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The purpose of this paper is to assess changes in rates of mental health problems and service utilisation for Australian regular injecting drug users (IDUs) from 2006 to 2012.

Data were taken from Illicit Drug Reporting System national surveys with 914 regular IDUs in 2006 and 883 in 2012. Changes in rates of self-reported mental health problems and service use were assessed.

Rates of self-reported mental health problems increased from 38.3 per cent in 2006 to 43.7 per cent in 2012 – mainly due to increases in anxiety rates. Conversely, there was a decrease in mental health service use from 70.2 to 58.4 per cent by 2012. However, there was a proportional increase in the use of psychologists. These trends remained after controlling for socio-demographic and medical differences between the 2006/2012 samples. K10 scores for 2012 participants validated the use of the self-report measures.

Reductions in stigma, improvements in mental health literacy, and modest increases in anxiety may explain increases in self-report of mental health problems. Stagnant service utilisation rates in an expanding population willing to self-report may explain decreasing service use. The introduction of key mental health reforms also may have contributed, particularly with the increase in psychologist access. This paper highlights the need for improved population monitoring of mental health in disadvantaged groups such as IDUs.

This paper is the first to assess changes in mental health outcomes over time in Australian IDUs. This examination covered a critical era in the mental health landscape, with significant increases in public awareness campaigns and major mental health reforms.