Monday, 25 October 2010
Private Members’ Business
Debate resumed, on motion by Mr Dutton:
That this House:
- notes that:
- mental illness afflicts more Australians than almost all other health disorders, only ranking behind cancer and heart disease in prevalence;
- forty-five per cent of the nation’s population will experience a mental health disorder at some point in life;
- younger Australians—those between 16 and 24—bear the brunt of mental illness, with prevalence of problems declining with age;
- with early and targeted treatment, many people can overcome mental illness or lower the incidence of progression or relapse;
- expansion of the headspace and Early Psychosis Prevention Intervention Centres (EPPIC) models could help an estimated 200 000 young Australians, and in doing so, free-up existing services for others with mental illnesses whilst alleviating pressures on public hospitals and emergency departments; and
- the Government has moved to cut services in mental healthcare;
- requires the Government to:
- expand the number of headspace centres to a minimum of 90 nationally;
- establish a national network of 20 EPPIC centres;
- provide an additional 800 beds for mental health, associated with the EPPIC centres;
- appropriate funds necessary to provide these critical steps to expanding mental health treatment facilities; and
- immediately provide additional funds for existing headspace centres; and
- sends a message to the Senate acquainting it of this resolution and requesting that it concur.
I am very pleased to speak to this motion on mental health, which has been moved by the member for Dickson and seconded by me. What this motion demonstrates is the important priority the coalition places on mental health. It is extraordinary to us that, after 18 months of a national health and hospital review, after 90 or 100 visits to hospitals led by the Prime Minister, the government’s response in the area of mental health has been so profoundly inadequate. It is not just us: mental health experts across Australia are staggered by the lack of vision and lack of action that this government has shown in the area of mental health.
As a member during this time I have been involved in many different aspects of the parliament with respect to mental health. We have had some very good parliamentary forums on the issue of youth suicide, and I was very pleased to be the founding co-chair of the Parliamentary Friends of Schizophrenia, a bipartisan group which has as its goal removing the stigma of mental health but also shedding some light on this condition, which has a lifetime incidence of affecting one in 100 Australians.
On behalf of the opposition we think it is important that the government does really focus on mental health. Mental illness afflicts more Australians than almost all other health disorders, only ranking behind cancer and heart disease in prevalence. According to figures from the Australian Institute of Health and Welfare, mental illness accounts for 13 per cent of the total burden of disease in Australia. These same figures show that almost half of the nation’s population, 45 per cent, will experience a mental health disorder at some point in their lives. Many more will be impacted by mental illness as a family member or a friend grapples with a mental health problem. I would like to take this opportunity to recognise the work done by organisations such as beyondblue, Lifeline and others—all of which have increased the profile and given avenues for people with a mental health issue to go to. If we consider an illness like depression, depression is really a chronic disease that should be managed as a chronic disease. The risk of relapse of depression is as high as 77.5 per cent. That is why it is important that it is treated actively for one year, perhaps three years.
It is widely acknowledged that mental health treatment in Australia is currently underfunded. Mental illness accounts for 13 per cent of the national health burden but receives only six per cent of the health funding. Today we are calling upon the government to implement the key elements of the coalition’s Direct Action Plan for Better Mental Health. One key aspect of our policy was a substantial increase in the number of headspace sites from 30 to 90. The headspace model is internationally recognised as being highly effective in combating mental illness. It is a youth-friendly site. It was the former member for Adelaide, Trish Worth, and the member for Sturt who started the rollout of the headspace sites. In fact, it was an initiative that that Howard government took to the 2004 election. There is a real question mark over the government’s commitment to headspace, as shown by their slow rollout and the lack of recurrent funding that is there for each centre.
We would also like to see a commitment from the government to establish a national network of 20 early psychosis and prevention intervention centres and to provide an additional 800 beds for mental health associated with these centres. Labor have made no specific commitment to mental health beds. The government have no idea of the number of mental health beds they will be funding or the models of care which will be associated with these beds. We believe it is important in the subacute space that we have mental health beds—and we have nominated 800—but also that they be associated with a network of early psychosis and prevention intervention centres. The EPPIC model is about improved access to services, early intervention targeting those who bear the brunt of mental illness—16- to 24-year-olds—and alleviating the pressure on public hospitals and overstretched emergency departments.
During the election Labor only promised $25.5 million for early psychosis intervention centres—which might, at a pinch, fund two. It will not provide us with a national network. It still will not address the gaps in servicing that currently exist in the area of mental health. Finally, the government must appropriate funds necessary to provide these critical steps to expanding mental health treatment facilities and immediately provide existing funds for existing headspace centres.
