Public Mental Health Services Research Articles

Three Things We Learned Along the Way: lessons for training in psychiatric epidemiology.

The COVID-19 pandemic, and its associated mortality, morbidity, deep social and economic impacts was a global traumatic stressor that challenged population mental health and our de-facto mental health care system in unprecedented ways. Yet in many respects, this 'crisis' is not new. Psychiatric epidemiologists have recognized for decades the need and unmet need of people in distress and the limits of the public mental health services in the United States. We argue that psychiatric epidemiologists have a critical role to play as we endeavor to address population mental health and draw attention to three areas of consideration: the need to elevate population based solutions; engaging equitably with lived experience; and interrogating recovery. Psychiatric epidemiology has a long history of both responding to and shaping our understandings of the relationships among psychiatric disorders and society through evolving methods and training, and the current socio-historical moment again suggests that shifts in our practice can strengthen our field and its impact.

“It Felt Like I Was Being Tailored to the Treatment Rather Than the Treatment Being Tailored to Me”: Patient Experiences of Helpful and Unhelpful Psychotherapy

ABSTRACT Objective This qualitative study explores patients’ experiences of psychotherapy, focusing on elements perceived as helpful or unhelpful and suggestions for improvement in the context of public mental health care. Methods A total of 148 adults (Mean age = 32.24, SD = 9.92) who had been or are currently receiving psychological treatment from the National Health Service (NHS) responded to an online survey. The survey included open-ended questions regarding their experiences of psychotherapy, asking them to identify helpful or unhelpful aspects, and suggestions for improvement. Using thematic analysis, key themes were identified. Results The analysis highlighted the patient’s preference for personalized treatment, the importance of therapeutic alliance, the demand for depth in therapy, and life skills and agency as therapeutic outcomes. Participants suggested improvements such as more tailored approaches and stronger therapist-patient relationships, supporting an adaptable, patient-centered model. Conclusion The study highlights challenges in public mental health services where patients might feel their specific needs are not being recognized and met and underscores the importance of personalized treatment plans that satisfy and evolve with patient needs, suggesting that therapists must be attentive and responsive to individual desires to enhance the patient experience.

Machine learning identifies different related factors associated with depression and suicidal ideation in Chinese children and adolescents

BackgroundDepression and suicidal ideation often co-occur in children and adolescents, yet they possess distinct characteristics. This study sought to identify the different related factors associated with depression and suicidal ideation. MethodsA nationwide cross-sectional survey collected data from Chinese children and adolescents aged 8 to 18 (N = 160,962; 48.91 % girls). The survey included inquiries about demographics, depression, suicidal ideation, anxiety, perceived stress, academic burnout, internet addiction, non-suicidal self-injury, bullying, and being bullied. Fifteen machine learning algorithms were conducted to identify the different related factors associated with depression and suicidal ideation. Additionally, we conducted external validation on an independent sample of 1,812,889 children and adolescents. ResultsOur findings revealed seven related factors linked to depression and six associated with suicidal ideation, with average accuracy rates of 86.86 % and 85.82 %, respectively. For depression, the most influential factors were anxiety, perceived stress, academic burnout, internet addiction, non-suicidal self-injury, experience of bullying, and age. Similarly, anxiety, non-suicidal self-injury, perceived stress, internet addiction, academic burnout, and age emerged as paramount factors for suicidal ideation. Moreover, these related factors showed notable variations in their predictive capacities for depression and suicidal ideation across different subgroups. ConclusionAnxiety emerged as the predominant shared factor for both depression and suicidal ideation, whereas the other related factors displayed distinct predictive patterns for each condition. These findings highlight the critical need for tailored strategies from public mental health service providers and policymakers to address the pressing concerns of depression and suicidal ideation.

Almost one in five emergency department presentations are by mental health clients: a secondary data analysis.

Mental health-related emergency department (ED) presentations are steadily increasing, including presentations for both mental health and non-mental health concerns by existing clients of mental health services. The study aim was to examine and compare mental health clients and non-clients' ED presentations, identify data and clinical gaps and make recommendations for improvement. De-identified 2017/2018 ED data were used to describe presentations for current and recent (within last 5 years) clients of specialist public mental health and addiction services, compared to presentations of non-mental health clients. Of 49,170 presentations, 18% were by clients of mental health services. Compared to other ED presenters, mental health clients were often younger, female and Māori, required more urgent care and waited longer. Mental health-related International Classification of Diseases (ICD) codes/referrals were most common for presentations by current mental health clients, whereas pain and trauma were often the reason for prior mental health clients' presentations. Discharge diagnoses rarely included self-harm behaviour, and admissions for these clients were more commonly by ED rather than mental health services. Mental health clients are common in ED. Enhanced mental health data capture and improved systems and processes are needed to ensure that ED staff can better meet their often-complex needs.

