House debates

Wednesday, 24 November 2021


Mental Health and Suicide Prevention Select Committee; Report

9:53 am

Photo of Fiona MartinFiona Martin (Reid, Liberal Party) Share this | | Hansard source

On behalf of the House of Representatives Select Committee on Mental Health and Suicide Prevention, I present the final report of the committee together with the minutes of proceedings.

Report made a parliamentary paper in accordance with standing order 39(e).

by leave—Over the past two years, significant natural disasters—drought, floods, bushfires and, of course, the COVID-19 pandemic—have put a significant spotlight on Australia's mental health services and their delivery. We have seen a significant increase in the demand for mental health services across Australia, and we know that this increased demand is being put on a system already undeniably under strain. It is being put on a mental health system that is fragmented and, at times, failing to provide the treatment and support that people who need it legitimately expect.

Access to quality mental health care when you need it is as essential as being able to see a GP. It is as essential as having a good road to drive on. Mental health services are essential services, and it is time that mental health and suicide prevention is given the same recognition as physical health, both within the health sector and by policymakers. While it is true that, as a society, we are getting better at having conversations about our mental health, there is still vital work to do to ensure that, when a conversation turns to seeking help, an individual can access services that are responsive and suited to their needs. Ensuring someone has early access to quality mental health services when they need them is not only just about doing what is right; it is also about recognising that failing to have effective early intervention and quality mental health services only leads to greater cost in the long run. The Productivity Commission inquiry report on mental health quantified the significant annual cost of mental ill-health and suicide at approximately $70 billion per year.

I commend the government for the work already being undertaken in this space, including the significant investment outlined within the 2021-22 budget and the upcoming National Mental Health and Suicide Prevention Agreement. If the government wants to improve services and minimise future cost, it must act decisively on the recommendations raised by the committee in its final report and across other relevant reports. There must be a shift to focusing on implementation.

I am committed to the recommendations of this report, and I am driven by both my professional and my personal experience to see this implemented. I am driven by the memory of the school desk that sat empty behind me one Monday morning 27 years ago; the memory of Brett, that tall, handsome, intelligent young man who was always kind but who would not be returning to school, because he had taken his own life. How often I still reflect on a life that was not fully lived.

Ensuring our schools and our children have access to evidence based, quality psychological services is absolutely vital. We would not accept a situation where our children could not access timely treatment for a broken bone. We should not accept a situation where it can take months for them to see the mental health services that they need. It is imperative that we increase the ratio of psychologists in schools to a minimum of one full-time equivalent on site for every 500 students across all levels of school. Psychologists and psychiatrists are the lifeblood of our mental health system, and it is critical that we produce more psychologists and psychiatrists in Australia.

I am driven as a psychologist to see the recommendations implemented. As a professional, having worked firsthand with families and children, I know the profoundly positive impact that early intervention can have. Effective reform across mental health and suicide prevention needs to be above politics, putting the needs of Australians first. To facilitate a bipartisan approach and ongoing parliamentary engagement, the committee has recommended the appointment of a standing committee on mental health, suicide prevention and social and emotional wellbeing in the next parliament. This will ensure mental health policy remains on the agenda and that the parliament can monitor the processes and implementation.

The committee has made 44 recommendations in total. These recommendations will improve access to mental health and suicide prevention services, manage workforce constraints and improve funding and evaluation. Investing in mental health, suicide prevention and social and emotional wellbeing has never been more important. Evidence was clear that the key points for early intervention are early in life and early in illness, supporting parents through pregnancy, providing scaffolding for children throughout school and helping adults transition through life stages with ready access, reliable information and clear pathways to appropriate services. To support this, we need significant structural reform, including enhancing our digital technologies. Australia needs a common mental health language shared across the community and a diverse, coordinated workforce that incorporates lived experience and a wide range of specialist skills.

We need to increase access to safe and supportive services for Australia's diverse population. People who are culturally and linguistically diverse, and LGBTIQ+, and people from rural and remote areas deserve equitable and inclusive services. To do this, our mental health and suicide prevention sectors require further investment in community infrastructure and culturally-competent trauma informed workforces. These investments are critical for building the connectedness and social and emotional wellbeing of Australians across their lifespan.

I also draw attention specifically to Australia's First Nations peoples. Representatives have told us that culture is key, and commissioning pathways for services in the social and cultural determinants of health is fundamental to affecting change. The evidence is there. What are we waiting for? The committee has recommended that priority be given to investing in Aboriginal and Torres Strait Islander leadership within the mental health system and fully implementing the Gayaa Dhuwi (Proud Spirit) Declaration.

On behalf of the committee, I would like to thank those who made their submissions, who participated in public hearings and who shared their time, knowledge and lived experience throughout the course of the inquiry. I acknowledge and thank the member for Dobell for her work and assistance throughout. I also extend my deep gratitude to the committee secretariat team, Greg Ward, Vikki Darrough, James Peters and Cathy Rouland, for their professionalism, their dedication and their commitment.

