(4). Australia is experiencing a severe scarcity of mental health workers.

　　To become a psychiatrist in Australia, it first needs to spend 4-6 years studying medicine and get a medical degree, then to receive one-year on-the-job training in the hospital before obtaining the general medical registration from the Medical Board of Australia. After that, it is to be qualified to apply for admission to the Royal Australian and New Zealand College of Psychiatrists (RANZCP), and to complete RANZCP's psychiatry professional training for at least five years and passing the essential examination. With the completion of all the above-mentioned requirements, an academician of the RANZCP psychiatrist is finally born.

IV.    Mental health system and promotion

　　In Australia, mental health services provided by general practitioners, psychiatrists, psychologists, occupational therapists and social workers are subsidized through Medicare. In addition to the subsidy from medical insurance, it has a series of other specialized mental health services, which can be provided from public and private psychiatric hospitals, psychiatric wards of public emergency hospitals, community care services and inpatient services.

　　According to the 2018-2019 Mental Health Facility Service Report, there were 160 public hospitals and 66 private hospitals in Australia that provide specialized mental health services. There are a nationwide total of 12,830 specialized mental health beds, among which have 7,003 beds in public hospitals and 3,309 beds in private hospitals, while 2,518 beds are for the inpatient mental health services, To put it simply, near two-thirds of the beds in Australia are operated by government organizations. In the community mental health care institutions, there employ 13,389 full-time workers.

　　There are a number of different programs or groups that have done something to promote mental health in Australia:

　　Headspace is the National Youth Mental Health Foundation, it started in 2006 and committed to providing early intervention of mental health services for teenagers between the ages of 12 and 25. Headspace provides mental health, physical health (including sexual health), alcohol and other drug rehabilitation services, and one-stop-shop for work and study support to young people through their 124 communities services centers across the country. Through telephone consultation services, occupational services and campus-based services, headspace  helps thousands of young people obtain vital support. All headspace centers are not only designated for the young, but young people also will be invited to participate in the design to ensure their relevant, accessible and efficient styles. Each headspace center provides unique services that reflect the needs of its local community.

　　Starting in February 2019, 14 advocates from the Australian Youth Mental Health Department came forward to lead a new youth participation plan. The program is funded by the MoH, and coordinated by the National Space Administration, a cross-sectoral initiative-Australian Youth Advocates For Mental Health (AYAMH) – it aimed at promoting youth mental health literacy, improve the ability to seek help and support the self-care ability of young people, and to reduce mental health stigma across Australia. The project was to focus on the experience of Aboriginal and young islanders in the Torres Strait. The advocates invited young Australians to jointly design a national plan to help improve the mental health and well-being of young Australians.

V.       Major issues, challenge, and opportunities

　　Inferred from the results of the latest national adult mental health and well-being survey in 2007, nearly half (45%) of Australians aged 16 to 85 would experience a mental illness once in their lifetime. Approximately one-fifth of the Australian population had experienced a kind of Common Mental Disorder in the past years, of which anxiety is the most prevalent, affecting approximately one-seventh (14.4%) of the population. It followed by emotional disorders (like depression, about 6.2%), and substance use disorders (such as alcohol addiction, accounting for about 5.1%). The recent survey of children and adolescents was held in 2013-2014 and the prevalence rate of mental illness in the past 12 months was 13.9%, the ADHD was the most common with 7.4% of all children and adolescents, and it followed by anxiety (6.9%) and depression (2.8%). In addition, in 2010, the Australian government conducted a survey on patients with mental disorders, such as schizophrenia, schizoaffective disorder, and bipolar disorder, etc., and it was estimated that about 64,000 people in the Australian population used specialized mental health services, accounting for about 0.5% of the population, and nearly half of them were patients with schizophrenia. Mental illnesses cause major diseases and social burdens. According to the estimate in 2015, the mental problems and substance use disorders ranked fourth (12%) for disease burden in Australia, while the top three were cancer (18%), cardiovascular disease (14%), and musculoskeletal disease (14%). Mental illness was the main cause of disability, which was only slightly next to musculoskeletal diseases (both combined). Furthermore, the mental disease is often comorbid with other physical illnesses (one eighth of mental illness patients also have physical illnesses), and one third of whom for applying the disability tuition are also diagnosed with mental illness.

VI.    Potential exchange issues

　　It has highly developed in the national mental health policy in Australia, and the construction of the community rehabilitation care system and case management is worthy of further discussion as a reference. Potential communication topics include some of recent policy priorities, such as suicide prevention, indigenous mental health, improvement of the physical health of patients with mental illness, integration of treatment, support services for patients with severe mental illness, etc.