A cost-effectiveness analysis of a housing and recovery program for people with severe and persistent mental illnesses and precarious housing

ABSTRACT The Doorway program supports people with Serious and Persistent Mental Illnesses (SPMIs) receiving care within Victoria’s public mental health system and who are precariously housed. This paper reports on its cost-effectiveness. The study design was difference-in-differences involving a Treatment-As-Usual comparison group (TAU) using deidentified client records. The primary outcome measure was the proportion of days of secure housing per participant during the study and pre-study periods. Similarly, health service usage was also extracted from participants’ records. The cost of public mental health service usage was then estimated, including using governmental published data. The program’s Incremental Cost Effectiveness Ratio (ICER) and Cost-effectiveness Acceptability Curve were estimated using the bootstrap method. An ICER threshold of Australian $50,000 per additional person housed (hereafter A$) at 100% was set to determine cost-effectiveness and the probability of cost effectiveness at A$50,000. Mean total costs (secure housing and mental health service usage) were greater for the Doorway group compared to the TAU group (A$22,987). Mean percentage of days securely housed was also greater for the Doorway group (by 45.4%). The ICER value was A$50,613, the probability of this being 83.1%. The Doorway intervention was both more costly and more effective. Its cost-effectiveness approximated the pre-specified ICER threshold.

Preparedness and training needs of a regional public mental health service to support people with intellectual disability.

To explore the preparedness and training needs of a regional public mental health workforce to support people with intellectual disability and mental ill health. Staff from a regional public mental health service in Victoria, Australia. A mixed-methods design comprised a survey, interviews and a focus group to collect data about staff attitudes, confidence, education and professional development regarding supporting people with intellectual disability and mental ill health. Descriptive and thematic analyses were used. Data from 31 survey respondents, seven interviews and one focus group were analysed. Survey descriptive analyses showed participants believed treating people with intellectual disability was part of their role but reported areas of low confidence along with insufficient education and training in intellectual disability mental health. Thematic analyses from interviews showed that underpinning confidence, education and training were the themes (1) need for flexibility, such as having more time and (2) solutions but with challenges, such as limited opportunity to upskill and availability of experts. A need for collaborative problem-solving where staff share skills and information to work towards person-centred solutions was a key theme from the focus group analysis. Professional development in intellectual disability mental health is required for the regional public mental health workforce but needs to account for the challenges experienced and reflect how teams function. Exploration of described preparedness offered a possible learning approach informed by workforce members. Collaborative learning approaches to supporting people with intellectual disability and mental ill health are suggested.

From principles to practice: Clarifying new obligations under Victoria's Mental Health and Wellbeing Act 2022.

To explain the new test for complying with the mental health principles under the Mental Health and Wellbeing Act 2022 (Vic). The principles carry over limitations from the previous Mental Health Act 2014 (Vic) while also containing new features. The 'all reasonable efforts to comply' and 'proper consideration' tests resemble the existing test under section 38(1) of the Charter of Human Rights and Responsibilities Act 2006 (Vic) that also apply to public mental health services. Taking these duties together, public mental health services, including hospital and community mental health boards, clinical directors and clinical governance processes, will need to show concrete evidence of specific rights and/or principles being deliberated in their decisions.

Changes in mentalization in patients with personality disorders during sequential brief-Adlerian psychodynamic psychotherapy: The role of therapists' technique and countertransference.

