Andrew Wallace (Fisher, Liberal Party) Share this | Link to this | Hansard source

I present the report of the Parliamentary Delegation Field Visit (Mental Health) to the United Kingdom, Netherlands, Sweden and Canada. I ask leave of the House to make a short statement in connection with the report.

Leave granted.

Senator Siewert, Senator O'Neill and I travelled during October 2017 to the United Kingdom, the Netherlands, Sweden and Canada as delegates on the Parliamentary Delegation Field Visit (Mental Health). We met with more than 50 researchers, medical practitioners, policymakers and officials at 35 meetings to examine mental health practices and policy perspectives in each of these four countries.

My own focus for the trip was to find out more about the treatment approaches deployed in these countries in the areas of eating disorders and the mental health of veterans and emergency services personnel. My electorate of Fisher is an emerging national leader in Australia in the treatment of eating disorders, with a $3.2 million Commonwealth government treatment trial taking place on the Sunshine Coast and the nation's first residential treatment facility for eating disorders being constructed, with the coalition government's support, in Mooloolah Valley by the local charity EndED in conjunction with the Butterfly Foundation. I would have to say that this trip that I went away on last year was instrumental in me pushing for these two trial projects on the Sunshine Coast. The Sunshine Coast is also a popular location for former members of the ADF to live after their service, with as many as 15,000 veterans calling our community home. As such, these issues are of substantial interest to my constituents.

Overall, one especially notable finding from the trip was the perception we encountered among many international experts that in fact Australia is a global leader in the treatment of mental health. The most common question that we were asked as we moved around was, 'Why are you here?' If anything, many overseas experts felt that there were lessons that their systems could learn from us. It is pretty disconcerting when you have been involved in the mental health space, as I have been, to think that many countries are looking towards us as world leaders. I know, as a matter of fact, that we have got a very, very long way to go.

However, I want to take a couple of minutes of the House's time to summarise some of the things that we learned about the issues on which I focused. On veterans' mental health, we saw strongly contrasting approaches in each country. Lacking a particular department for veterans' affairs, the United Kingdom has sought to build closer links between the National Health Service and charities which can provide services like housing and drop-in support. They have created a network of British Armed Forces champions within key NHS services and are supporting these new staff with a comprehensive directory of NHS services that can be offered to veterans to encourage a patient-centric approach.

In Sweden the focus of their approach is on the proactive and pre-emptive management of service men and women's mental health. Their armed forces engage in extensive predeployment training on mental health to prepare personnel for the experiences that they are likely to encounter and to provide them with coping strategies. During deployments, officers use a structured tool including weekly assessments to manage stress, while following deployment Sweden uses a five-year active assessment process and follow-up reunions to promote normalisation of reactions to veterans' experiences.

The Canadian Armed Forces have a very different and very impressive approach, with the Canadian Armed Forces delivering outpatient services directly through its Canadian Forces Health Services arm and purchasing other services from the civilian sector. The Canadian Forces Health Services has its own Directorate of Mental Health, which provides clinical programs, education and training. They have 31 clinics with mental health services across Canada and Europe, and access to a further 1,200 private practitioners. This work is supported by a range of workplace outreach programs, family resources and vocational transition schemes. It is no surprise that the Canadian emergency services are now looking to adopt a similar national strategy.

On eating disorders, in London we heard from the renowned research group at King's College who are at the cutting edge of research in this field. They told us about the recent classification of diabulimia as an eating disorder, and about the science they are doing on the role that genetics has to play in eating disorders. Professor Treasure and the team emphasised the importance of involving family members and carers in an understanding of eating disorders and making sure they are part of building resilience in sufferers. King's College's Eating Disorders Research Group as well as Novarum and the Mandometer clinic in Sweden provide training and consultancy for other practitioners around their respective countries to ensure that their successful approaches are adopted nationwide.

In Sweden we visited the Mandometer clinic, who claim to have achieved very impressive outcomes through minimising the use of traditional therapies and antidepressants and instead relying on the use of mealtime feedback and counselling to normalise eating behaviours.

However, in the Netherlands we met with Novarum who deliver cognitive behavioural therapy enhanced, or CBTE, for the treatment of eating disorders. We were told about how this therapy is more effective and lower cost than other approaches, reducing the average treatment time from nine months to just eight weeks. Novarum avoid group therapy, focusing on treatment which is personalised, and varies according to the individual circumstances. As they say it is 'better to do a few things right than many things badly'. The strong results of cognitive behavioural therapy enhanced were also emphasised by the Karolinska Institutet Centre for Psychiatry Research in Sweden.

These are only a tiny selection of the research and approaches we benefited from during the trip, and the report I'm tabling today contains more than 50 pages of information that we gathered. I would encourage all members of the House that have an interest in mental health to review the report and consider how we might incorporate these lessons into our own policy deliberations.

I'd like to take this opportunity to thank all of the many officials, policymakers, and practitioners, and particularly those from our overseas missions, who were very generous with their time and expertise during our visit and, of course, as I said, officers of the Department of Foreign Affairs and Trade who accompanied us throughout. In particular, on behalf of the delegation I would like to thank High Commissioners their Excellencies then the Hon. Alexander Downer, Dr Brett Mason, Mr Jonathon Keena, and Mr Tony Negus. I'd also like to thank their staff, Matt Anderson and Duncan Hewitt in the United Kingdom, Maaike den Besten in the Netherlands, Antony Lynch and Susanna Fridlund in Sweden and Andrew Clarke and Brittany Noakes in Canada. The professionalism and knowledge of all of these representatives of Australia was absolutely first rate and made a huge difference to the delegation's success. Finally, I'd like to thank my fellow delegates Senators Siewert and O'Neill for a very productive and successful trip, and the Chief Government Whip for choosing me to undertake this trip.