Effectiveness of care and support of SMHS mental health clients during admission and following discharge

Two women seated at a desk working on paperwork.

Mental health inpatient services aim to provide treatment to enable consumers to return to the community as soon as possible.

A key indicator of the National Mental Health Strategy (external site) is the readmission of a client to a mental healthcare facility following a recent discharge. This indicator may assist hospitals and health services to identify and address episodes of care where the inpatient treatment may be incomplete or ineffective, or where follow-up care was inadequate to maintain the person’s treatment out of hospital. 

Internationally, one month (28-days) has been identified as an appropriate time period for the measurement of unplanned readmissions following discharge from an acute mental health inpatient service.


Measuring unplanned readmissions

The unplanned readmission rate is measured as the percentage of overnight separations an acute specialised mental health inpatient unit which is followed by unplanned readmission to the same, or to another designated acute specialised mental health inpatient unit, within 28-days of discharge.

WA Health defines an acute specialised mental health inpatient unit as a service that provides voluntary and involuntary short-term inpatient management and treatment during an acute phase of mental illness, until the person has recovered enough to be treated effectively and safely in the community.

A separation for this measure occurs anytime a client leaves an acute mental health care facility following a planned discharge, or discharge against medical advice.

The rate is calculated by dividing the number of clients experiencing an unplanned readmission within 28-days of discharge, by the number of patients discharged within the same reference period, which is then multiplied by 100 to get a percentage.

The indicator is reported against the hospital from which the patient was discharged rather than the hospital or facility to which the patient was readmitted.

Benchmark rates

The benchmark rate for this indicator is ≤12 per cent as established by WA Health to monitor readmissions within a short time frame that may flag deficiencies in inpatient treatment and/or follow-up care.

See how we measure up

The graph below shows the overall SMHS unplanned readmission rate for mental health patients at SMHS hospitals with an acute mental health unit:

  • FHHS – Fremantle Hospital and Health Service
  • FSH – Fiona Stanley Hospital
  • RkPG – Rockingham Peel Group

Figure 1: Percentage of unplanned readmissions to an acute specialised mental health inpatient unit within 28 days of discharge, March 2017 – September 2018

The overall SMHS rate averaged 15.1 per cent between March  and December 2017, and then dropped to a rate of 8 per cent, below the ≤12 per cent benchmark in December 2017. For January to June  2018, SMHS averaged a rate of 17.9 per cent.

What do these figures show?
  • The overall SMHS rate averaged 15.1 per cent between March  and December 2017, and then dropped to a rate of 8 per cent, below the ≤12 per cent benchmark in December 2017. For January to June  2018, SMHS averaged a rate of 17.9 per cent.
  • It should be noted that a number of the readmissions included in this indicator relate to patients who have crisis management plans in place and are therefore  encouraged to return to hospital if certain criteria are met. Whilst this model of care is in line with international evidence-based best practice, additional strategies have been implemented by SMHS hospitals to further support the care and services provided to these patients. 
Produced by

South Metropolitan Health Service