The aim of the present work was to study the relationship between therapists' technique, therapists' CT, and patients' mentalization, in a sample of patients with PDs undergoing a 40-session program of sequential brief-adlerian psychodynamic psychotherapy, a psychodynamic therapeutic model specifically developed for the treatment of PDs in public mental health services. Eighty-seven patients with PD and their therapists completed ratings of mentalization (mentalization imbalances scale and reflective functioning questionnaire), CT (therapist response questionnaire), and therapists' intervention (comparative psychotherapy process scale) at five different time points (Sessions 5, 10, 20, 30, and 40). Results showed that patients' mentalizing problematics decreased over time. Moreover, we found a reduction of therapists' disengaged CT, and an increase in positive CT over time. Regarding therapists' techniques, psychodynamic-interpersonal interventions were on average higher than cognitive-behavioral, but both techniques were used increasingly over time. Our results also showed significant and clinically coherent interactions between therapist's CT and techniques and between patient's mentalization imbalance and therapist's response. Our results highlighted the importance of early stages in therapy, since the most significant relationships between the various process variables (patient's mentalizing imbalances, therapist's techniques, and emotional responses) are observed between t₁ and t₂, corresponding to the initial phases of the treatments. Clinical implications will be discussed. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Evaluation of a smoking cessation program for adults with severe mental illness in a public mental health service.

Smoking rates have decreased in the general population but remain high among people with severe mental illness (SMI). An individualized smoking cessation program was tested with 99 adults with SMI. The program showed it is possible to help people with SMI smoke fewer cigarettes and reduce nicotine addiction. Customized smoking cessation programs are essential for those with high nicotine dependence and mental health challenges. Mental health services should offer tailored tobacco cessation programs because these programs can improve the health of people with mental illness who smoke. It is important for mental health services to follow government guidelines and provide evidence-based support. INTRODUCTION: Despite significant reductions in smoking rates in the general population over recent decades, smoking rates remain relatively unchanged among people with SMI. To evaluate the feasibility and preliminary effectiveness of the Keep Quitting in Mind pilot program, an individualized smoking cessation program for people experiencing SMI. In total, 99 adult participants with SMI and engaged with a community mental health service, participated in the intervention. The intervention included motivational interviewing and goal setting, in addition to provision of pharmaceutical aids (including nicotine replacement therapy). Analysis determined that the Keep Quitting in Mind pilot program was feasible in a public adult mental health service and participation in the program was associated with reductions in the number of cigarettes smoked daily and level of nicotine addiction. This real-world pilot program demonstrated feasibility and potential effectiveness in reducing smoking among adults with mental illness. Aligning with government guidelines, tailored smoking cessation programs are crucial due to high nicotine dependence and mental health complexities. Given the high rates of cigarette smoking by people with mental illness and the cardiometabolic health risks associated with this, mental health services should consider adding evidence-based and bespoke tobacco cessation programs as part of core business.

Group Acceptance and Commitment Therapy for Recovery From Psychosis: Protocol for a Single-Group Waitlist Trial.

Psychological interventions, along with antipsychotic medications, are recommended for adults diagnosed with a psychotic disorder. While initially designed to mitigate positive symptoms, psychological interventions targeting personal recovery were developed and aligned with the recovery framework that many mental health services have adopted. Acceptance and Commitment Therapy (ACT) for psychosis is one such intervention that shows promise when delivered in an individual format. There is preliminary evidence that ACT for psychosis in a group format improves recovery. This trial aims to evaluate the effectiveness of the "Recovery ACT" group program on personal recovery among adults living with a psychotic disorder. Our unfunded study is a multiagency, prospective, nonrandomized, waitlist control, single-group trial of the Recovery ACT group program. The program involves 7 weekly group sessions of 90 minutes duration and a 90-minute booster session held 1 month later. We intend to recruit 160 adults living with a psychotic disorder who enroll in a group that is offered as a routine clinical service at participating public mental health services in Melbourne, Victoria, Australia. The 4 assessment time points are 4-6 weeks before the start of the group program, at the start of the group program, at the end of the group program, and at the booster session. There is an optional midgroup assessment and follow-up study. The primary outcome is personal recovery. Secondary outcomes include participants' well-being and psychological flexibility processes. Qualitative data are also collected from participants and facilitators. Recruitment began in September 2019 and is ongoing until 2024, subsequent to a 24-month disruption due to the COVID-19 pandemic. As of the submission of this paper, 93 participants consented to the evaluation, 65 completed T1 measures, and 40 had a complete data set for the proposed analyses. This is the first trial evaluating the effectiveness of the Recovery ACT group program on personal recovery for adults living with a psychotic disorder. Findings will contribute to knowledge about psychosocial interventions for adults living with psychosis. This trial may also serve as an example of a partnership between clinicians and academics that can facilitate the translation of research into practice. Australian New Zealand Clinical Trials Registry ACTRN12620000223932; https://anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12620000223932. DERR1-10.2196/49849.