In the 2006 budget, when the Leader of the Opposition was health minister, the Howard government committed to spend $1.9 billion over five year to June next year. This still remains the single biggest investment in mental health by any government in Australian history. It is something which I am very proud to be associated with. What we did was we used the infrastructure of Medicare to create a greater role for general practitioners in primary care and for allied health professionals. It followed on from Senate committee reports, and also from the Not for service report, which was released by the Mental Health Council of Australia in October 2005.
Since the 2007 election, funding has been reduced substantially. Labor have cut funding to mental health in a range of programs in their first two budgets. They cut funding for the Mental Health Nurse Incentive Program from $191 million to $63 million. They removed OTs and social workers from the MBS Better Access program. They cut funding to mental health services in rural and remote areas. In the Rudd-Gillard government’s national health and hospital reform plan, mental health was completely overlooked, with mental health amounting to less than two per cent of the total reforms.
The medical profession was so disenchanted by the government’s health reforms that we saw our best resigning from government positions. Professor John Mendoza, chair of the National Advisory Council on Mental Health, resigned from his position, writing:
It is now abundantly clear that there is no vision or commitment from the Rudd Government to mental health.
The Commonwealth government needs to listen to the calls from the community, from health experts and from the opposition. They need to provide national focus and leadership in the areas of mental health. The coalition set out in the election campaign a very clear policy and a very clear framework for mental health and, at the time, our policy on mental health was acknowledged by stakeholders as a major advance for early intervention and the treatment of mental illnesses. We need to work towards a society that understands and can respond to the personal and social impact of mental illness, and there needs to be a bipartisan approach to achieving this end.
The bottom line is that we need a national, uniform approach to combating mental illness. That is why we call on the government to act now to expand the number of headspace sites to a minimum of 90 nationally, to establish a national network of 20 early psychosis prevention and intervention centres, to provide an additional 800 beds for mental health associated with these centres, to ensure that these centres are adequately funded and to immediately provide additional funds for the existing headspace centres. This is an important priority. There is a strong feeling in the community that mental health has not been well addressed by this government. This is an area where the government needs to act, and that is why we are calling on the government to take action and adopt the coalition’s policy on mental health.
I rise to speak in support of better initiatives, more initiatives and a more responsive way of acting with mental health services, but I want to put on the record that, while the member for Boothby was just saying we need to work in a bipartisan way, I suggest that their motion is not a way forward for working in a bipartisan way. The member for Boothby also attacked the government, saying that in 18 months we did not completely reform the whole mental health system. The federal government does not wholly manage the mental health system; it is done with states and territories and does not purely rest with the federal government. Attacking the government by saying that in 18 months it did not completely reform it, change it and fix every problem in mental health—it is just ludicrous to think that those things could happen. I do not want to relive the past, but I could say that in the 12 years or more that they were in government they did not fix it. They did not move to fix it. The coalition government also did not appoint a minister for mental health. But I do not want to spend too much time dwelling on that. I just rebut some of those comments because they are absolute nonsense, and to say that the government has no commitment is simply not true.
There is for the first time a Commonwealth minister for mental health. That did not exist before. I know that the Minister for Mental Health and Ageing, in one of his first speeches—I think he had been minister for 40-odd hours—said he could not describe what an honour it was and how excited he was to be in that position. He also outlined some of the issues and realities that we have to face. Some of those are that, as a community, we know that we have not done well enough for people who suffer mental ill health, for their carers and for families—if they are fortunate enough to have that caring network around them. There has been underperformance for decades, and it flows from decades of government inaction at all levels: bad planning, wrong priorities, and non-responsive services. There is a whole lot that needs to be done. The Prime Minister has said that, yes, we have to do better, and that is where we have started. To work in a bipartisan way means we have to recognise that and work out what we have to do now. To come up with a policy in an election, as the coalition did, and say, ‘This is the blueprint; this is the way to fix it all,’ is ludicrous. You cannot come up with something at such short notice—in such a short time—and say, ‘This is going to do it.’
Funding is always important. We need more funding. I always say I welcome more funding. But we also have to direct that funding. We have to make sure that it is going to work and gets to the people it needs to get to. We have to ensure that when someone fronts up to a health service with a problem that is to do with their mental health they are responded to in whatever way is needed. We know that sometimes in our health systems all around Australia people do not get a response or the care that they need when they front up, and if their particular disorder or presentation of symptoms does not fit a service then they may not get through the door. Those are some of the things that we have to stop. Places like the headspaces are critical, but there is more that is needed. There is the early intervention for psychosis. We need to do more early intervention for young people—but intervention in a way that works. The headspaces are being rolled out; there will be about 30 extra. I know that, like all members, I will be saying I want one in my area, and I know that it will be competitive. It is hard to do. We have the health services that are able to respond with the care that is needed for the people in their communities, and some of the health reforms will start to lead the way to doing that.
