Differences in Use of Government Subsidised Mental Health Services by Men and Women with Psychological Distress: A Study of 229,628 Australians Aged 45 Years and Over

  • Xenia Dolja-Gore
  • Deborah Loxton
  • Catherine D’Este
  • Fiona Blyth
  • Julie Byles
Brief Report


This study examined factors associated with use of government subsidised mental health services by 229,628 men and women from the Sax Institute’s 45 and Up Study. Logistical regression models assessed use of mental health services by gender and according to level of psychological distress. Approximately equal proportion of men and women had high psychological distress scores (approximately 7%) but only 7% of these men and 11% of these women used services. Use was associated with predisposing (younger age and higher education), enabling (private health insurance) and need factors (higher psychological distress scores). Associations were similar for men and women except urban area of residence, separated/divorced marital status, and smoking were associated with service use for women but not men. Results suggest some inequity in the use of services by those with higher levels of need and further efforts may be required to reach people with higher need but lower service use.


Access to care Mental health services Severe psychosocial distress 



This research was completed using data collected through the 45 and Up Study ( The 45 and Up Study is managed by the Sax Institute in collaboration with major partner Cancer Council NSW; and partners: the National Heart Foundation of Australia (NSW Division); NSW Ministry of Health; NSW Government Family & Community Services – Carers, Ageing and Disability Inclusion; and the Australian Red Cross Blood Service. We thank the many thousands of people participating in the 45 and Up Study. This specific project was conducted by the University of Newcastle and the Sax Institute. We acknowledge the Australian Government Department of Human Services for providing the Pharmaceutical Benefits Scheme and Medical Benefits Schedule data.

Compliance with Ethical Standards

Conflict of interest

All authors have read and understood the Community Mental Health Journal policy on declaration of interests and all authors declare: JB was funded by Beyondblue through the SAX institute to carry out the research for the submitted work but this does not represent a conflict of interest; both JB and DL from ‘The Priority Research Centre for Generational Health and Ageing’ research centre have a financial relationships with the Department of Health and Ageing who fund the Australian Longitudinal Study on Women’s Health study this dataset was not used in the current study and is not a conflict of interest in this research; no other relationships or activities exist that could appear to have influenced the submitted work.

Ethics Approval

The 45 and Up study is bound by the Australian Commonwealth and State privacy legislation, including the Health Records and Information Privacy Act and the NSW Health Privacy Manual. In addition, ethical approval for the 45 and Up Study as a whole was obtained from the University of New South Wales Human Research Ethics Committee. Participants are non-identifiable and personal information is not disclosed to the researcher. For this project privacy protocols were signed and the project specifications were approved by the Sax Institute for use of the 45 and Up Study data. This study was approved by the University of New South Wales and University of Newcastle Human Research Ethics Committees.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Xenia Dolja-Gore
    • 1
    • 2
    • 6
  • Deborah Loxton
    • 1
    • 2
  • Catherine D’Este
    • 3
  • Fiona Blyth
    • 4
  • Julie Byles
    • 1
    • 2
    • 5
  1. 1.Research Centre for Generational Health and AgeingThe University of NewcastleCallaghanAustralia
  2. 2.The Australian Longitudinal study on Women’s HealthThe University of NewcastleCallaghanAustralia
  3. 3.National Centre for Epidemiology and Population Health (NCEPH) Research School of Population HealthANU College of Medicine, Biology and EnvironmentCanberraAustralia
  4. 4.CHAMP Study Centre for Education and Research on Ageing Concord Hospital, Concord Clinical SchoolUniversity of SydneySydneyAustralia
  5. 5.Faculty of Health and MedicineThe University of NewcastleCallaghanAustralia
  6. 6.University of NewcastleNew Lambton HeightsAustralia

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