Tony Pasin (Barker, Liberal Party) Share this | Hansard source

Make no mistake, as we emerge from the COVID-19 pandemic, we are experiencing another arguably more alarming one the shadow pandemic. As this report states, approximately one in five Australians and nearly half of all adults will experience a mental or behavioural condition in their lifetime. Over 65,000 Australians make a suicide attempt each year, and over 3,000 Australians per year, sadly, end their lives that way.

I've been aware of the need to improve mental health services. Indeed, one of my very first campaigns when I ran for the federal parliament was to establish a headspace facility in Mount Gambier. I was pleased to deliver this, and Limestone Coast youth now have access to important mental health services. Now I'm campaigning for an adult Head to Health centre for Barker because I know that we need to improve access to community-based mental health services to a broader demographic, particularly in rural and regional communities. As this report outlines, the committee has heard that, across the board, there are insufficient services to treat people, whether with preventative interventions, low-level care or, indeed, high-level interventions. Services are needed to cater to different populations, especially those who require acute care, are living in rural and remote areas or are at risk of suicide.

Following the finalisation of this report, the South Australian coroner handed down the findings of an inquest into the death of Theo Nicholas Papageorgiou, who, at the age of 27, died as a result of compression of the neck due to hanging. While this inquest did not form part of the committee's inquiry, I want to take the opportunity to outline the circumstances of Theo's death, as they highlight quite blatantly the failing of our mental health system. The deputy coroner found that Theo's death was preventable. The inquest uncovered multiple failings in the mental health system in the Riverland, the regional community where Theo lived and worked. Despite Theo's parents doing their unquestionable best to seek the support for Theo that he needed, a lack of appropriate facilities and services and disjointed service provision failed Theo, and it failed his family. Theo was misdiagnosed. There was no communication between the clinicians in the Riverland who saw Theo, and there was a culture of passing the buck. Theo was placed on an inpatient treatment order at the Riverland General Hospital in November 2015. But the Riverland General Hospital did not—and still does not—have a closed ward capable of keeping Theo detained past the initial seven-day order. Rather than Theo being moved to an appropriate facility in Adelaide, he was sent home, despite being clearly and profoundly mentally unwell. Theo was floridly psychotic and was having delusional thoughts at this time.

The inquest found that the psychiatrist who had recently taken over the case was overwhelmed by work and did not have the full background to Theo's case. The deputy coroner remarked:

In many ways it is astonishing that—

the psychiatrist—

would not have been aware of Theo's complete mental history going back to 2014.

He also said:

It is difficult to see how discharge of Theo could have been contemplated as early as the second or third day given his presentation.

A couple of months later Theo's condition deteriorated and he fell into severe depression. At that point Theo's parents attempted twice to have Theo detained again through presentations at the emergency department of the Riverland General Hospital, which is a private service operated by GPs. The mental health ward in which Theo had previously received treatment is located under the same roof but operated by the state government. Both attempts by Theo's parents to have Theo detained again were denied in the emergency department, and Theo was sent home. The coroner noted that, because of the divide between the mental health ward and the emergency department, no consultation notes were passed between the services. The morning after Theo's parents' second attempt to have him detained, he was found dead. Theo's death occurred three days before he was due to see the 'visiting psychiatrist'—'visiting' being the key word.

The inquest heard that funding issues affecting country mental health services still exist more than five years after Theo's death. Recommendations in the coroner's report include the need for more psychiatrists in country South Australia. There are currently only three psychiatrists focused on acute cases and semi-acute cases in country South Australia, and two of them are in temporary positions. As the committee heard, to address workforce issues the federal government established an independent task force, the National Mental Health Workforce Strategy Taskforce, to work with the Commonwealth Department of Health and the National Mental Health Commission to develop a 10-year national mental health workforce strategy. The committee also heard from the Royal Australian and New Zealand College of Psychiatrists, who reinforced that there are access challenges, particularly in regard to psychiatrists. This is something Theo and his parents faced firsthand.

The federal government has committed $11 million in funding so far to boost the psychiatric workforce by increasing the number of training places, including in regional and remote areas, as well as additional funding to provide scholarships and clinical placements for nurses, psychologists and allied health practitioners. As the committee comments:

Over the years Australian governments have made commitments to providing equity of services to regional, rural and remote communities. Yet, Australia still has unacceptably high numbers of people unable to access the services they need in the right place at the right time.

The committee was pleased to see the additional money in the 2021-22 budget to increase training places for psychiatrists and scholarships and clinical placements to develop other mental health professionals, noting the skewed distribution of the mental health workforce and that a focus of these placements should be on strengthening—and I stress this—the regional, rural and remote mental health workforce.

While the federal government takes the lead on a 10-year workforce strategy that includes more training places for psychiatrists, the state government must immediately move to decentralise and increase the provision of mental health services. As Theo's case tragically highlights, we desperately need more psychiatric services in country South Australia. Currently, there is very little support for regional staff who work in Country Health SA's 13 mental health teams, a system that is, as Theo's case identified, completely inadequate. The few psychiatrists who do work in country SA, including the visiting psychiatrist who saw Theo, are overwhelmed by work.

I am a member of this committee and I heard the evidence that was presented. I've also represented regional communities in South Australia, including the Riverland, where Theo Papageorgiou lived and worked. He was a well-respected and much-loved member of the community. I also chair the parliament's Select Committee on Regional Australia. I know that our regions are a great place to live.

A division having been called in the House of Repr esentatives—

Sitting suspended from 11:09 to 11:5 2

Before we suspended for a division in the House, I indicated that I have been a part of the work of this committee and I've heard the evidence presented. I also represent regional communities in South Australia, including the Riverland, where Theo Papageorgiou lived and worked and was a well-respected and much-loved member of our local community. I chair the parliament's Select Committee on Regional Australia. I know that our regions are great places to live. I know that people who live in our regions are resilient and punch above their weight. I know that they do this while not having access to the same level of services as those who live in metropolitan areas. That's just the reality. But regional people deserve better than what this report has highlighted. Theo and his parents, Poppy and Jack, deserved better. The committee heard that Lifeline Australia estimates that, for each life lost to suicide, the impacts are felt by up to 135 people, including family members, work colleagues, friends, first responders and others. Imagine what this does in a regional community that is, by definition, far more connected.

As governments, we need to do better. The report makes it plain. This is not just at a federal level. I will be meeting with the South Australian minister for health to discuss the coroner's report that I've spoken about today and its important recommendations, including that we make resident psychiatrists available to regional South Australians. The system, sadly, is failing, and I'll be fighting at every level, within my own government and with the state government, to listen to this committee's recommendations and those of the South Australian coroner and act now to ensure that we put as much effort into the shadow pandemic and the mental health challenges as we've put into the COVID-19 pandemic and its challenges. I commend the report to the House and I thank Jack and Poppy Papageorgiou for allowing me to speak about Theo in this place.

See this speech in context