Table 1.
Comparison of mental health service systems in Australia, New Zealand, Canada and the United States
| Australia | Canada | New Zealand | United States | |
|---|---|---|---|---|
| Health service system and private insurance role | Universal public medical insurance programme (Medicare); regionally administered public hospital funding ~47.3% buy complementary and supplementary coverage | Universal public medical insurance programme that plans and funds (mainly private) provision, administered separately by each province/territory ~67% buy complementary coverage for non-covered benefits | National healthcare system; District Health Boards are responsible for planning, funding and provision ~33% buy complementary coverage and supplementary coverage | Medicare provides insurance for those aged 65 and older, some disabled; Medicaid provides insurance for low-income; for those without employer coverage, state-level insurance exchanges exist with income-based subsidies ~66% of population is covered by primary private voluntary insurance (employer-based and individual) |
| Funding for mental health | Mental health-related general practitioner (GP), psychologist and specialist consultations are reimbursed by Medicare; inpatient admissions to public hospitals are free | Mainstream GP, specialist and hospital mental health services are provided free by provinces and territories; National government supports mental health services for a subset of populations | District Health Boards fund community and institutional care for mental health needs; inpatient and outpatient public hospital services are free | Most private health insurance plans are required to cover mental health and substance use disorder services; all Medicaid and Medicare cover some mental health services |
| Health service system applicable to Indigenous population | Largely administered by mainstream organisations; some care is provided by the National Aboriginal Community Controlled Organisation, a network of independent local health services owned and run by local Aboriginal and Torres Strait Islander communities | Through the First Nations and Inuit Health Branch, the federal government delivers certain mental health services and funds non-insured health benefits (including counselling) to eligible First Nations and Inuit communities | Primary Health Organisations, funded by District Health Boards, are customised to their enrolled populations, sometimes with a focus on the Maori population | The federal government fully funds health services, including mental health services, for Native Americans and Alaska Natives through a combination of Medicaid and care delivered by the Indian Health Service |