A spatial analysis of referrals to a primary mental health programme in Western Sydney from 2012 to 2015

Access to Allied Psychological Services is a primary mental health programme targeting hard-to-reach populations throughout Australia. This research aims to identify patterns of referrals to the programme in the Western Sydney Primary Health Network region from 2012 to 2015. The referral rates were analysed by using spatial autocorrelation indexes and spatial regression. The study area was described through the identification of the most disadvantaged areas and through consideration of three socio-economic indicators: percentage of Aboriginal and Torres Strait Islander Australians, low educational attainment and low weekly incomes. A large hot spot (identifying high referral rates) was located across the duration of the study in the south-western urban area that partially covered a disadvantaged area. The main cold spot (identifying low referral rates) was located in the south-eastern urban area, covering another disadvantaged area, however critically this association disappeared over time. Our modelling showed that the referral rates had a direct association with the percentage of Aboriginal and Torres Strait Islander peoples with low incomes, and an indirect association with low educational attainment. The results and technique are useful in monitoring and addressing inequality in health planning and policy.