I agree with paragraphs 1(a) to 1(e) of the motion of the honourable member for Dickson, in which he notes certain things, but I disagree with his comment in paragraph 1(f) because it simply is not true. I shall turn to that soon. I also have to disagree with paragraph (2), requiring the government to do what is contained in 2(a) to 2(e). It is no use our coming in here and being prescriptive. We have to work through the issues, work with the mental health experts and work with the teams. We need to have mental health as an integrated part of our health system. In some areas, this has not been the case and there has been a discrepancy in services. I can remember years ago looking at how much funding per person there was for mental health in each state and territory and finding there were lots of discrepancies. That is one of the things that is being addressed through the COAG agreement, including the COAG agreement in April this year. Do we need more money in another state or not? Maybe we do and maybe we do not, but they are not easy issues and they are not issues that we can determine by standing up and speaking on a motion about mental health.
I have worked as a mental health advocate. I have worked as a lawyer representing people in institutions in different places. I have had a long involvement in the area both professionally and personally. I know that we have too many people with mental ill health in jails and they should not be in jails. Those are some of the issues that will be dealt with through COAG, through health reform and through the agreements, but we cannot resolve all of those there.
The current forward estimates include $1.2 billion of spending on specific mental health initiatives, and that is beyond the Medicare benefits schedule and the PBS. That is a doubling of the previous government’s expenditure over its last four years. I do not say this by way of crowing; I say it by way of fact. Those members on the other side who said the government is cutting funding and not doing enough ought to think long and hard before they start to throw out those comments. We are rolling out the first 10 of up to 30 new headspace sites and the Minister for Mental Health and Ageing has written to the states seeking their interest in partnering with the Commonwealth to develop the Early Psychosis Prevention and Intervention Centre. That is the first ever Commonwealth investment in the EPPIC model since its introduction in 1992 and it comes from the federal government. The expansion of the subacute beds—that is, the 1,300 beds which were committed at COAG—will support mental health as well.
There is also the $277 million suicide prevention plan announced in the election, and that will boost front line services like Lifeline, which will be able to take tens of thousands of additional calls. Don’t Lifeline do a wonderful job? Where would we be without Lifeline in our communities? There are so many groups that I am loathe to name just one, but we all know the work that Lifeline do. Just having someone answering telephone calls and being there really does make a difference. There is also the expansion of the psychological services on the ground for people who have attempted or are at high risk of suicide, particularly after discharge from hospital. I have looked at the statistics, as I am sure everyone else has, about people who are discharged from hospital after attempting suicide and about how there has not been any follow-up. Those are some of the things that we have to change, but wasn’t it wonderful that during the last election everyone was talking about mental health? Who would have thought years ago that we would be in an election with the media, with members of parliament and with parties focusing on mental health initiatives, discussion and debate. It seemed to me to be a coming of age, in a sense, that mental health is clearly on the mainstream agenda, which is where it should be. The fact is that we now have a Minister for Mental Health and Ageing, someone who can be a primary advocate at the federal level and with the states and territories through COAG. Each and every one of us as MPs is an advocate for people who have mental ill health.
I am very pleased to have an opportunity to speak to this motion of the member for Dickson. I think that we need to give the subject even greater airing than it has had in these last few months. I have been here longer than the member for Page and in 1996 I had responsibility as minister to roll out a national youth suicide prevention program. So we on our side have had quite a long commitment in dealing with this, albeit we probably still did not give it the continuity that it deserved. A number of us also pushed for the $1.5 billion that the Howard government injected into mental health in that last term in government.
I was pleased to hear the contribution of the member for Page and that of my colleague the member for Boothby on this subject because in 2010, frankly, mental health is still an issue that is frequently swept under the carpet in our country. It is incredible to think that a complaint that will affect over 45 per cent of Australians to some degree rates low on the list of priorities, particularly government priorities. Even when we heard the continued rhetoric about national health reform in the lead-up to the election, the government promised only $277 million over four years compared to the coalition’s commitment of $1.5 billion over the same period, an amount of over five times as much as the government. But funding alone is not the solution to effectively treat mental health. It must be targeted through innovative services, and I agree with the member for Page on that point. It must be targeted at an early stage to those who need it most.