Development of a psychological health promotion intervention for ultra-orthodox Jewish mothers of children with ADHD using the intervention mapping protocol

BackgroundAttention Deficit Hyperactivity Disorder (ADHD) is a common neuro-developmental health condition in children and adolescents, in which its associated behavior manifestations are known to negatively affect members of the family unit, especially mothers. Ultra-orthodox Jewish (UOJ) community is growing globally and mothers of children with ADHD in this community are potentially at risk for negative health outcomes. As the UOJ community is culturally conservative, maintaining a distinct separation from outside influences, they often avoid utilizing public mental health services due to stigma and a lack of culturally sensitive treatments. Thus, this study aimed to develop a theory-driven and culturally appropriate psychological health promotion intervention for these mothers using the Intervention Mapping protocol.MethodsA mixed-method design was used. Qualitative content analysis was performed on four focus groups (n=25). Additionally, descriptive statistics including the content validity index was used to measure feedback regarding the developed intervention protocol’s relevance, effectiveness, and appropriateness Theoretical models for behavior change, including the Behavior Change Wheel’s COM-B system and the Theoretical Domains Framework, and literature on ADHD in the general population and the ultra-orthodox community were integrated in the process. Intervention components were systematically derived from findings.ResultsKey determinants of health behavior change were identified, resulting in formulating intervention objectives addressing stigma reduction surrounding ADHD, increasing knowledge about the ADHD condition and treatment, awareness of the school systems’ capabilities in meeting the ADHD child’s needs, enhancing mothers’ advocacy skills, and maternal self-care. Intervention? strategies included a group setting, providing information on health consequences, social support, re-attribution, active learning, goal setting, and promoting an identity associated with the desired behavior change. Mothers’ quantitative feedback confirmed the overall relevance, effectiveness, and appropriateness of the interventions’ content (CVIavg= .86, .85, .87).ConclusionsIntervention Mapping facilitated the development of a culturally sensitive psychological health promotion intervention for ultra-orthodox Jewish mothers of children with ADHD. Further research is warranted to assess intervention feasibility and effectiveness.

SNS 기반 모바일 정신건강서비스 플랫폼 이용경험에 관한 현상학적 연구

This study is a phenomenological study on the experience of using a mobile mental health service platform developed and provided by mental health social welfare experts, and was conducted to provide practical policy and practical suggestions for the necessity of a mobile mental health service platform and the use of a professional mobile mental health service platform in Korea's mental health service delivery system. To this study, data were collected from 12 research participants who have been continuously using the platform for more than a year, and the data were analyzed by applying Giorgi's phenomenological perspective to deeply analyze the nature and meaning of the experience of the phenomenon. As a result of the analysis, 7 components and 20 sub-components were derived, and the components were found to struggle in the beginning and despair of the problem, mental health services I used and negative memories, various mental health services experienced in accidental spaces, reasons for continuing to find the mobile mental health service platform, psychological stability and practical change and recovery, limitations of personal mobile mental health service platforms, and partnerships with public mental health services. Based on these analysis results, the conclusions of this study and practical suggestions were presented.

Exploring safety culture within inpatient mental health units: The results from participant observation across three mental health services.

In Australia, acute inpatient units within public mental health services have become the last resort for mental health care. This research explored barriers and facilitators to safe, person-centred, recovery-oriented mental health care in these settings. It utilised participant observations conducted by mental health nurses in acute inpatient units. These units were located in three distinct facilities, each serving different areas: a large metropolitan suburban area in a State capital, a mid-sized regional city, and a small city with a large rural catchment area. Our findings highlighted that, in the three inpatient settings, nurses tended to avoid common areas they shared with consumers, except for brief, task-related visits. The prioritisation of administrative tasks seemed to arise in a situation where nurses lacked awareness of alternative practices and activities. Consumers spent prolonged periods of the day sitting in communal areas, where the main distraction was watching television. Boredom was a common issue across these environments. The nursing team structure in the inpatient units provided a mechanism for promoting a sense of psychological safety for staff and were a key element in how safety culture was sustained.

A qualitative evaluation of a co-design process involving young people at risk of suicide.