There are many different types of mental illness, and we cannot just treat it as one homogenous illness. It manifests in so many different ways. It is like comparing a heart attack with a stroke or with kidney failure. We have to also understand that there are different types of mental illness, and they need different kinds of treatment and proper diagnosis. We have seen, through recent publicity, some very high profile cases and the terrible consequences of misdiagnosing mental illness and treating bipolar disorder as depression. These are very different mental illnesses. Many of them are life threatening in a very real way, and many of them are for a lifetime. As the member for Boothby said, it should be treated as a chronic illness because it is never going to go away; it has to be managed for the whole of life. We know some people go through periods of depression when adverse events happen in their life, and they might get over it with treatment within a few months or a few years. But some kinds of mental disorders are chronic illnesses that have to be treated for the whole of life, and that is often overlooked.
This is why the coalition’s commitment expressly mirrored the recommendations of the National Health and Hospital Reform Commission, particularly that:
… a youth friendly community-based service, which provides information and screening for mental disorders and sexual health, be rolled out nationally for all young Australians—
… the Early Psychosis Prevention and Intervention Centre model be implemented nationally so that early intervention … becomes the norm.
The coalition’s policy provides for 20 early psychosis intervention centres based on the EPPIC model and 800 mental health beds and, importantly, 60 additional youth headspace sites. Youth headspace deserves to be singled out because of the benefits it provides in catching demographics that do not usually seek assistance. Of every Australian that has a mental disorder, only 35 per cent actually get treatment—and I will come back to that shortly—compared with 80 to 90 per cent of people with physical health problems. In young people with a mental disorder, the percentage of those treated drops to 25 per cent and for young males, 15 per cent.
Mental health expert, Professor Patrick McGorry, commented in an ABC radio interview the day after being awarded Australian of the Year that the particularly low diagnosis and treatment of young people is ‘simply because we’ve dismissed it as part of growing up’. He noted:
… people say all the time to me, both at professional and public forums, how do you tell when your teenager or your young adult isn’t actually experiencing a mental disorder or a mental health problem for which they need some health or mental treatment?
Trying to answer that question is near impossible for parents. Instead, the focus of youth headspace is on providing a community based youth friendly, low stigma, one-stop shop where people who are experiencing mental health concerns can literally drop in and discuss their concerns with professionals in a supportive environment. From there, an appropriate diagnosis or course of action can be determined. At this one-stop shop individuals can also seek treatment for substance abuse problems.
In the last parliament I was part of the Standing Committee on Family, Community, Housing and Youth, and we did a very good report on youth homelessness, Housing the Homeless. But it became abundantly evident during that inquiry into homelessness that so often the condition of many young people goes undiagnosed. Mental health issues then have a tendency to spiral out of control, and these events lead to homelessness, drug dependency and all the related general health issues. We took evidence of young people with anxiety disorders and behavioural issues that saw them kicked out of home at a young age, their undiagnosed disorders escalating along with increasing vulnerability. Some of these young people were 13 and 14, and they were living under bridges at that age. As a method of coping with the pain, this morphed into drug dependency, which leads to disruption of education, long-term unemployment and, too often, trouble with the law and prison. It is a great tragedy of isolation from mainstream community and family life and invariably leads to premature and life-threatening illness.
Data from the Youth Action and Policy Association notes that homeless youths are four times more likely to have mental health issues than youth in safe and secure environments. Statistics further show that 50 per cent of young people accessing housing or homeless agencies have one or more identifiable mental health issues. This data shows a great need for more appropriate support of supervised care than what already exists. The situation was highlighted just this weekend in the West Australian, which ran a story titled ‘Youth in distress’. In an interview with Merryn Kenderdine, who voluntarily admitted herself to the Way Centre in Bentley when she was a teenager a number of years ago, she explained:
I did not get a lot of help or treatment there … they were mainly making sure that I didn’t run away, kill myself or anything like that.
She said that patients were not let outside, and went on to say:
It was just this small courtyard where you could smoke … there was no sporting activity. You couldn’t go out and kick a ball. It was bare minimum.
Most worryingly, she said:
A lot these kids are left with a sense of fear of their illness itself and their life as a result of that experience. The other impact potentially is that if they run into strife in the future, they won’t access services because of the experience they had before.
Since Ms Kenderdine’s time at the facility, more funds have been committed by the state government, but the situation highlights the lack of overarching funding support and vision which can and should be provided by the Commonwealth. Speaking on radio in January, Professor McGorry outlined his view on why such support is not forthcoming. He believes we lack confidence and that it is a common position in Australia in mental health.
The COAG National Action Plan for Mental Health notes on page 18 that the first insights into the sheer number of people who receive no treatment for mental health disorders came from the national population surveys over a decade ago. These surveys showed that 11 per cent of Australians had a mental health disorder but received no treatment. The action plan surmises that, if the findings of a decade ago are generalised today, the number of Australians not being treated is 2.3 million individuals. Imagine if we failed to treat 2.3 million people with cancer, or 2.3 million people with heart conditions, or 2.3 million people who had had a stroke. Imagine the outcry. I think it has been too long that we have left mental health problems the poor relation to all other health problems. We have the architecture for change in place. All that is needed now is the political will to do something.
Mental illness affects every state and territory, every city, every town, every community and every family. It should be something on which we come to this place with goodwill, with friendship and with affection towards one another in looking at how we can tackle this serious problem. While, to a certain extent, I would be happy for the member for Dickson to put forward motions urging us to do more with respect to mental health and the mental illnesses that people suffer from each day, in each place and in each family, to be lectured by the member for Boothby about our alleged failings, faults and foibles with respect to what we have done in relation to mental health, in circumstances where the coalition’s record is not as they purport it to be, really sticks in my craw. This is a serious issue and it should be treated in that way, not used as a political point-scoring method by the member for Boothby.
But, if you really want to look at it and if the coalition really want to put to us what their record is with respect to health, look at what they did across the country, and I will look at what we did in my community. We know that, when the opposition leader was the minister for health—and the forward estimates indicate this; they cannot deny it—a billion dollars was taken out of the health system. What did we do when we were first elected in 2007? We immediately put money into health and hospitals across the country and lined up the states and territories in relation to that. In my community alone, we have an Ipswich GP superclinic now functioning at the University of Queensland, dealing with all kinds of health needs of people. Right beside it is the federally funded University of Queensland Psychology Clinic. If the coalition had their way, that GP superclinic would be shut down. It is the same thing with respect to health and doctors. The coalition are the ones who capped the number of doctors.
They did. They capped it in 2004, when Tony Abbott was the minister for health. That is what they did. We have made a strong commitment and we are funding more doctors, more nurses and more training places. E-health is another aspect important to mental health. Again, we had the shadow minister for communications here today in this place sitting opposite, where the member for Dickson currently sits, with a private member’s motion. He was in the House earlier today with a bill with respect to, really, attempting to procrastinate and delay on the National Broadband Network, which is so critical for e-health. So the coalition have form with respect to this issue, and it is a bit rich for them to come in here and start lecturing us on these types of matters.
The truth is that we are the first government ever to have a minister for mental health. We make no secret of the fact—the minister said this today in question time—that there is a lot more to do. We have started, and the COAG reforms have invested significant additional resources in mental health. This includes the headspace and EPPIC sites, not to mention a major investment in subacute beds. As the minister said in his answer today, many of those are associated with mental health. Of course, this comes on top of our primary care and hospital reforms, which we believe will have a significant impact across the whole spectrum of patients, including those suffering from mental health problems.
In my electorate, we have seen significant investments in health and hospitals, including significant investment in Ipswich General Hospital. We have seen a substantial increase in funding, and the Ipswich General Hospital is the hub around which the health service operates in the city of Ipswich. There is additional funding to assist great organisations in my local community that deal with people suffering from ill health. This supports wonderful people like Diane Bos, who is the manager of the Ipswich and West Moreton Lifeline service. It supports Southern Cross community care, Focal Extended and ALARA—wonderful organisations receiving assistance from the federal government to provide help for those people suffering from mental disability.
The coalition purports to give us lectures on funding for mental health, and we have seen tonight spokespeople for those opposite saying that they put a lot more money into mental health and propose to do so in future. Let us have a look at the record. With respect to mental health funding under the Medicare Benefits Schedule, pharmaceutical benefits funding and funding for mental-health-specific programs, including Indigenous programs to do with mental health services, we will nearly double that over the next four years—$1.2 billion from 2010-11 to 2013-14. That compares to—wait for it—only $516.3 million from 2004-05 to 2007-08. Five hundred and sixteen million dollars is not the same as $1.2 billion, the money that this government is putting in. The Howard government put nothing like the kind of funding that the federal Labor government has put since 2007 and will put into mental health services. Furthermore, as part of our election commitment, there is $277 million allocated over four years for mental health. That will go principally towards tackling issues of suicide. I have dealt with many chaplains in my electorate, and they do wonderful work in the schools with young people suffering from depression, anxiety and other kinds of difficulties. I have dealt with the wonderful organisations I have spoken about tonight, who do great work with people who are suffering challenges in their lives from mental illness, particularly depression. Three-quarters of those people who kill themselves are men, so mental health with respect to men is a big challenge.
There is a lot more to do, but the funding we are putting into front-line services will make a difference. There is nearly $114 million to provide services to those at greatest risk of suicide, including psychology and psychiatric services and non-clinical support to assist people with severe mental illness and carers with day-to-day needs. That is why I said the psychology clinic on the University of Queensland Ipswich campus, receiving federal government funding via the division of general practice, will make a difference in the lives of people locally.