Co-design is becoming common practice in the development of mental health services, however, little is known about the experience of such practices, particularly when young people are involved. The aim of this study was to conduct a process evaluation of the co-design which was undertaken for the development of an intervention for youth and adolescents at risk of suicide. This paper briefly outlines the co-design process undertaken during a COVID-19 lockdown and then focuses on a qualitative evaluation of the experience of taking part in a co-design process. The evaluation involved young consumers of a public youth mental health service, their carers/parents and service delivery staff who had taken part in the co-design process. This study used follow-up semistructured interviews with the co-design participants to explore their experience of the co-design process. Inductive thematic analysis was used to draw out common themes from the qualitative data. It was found that despite the practical efforts of the project team to minimise known issues in co-design, challenges centred around perceptions regarding power imbalance, the need for extensive consultation and time constraints still arose. Despite these challenges, the study found that the co-design provided a human-centred, accessible and rewarding process for young people, parents and staff members, leaving them with the feeling that they had made a worthwhile contribution to the design of the new service, as well as contributing to changing practice in service design. With sensitivity and adaptation to usual practice, it is possible to include young people with suicidal ideation, their parents/carers and professional staff in a safe and effective co-design process. The authors would like to thank and acknowledge the young people with a lived experience and their carers who participated in the co-design process and research evaluation component of this study. We also wish to thank the clinical staff, peer workers and family peer workers who participated in this research.

Risk and protective factors for substance use and media addictive behaviors in adolescents during the COVID-19 pandemic.

This study examined the long-term effects of the COVID-19 pandemic on adolescents' substance use, digital media use, and symptoms of internet, gaming, and social media addiction. A nationally representative longitudinal cohort of 1665 Israeli teens and preteens, aged 9-16, completed questionnaires assessing substance use prevalence, daily screen time, symptoms of media addiction, and potential risk and protective factors. Data were collected before the pandemic (October 2019), after the second wave lockdown (November 2020), and after the fifth wave (April 2022) in Israel. The analysis documented significant increases in substance use, daily screen time, and social media addiction indices over time. Gratitude, life satisfaction, positive emotions, future orientation, grit, and secure attachment emerged as significant protective factors. Sensation-seeking, negative emotions, and mental health symptoms were identified as risk factors. These findings highlight the importance of educational and public mental health services in addressing the pandemic's long-term impact on the mental health and addictive behaviors of adolescents. They also emphasize the significance of enhancing protective factors and reducing risk factors to effectively mitigate substance and digital media abuse among adolescents.

Religious coping and suicidal ideation as a predictive model for suicide attempts

Background and objective: Religious coping can help understanding suicide in its prevention and intervention. The objective of this study was to investigate if religious coping and suicidal ideation could be used as a predictive model for suicide attempts.Methods: This is a survey and correlational delineation, carried out in southern Brazil with 260 adults assisted by the a public mental health service in two cities in northern Paraná from October 2020 to June 2021. For data collection, three instruments were used: The first one was a sociodemographic/clinical questionnaire to profile the participants; The second instrument was composed of 30 items dealing with impulsivity manifestations. The third instrument was used because it addresses coping and how people deal with everyday adversity through faith. Logistic regression analysis was used, through the SPSS®, v. 28. The dichotomous outcome variable was the suicide attempt, and the independent variables were a negative domain of the RCOPE scale. At first, three regression models were considered. A greater adherence happened only when the nominal variable “Have you ever tried to commit suicide?” qualified as an outcome variable.Results: The suicide attempt as an outcome and the other variables performing as predictive represented a higher sensitivity (96.8%) compared to the previous models. As the negative coping score was increased by 1 unit, there was also an increase in the chances of suicide attempting by 1.83 times (95% CI 1.11;3.00).Conclusions: It was discussed that religiosity has a positive impact on suicidal behavior, as it provides well-being/happiness, especially for those with mental disorders. This study would contribute to understanding the role and effects of religious coping in the process of counseling by healthcare workers. It is the first study to present predictive modelling for suicide attempt from negative religious coping. Hopefully, it would contribute to improve the process of counseling by mental health nurses and other healthcare workers.

Acceptability and feasibility of recovery-oriented group acceptance and commitment therapy for psychosis in routine practice: an uncontrolled pilot study.