I mentioned Lifeline before. Lifeline Australia is also receiving assistance. There is $74.3 million for direct suicide prevention and crisis intervention, including funding to provide safety at suicide hot spots. There are more services, particularly through Lifeline Australia. I want to pay tribute to the Reverend Diane Bos, who I mentioned before. She is a pillar of the local Uniting Church and has been involved as the general manager of Lifeline in Ipswich. The work that she does should not be underestimated—it is tremendous. Her love, affection and capacity to show care for those in need are so evident in her life. She puts her concern for her fellow human beings into practice, and I want to pay tribute to her.
I mentioned assistance to men in greatest need before: $22.8 million to provide services and support to men at greatest risk. Funding through beyondblue will assist up to 30,000 additional men each year. I also mentioned young people. There are many great chaplains, counsellors and people who work with young people in my electorate. There is $66 million to promote good mental health and resilience in young people, to prevent suicide later in life. Much of what we are doing comes from the COAG process, working in consultation with the states and territories to achieve good outcomes.
Every community suffers problems with mental health and illness. Some people suffer these problems temporarily. For some it is chronic, severe, debilitating, employment inhibiting and stifling to recreation. This is a serious problem, and I would hope and expect that those opposite would adopt a more conciliatory and bipartisan approach and not use these motions to simply attack us.
I would like to start by acknowledging the contributions of each of the members from both sides on what is an incredibly important motion. In particular I would like to thank very much the member for Boothby, who commenced the debate in my absence due to commitments in the other chamber. I also thank the member for Pearce, who has had a long-abiding interest in this area and in health issues generally. She did great credit to herself in her contribution tonight as well.
During the recent election campaign the case was compelling to act and to act decisively when it came to the issue of mental health. Much debate had taken place across a long period of time right around the country about the need for hospital reform and the way in which we deliver health services needing to be dragged into the 21st century. There had been failings at a state government level right around the country for a generation in the way in which different health services were proposed and implemented. Something had to give way.
The then Prime Minister, Kevin Rudd, had made a promise in relation to hospitals and the delivery of health services at the 2007 election. Expectation was incredibly high during the course of the last three years about how it was that the government was going to implement this change, not just in relation to hospitals and the management of hospitals but, importantly, in relation to the delivery of primary health care as well. Of course, people were bitterly disappointed—quite astounded and dumbfounded—at the lack of response when it came to the incredibly important issue of mental health. The fact that the government had provided responses to the Christine Bennett report and yet had not at any stage attempted to make a comprehensive response to mental health meant that they were condemned by many.
As we spoke to people right across the country in the lead up to the campaign, and also over the course of the entire last three years, people—particularly the health experts—were particularly disappointed at the government’s ultimate response that this was something they were going to deal with in their second term of government. Every expert had been led to believe that this was a No. 1 priority for the government. The promotion of Pat McGorry to Australian of the Year only ramped up that expectation and, of course, people became bitterly disappointed when this government did not act on mental health.
So, whilst I welcome this motion and debate, I am disappointed about the government’s response—not just during the election campaign but since. I know that the government will say to the Independents and to health experts around the country at the moment: ‘Just wait. Just wait and see what this government does, because we’re promising to do a lot in relation to mental health.’ They will say to the Independents, probably tonight, ‘This motion is not worthy of support because the Gillard government is on the cusp of putting money into mental health.’ My message to them and to the experts who have had so much to contribute in this space is that that is the same empty rhetoric that they were provided with in the last three years by the Rudd-Gillard government.
This coalition grasped the issue of mental health, and we put it squarely on the agenda during the last election campaign. People expected the coalition to retreat on the issue of health and we did the opposite. We took the fight up to the government on what we thought was a failed plan in relation to their hospitals proposal, which only dramatically increased the number of bureaucrats in the system and which has been at the heart of dysfunction and the reason for failure at a state level over the course of the last 10 or 15 years. We embraced much of what the experts had to say because we did not believe that mental health was an area where we needed another inquiry. We did not believe that mental health was an area that needed to be put off until tomorrow. We believe that the government needs to have action in place immediately. It is completely without credibility that the government would argue that they could put in place proper reform in the health space without providing a direct and important response to mental health.