Personal recovery is a persisting concern for people with psychotic disorders. Accordingly, mental health services have adopted frameworks of personal recovery, prioritizing adaptation to psychosis alongside symptom remission. Group acceptance and commitment therapy (ACT) for psychosis aims to promote personal recovery alongside improved mood and quality of life. The objectives of this uncontrolled, prospective pilot study were to determine whether 'Recovery ACT' groups for adults are a feasible, acceptable and safe program within public mental health services, and assess effectiveness through measuring changes in personal recovery, wellbeing, and psychological flexibility. Program feasibility, acceptability and safety indicators were collected from referred consumers (n=105). Adults (n=80) diagnosed with psychotic disorders participated in an evaluation of 'Recovery ACT' groups in Australian community public mental health services. Participants completed pre- and post-group measures assessing personal recovery, wellbeing, and psychological flexibility. Of 101 group enrollees, 78.2% attended at least one group session (n=79); 73.8% attended three or more, suggesting feasibility. Eighty of 91 first-time attendees participated in the evaluation. Based on completer analyses (n=39), participants' personal recovery and wellbeing increased post-group. Outcome changes correlated with the linear combination of psychological flexibility measures. 'Recovery ACT' groups are feasible, acceptable and safe in Australian public mental health services. 'Recovery ACT' may improve personal recovery, wellbeing, and psychological flexibility. Uncontrolled study design, completer analyses, and program discontinuation rates limit conclusions.

The Psychiatric Reform in Andalusia (Spain). Four decades of transformations in Public Mental Health Services

The article aims to present in a summarized way the most outstanding characteristics of the process of transformation of public structures of attention to mental health problems, officially initiated in Andalusia in June 1984, with the approval by Parliament of law on the subject.
 Throughout these almost 40 years the archaic structure of services that characterized psychiatric care has been transformed into a complex network of community orientation, surpassing the Psychiatric Hospitals and with a health sector integrated into the Public Health System and another intersectoral dependent on the FAISEM public Foundation.
 The text presents the previous characteristics, the lines of work developed, and the main results obtained, with a positive assessment in relation to the initial situation, but also with important aspects not adequately resolved and that need subsequent developments that, however, are not being addressed today.

Reflections on culture in practice amongst team leaders and directors in Australian public mental health services

ABSTRACT Objective This study explores team leaders’ and directors’ perceptions of the facilitators and barriers to effective mental health care to meet the needs of culturally and linguistically diverse (CALD) clients in the public mental health system across greater Brisbane, Australia. This is critical given Australia’s cultural diversity and treatment limitations and gaps for CALD clients. Method A purposive sample of decision-makers working in the public mental health system (N = 6) completed semi-structured interviews. A thematic analysis was undertaken to identify dominant themes. Results Participants discussed planning, delivery, and evaluation of culturally inclusive and effective mental health care. When planning for culturally appropriate services, collaboration with internal services, such as multicultural specialist services, was the most frequently discussed facilitator, while limited resources were the most identified barrier. Clinicians’ cultural sensitivity and biases were identified as an important influence on service delivery. Participants identified significant gaps in evaluation and limited data collection to support the evaluation of cultural safety within services. Conclusion The findings provide insight into systemic factors affecting culturally inclusive and safe practices in an Australian public mental health setting. Implications for research, policy, and practice are discussed.

Younger people with dementia registered to public mental health services in Victoria, Australia.

ObjectivesIndividuals living with young-onset dementia fall through the gaps of adult and geriatric services. Given that non-cognitive symptoms of dementia in younger people are often psychiatric and behavioural in nature, these people may contact mental health services. There is sparse information investigating the frequency of people with young-onset dementia who contact mental health triage in Victoria.MethodsTriage data were obtained from the Victorian Agency for Health Information. The data contained demographics for people registered with Victorian mental health services. Consumers who had an International Classification for Diseases code for dementia and were aged less than 65 years were identified as people with young-onset dementia. Using information of the frequency of people with young-onset dementia who were registered with each area-based mental health service, population census statistics were used to make estimates of the frequency of young-onset dementia.ResultsOf the 6172 people who had a dementia diagnosis, 1020 of them were aged less than 65 years and had young-onset dementia. There were proportionally more men who had young-onset dementia compared to women. There were more people with young-onset dementia registered to rural mental health services compared to metropolitan services.ConclusionFindings provide important information for service planning in Victoria. Recommendations include upskilling and education for the assessment of dementia for those clinicians who work in mental health services, particularly in rural regions.