Much of the debate has been about the stress on emergency departments and that families are going through. Of course, we are all shaped by our own life experiences, but I can remember in a previous life—many years ago, as a police officer—fronting families who had had suicide attempts by children in the family, accompanying ambulances with some of those people to emergency departments and parents who were grieving and in a complete state of shock and despair when a message had to be delivered that their young child, male or female, had taken their life. That is a burden that no family, no parent, should ever have to incur. What we had hoped, by putting this issue front and centre, was that we could relieve some of that pressure, that we could take away the angst and the pressure that families face, that we could take away the inappropriate care being offered at emergency departments at two or three o’clock in the morning when people present with suicide attempts, because not only is the expertise not available but the whole-of-care that that patient requires is not available. That of course puts extra pressure and stresses not just on the emergency department workers but the doctors and nurses trying to deal with other cases that present during emergency hours. What we put forward was something that we had consulted quite widely about, and we had a comprehensive plan that was endorsed by many prominent Australians in this space. We proposed during the election campaign that the number of headspace centres go to a minimum of 90 nationally, and the establishment of 20 EPPIC centres, early psychosis prevention and intervention centres, that would have on average 20 acute and 20 subacute beds at each of those centres—an additional 800 beds nationwide. When we said that we wanted appropriate funds to put some of these services into place, this was were received with great acclamation from many people, including Pat McGorry, John Mendoza, Ian Hickey and others.
It is important to recognise what some experts had to say. They were dismissed by the government; they were embraced by us. David Crosbie, who is the CEO of the Mental Health Council of Australia, is soon to step down. He is a distinguished Australian who has made an extraordinary contribution, and he said:
Mental health is a part of the final COAG health reform agreement. … The commitment of the Federal Government to become a major player in community mental health is restated in the agreement, but it is not enacted.
Professor Ian Hickey, again, is a leading Australian, a world expert and a person of whom Australians should be proud. He is from the Brain and Mind Institute, and he said in relation to the coalition’s commitment:
This is exactly the size and the scale and the focus that we’ve been looking for and it is what the Australian government can actually do.
John Mendoza, who was the chair of the Prime Minister’s mental health advisory council—appointed personally by Kevin Rudd—resigned in disgust at the inaction of the Rudd-Gillard government in relation to mental health. When the coalition made its announcement he said:
… it creates a whole new service infrastructure, that offers … evidence-based services to hundreds of thousands of young Australians and their families, who at the moment are locked out of any specialist support for what are the most common illnesses in early adulthood.
Professor Pat McGorry, the Australian of the Year, again, an incredibly well-credentialled expert in mental health, not just within our country but internationally, said of the coalition’s policy that it would help up to 100,000 young people. He also said:
… this policy would save lives, ensure young lives are not stunted or derailed, and stem the tide of Australians with untreated mental illnesses flowing to our emergency departments, onto our streets and into our prisons.
These were the independent voices who looked, quite critically, at what the coalition had to offer, and they said that we were spot-on.
It is why, as I said before, I am disappointed with the response from the government tonight. I hoped that out of this motion we would get a sense of bipartisanship—that the government would accept that more needed to be done and that they would do it sooner rather than later. They will be saying to all and sundry that action is just around the corner, but they have said that for the last three years, and if people go meek and mild and weak in relation to this motion if it is put to a vote then they are really signing up to the government’s continued plan of inaction. There has been much debate in relation to this motion about the facts and the contributions of both the former coalition government and the government since it was elected in 2007, but let me restate for the record—and it is incredibly important to do so: between 1995-96 and 2002-03, expenditure on mental health under the Howard government increased by 53 per cent, from $792 million to $1.2 billion. In 2006—and this is the most important point—the Howard government made the biggest single investment in mental health of $1.9 billion over five years. So what we proposed with $1.5 billion in the election campaign, had we been elected, would have been the second-biggest investment in mental health in this country’s history, only matched by that $1.9 billion which was put in place by the Howard government in 2006. When you look at Labor’s record, it is only the last May budget that people need to be reminded of. This government tried to cut the money going into mental health, and they should be condemned for that. This motion should be supported because it is in the interests of all Australians.
At age 22, I gave the eulogy at the funeral of my friend Andrew McIntosh, who had taken his own life. It was one of the hardest things I had ever had to do. Andrew was a high school friend of mine, a gifted athlete who could pick up a new sport within a few hours, a person who took the time to listen to his mates and who was always there to share a laugh. He drove a bright yellow Valiant Charger, loved music and was always up for a night out. Andrew was studying sports education at the time of his death. We all thought that he was on his way to becoming a great teacher. But none of us caught sight of the fact that the black dog had found its way inside him. Andrew died in 1994, but I know that his parents, Grahame and Rena McIntosh, still miss him every day.
I thought of Andrew in January of this year when I attended the funeral of Canberra lad Alex Hodgins, son of Judy and Tony Hodgins, who run the Gods Cafe at the Australian National University. Alex was a handsome man with a ready smile, and I knew him through the Gods Cafe, where he would often make my daily coffee and we would have a chat about what he was up to or what I was thinking about that day. On that day, back in January of this year, Alex’s loss had touched hundreds of his friends, and the church in Ainslie was overflowing with young men and women in the flower of their lives, all dressed in black, with their puffy red eyes.
There is no simple solution to reducing suicide, but we can improve the odds of survival. One of John Howard’s first acts as Prime Minister was the national firearms agreement, which cut the suicide rate by making it harder for people to get their hands on a firearm. Australians are also better at talking about depression today, thanks in part to public advocates like Jeff Kennett and Jack Heath, but there are still too many young people who take their own lives; too many parents who bury their own children. As a society, I think we can do better. I do not agree with parts of this motion we are debating today—I think it is a little too simplistic and there are some inaccurate claims about the current government—but I do respect the opportunity to talk today about the critical issue of suicide, the issues of mental health and what we can do about them.
At the moment the Labor government is delivering a range of new reforms which are aimed at trying to improve the way in which we as a society deal with mental health.
The Gillard government is rolling out up to 30 new youth-friendly services and providing extra funding for the existing 30 headspace sites. Headspace is a program that works with community youth services. The government is providing $25½ million over four years to expand the Early Psychosis Prevention and Intervention Centre, the EPPIC model which is referred to in the motion, in partnership with states and territories. The government is providing $13 million over two years to employ extra mental health nurses. The government is also providing $5½ million to extend the Mental Health Support for Drought Affected Communities Initiative through to 2011. And the Gillard government is providing resources in direct suicide prevention and crisis intervention programs, such as improving safety at suicide hotspots and increasing funding for Lifeline Australia.
I met recently with Mike Zissler, the CEO of Lifeline, and talked to him about the way in which Lifeline operates and the important role that Lifeline plays, not only through its well-known telephone hotline but also through the counselling support it can provide and through the training that Lifeline does in teaching us how to have a sensible conversation about suicide. Mike talked to me about the importance of using the ‘s’ word—of actually saying to someone you think might be contemplating suicide: ‘Are you thinking about suicide?’ He said that their research has shown that asking that simple question, actually using the word ‘suicide’, will often result in somebody who is on the brink saying, ‘Well, yes, I am thinking about suicide,’ and provide that crucial window to do something about it.
The government is providing more services and support to men, who, as previous speakers have noted, comprise about three-quarters of suicide victims, and through programs such as beyondblue expanding the reach of suicide support to men. The Gillard government is also providing resources to promote good mental health and resilience in young people in order to prevent suicide later in life. As previous speakers have also noted, this has been the first ever Commonwealth investment in the EPPIC model since its introduction in 1992. The Gillard government also has the first Commonwealth minister for mental health, recognising the importance that this government places on the issue of mental health. Labor has been building resilience in young children by expanding the KidsMatter program and has been funding initiatives in high-risk communities such as Indigenous Australia, which accounts for a disproportionate share of all suicides. Mental health is a particular second-term priority for the Gillard government. I know that the Minister for Health and Ageing has a series of meetings planned around the country with consumers and carers. He will be out there listening to their experiences and having those stories shape Labor’s policy.
On 12 October 2010 I opened a day-long event in my electorate titled ‘Towards recovery: how do we talk about suicide?’ It was run by the ACT Transcultural Mental Health Centre and the Mental Health Community Coalition. I wish to use the opportunity today to pay tribute to the hard-working organisers, including Simon Tatz, Brooke McKail and Simon Biereck. The event was conducted in Pilgrim House as part of Mental Health Week. Events like this help emphasise the importance of talking about suicide and help allow community groups, which provide the solution to this problem, to come together and talk about how they have addressed the issue and how we can do better.
I would like to finish my comments today by talking about the experiences of one of my staff, Lyndell Tutty. Lyndell is a woman who is always ready with a smile and a joke. She is somebody who is ready to make fun of me wherever I need to be taken down a few pegs. You would never know it from looking at Lyndell that she has had her own very serious battles with depression. Lyndell provided me with terrific help today in preparing the comments I have made in this place. I want to finish by quoting from her words on dealing with depression. She said:
Education, recognising the symptoms, the triggers, and early intervention are the key.
With education you are provided with tools and therefore hope and confidence that you can either manage your illness or beat it.
When you have no confidence and feel soulless the last thing you can do is believe in yourself, but with support, hope and education you can try your best to ride the dark moments until you are strong enough to believe.
Lyndell is now a terrific contributor to public policy in Australia and I am really proud to have her on my staff and to have the opportunity to contribute to this important discussion today.