The compounding trauma from living through extreme weather events, bushfires, floods and droughts along with COVID-19 and increasing levels of anxiety about the future must not be ignored. Australia needs a whole-of-government, whole-of-parliament approach to mental health and suicide prevention. The committee's recommendations have been developed with this in mind. On behalf of the committee, I commend the report to the House.

10:03 am

Photo of Emma McBrideEmma McBride (Dobell, Australian Labor Party, Shadow Assistant Minister for Mental Health) Share this | | Hansard source

by leave—I'd like to start by acknowledging the work of the chair, Dr Fiona Martin, the member for Reid. Fiona and I share a deep mutual interest in the work of this committee, and her background and experience is evident in this final report. Fiona, you are honouring the memory of Brett. My Labor colleagues and friends, the member for Werriwa and the member for Macquarie, who, through quarantine and whilst supporting their own communities through the pandemic, committed fully to the work of this committee, championing access and affordability for the millions of Australians living in the outer suburbs and the regions. I would also like to thank the many individuals and organisations who made submissions and gave evidence to this inquiry. It is as the member for Reid has said: it is our responsibility to you to see these words translate into action and meaningful change.

The risk to Australians' mental health and wellbeing through COVID-19 has often been described as the shadow pandemic. The loss of loved ones, separation from family and friends, business closures and job losses have had a significant impact on the mental health and wellbeing of hundreds and thousands of Australians. This has been particularly felt in the states, who, in keeping all Australians safe, endured long and repeated lockdowns, for which we are all very grateful. Many Australians have lived through COVID-19 while enduring bushfires, floods, droughts and other natural disasters. These events have further exposed the gaps in Australia's mental health systems and the growing disparity of access and affordability, especially for those living outside of big cities. This burden, carried disproportionately by the most vulnerable in our communities, has been brought into sharper focus through the global pandemic. Unless we as a country address inequities to access to services and the underlying social determinants, including housing, employment and education, we won't see a significant shift in our lifetimes so that, wherever you're born and wherever you live, grow up and age in Australia, you enjoy a good quality of life.

This is about people, and it's about the economy. The Productivity Commission found that in 2018-19, prior to COVID-19 and the Black Summer bushfires, the annual cost of mental ill health and suicide was around, as the chair has said, $70 billion. As can be seen from the reviews cited in the terms of reference for this inquiry, considerable work has already been undertaken to examine this problem and to recommend action. The Productivity Commission inquiry report Mental health, the report of the National Suicide Prevention Office and the Royal Commission into Victoria's Mental Health System have all made recommendations on how to improve the provision of mental health services. But what is needed is a sense of urgency—swift action to implement the recommendations in this report and preceding reports and proper funding to allow this to happen.

A key recommendation of this report is accessibility. It must be front of mind for researchers, policymakers, practitioners and funders. As evidence has shown and lived experience tells, accessibility is most acute for the most vulnerable Australians—those on low or fixed incomes, people from culturally and linguistically diverse backgrounds, Aboriginal and Torres Strait Islander peoples and those living outside of big cities. It is urgent, and we must act.

Then there are carers. The current mental health system does not work well to support those caring for people living with mental ill health. Despite their roles and significant responsibilities, carers often feel left out and overlooked. The report recommends a national carer strategy which includes a way for unpaid carers to be integrated into care teams and to access training for suicide awareness, risk and prevention, and a clear pathway for engagement for carer advocates and representative bodies. This must happen.

As a pharmacist, I understand the valuable role of pharmacists and other allied health workers in mental health and suicide prevention. Community pharmacists are often the first point of contact for many people experiencing mental ill health problems. Their role can span through to key members of multidisciplinary teams in acute inpatient settings. To support pharmacists in this role, the committee recommends evaluation of pharmacy mental health training and support for more mental health training for pharmacists and pharmacy staff.

My own experience as a pharmacist working in acute adult inpatient mental health units at Wyong hospital in the electorate I represent largely led to me being in this place. I worked alongside dedicated and capable nurses, social workers, OTs, psychologists and doctors doing their very best in a system under enormous strain. I saw firsthand the circumstances of people's lives that led to sometimes lengthy inpatient stays in stretched and underfunded public adult mental health units, only to be discharged often to the circumstances that made them sick. We discharged people to couches, to caravans, to caves. In a community where rents in the private rental market have increased by $3,600 a year, this problem has become a crisis.

The problems identified by this committee are not new. But progress in this area is being slowed by lack of clarity around funding and responsibilities between Australian and state and territory governments. I urge the government to finalise negotiations for a new national agreement on mental health and suicide prevention as a matter of urgency.

Another significant obstacle to action is the mental health workforce. There are simply not enough mental health workers, and there are barriers to employing existing workers in the areas of greatest need, or to work to the top of their skills and training, the top of their scope of practice. The National Mental Health Workforce Strategy must be finalised and acted on as a matter of urgency. Mental health is a bipartisan space, and it is above politics. We must work to ensure that the announcements made by the government are implemented, that the recommendations of this report and preceding reports are implemented, that there is a sense of urgency and that we don't have experiences, like the chair and I have had, of friends and colleagues who have had lives cut short, who should have been able to live full and active lives in our communities.

The government must work with the states and territories and with advocacy groups, not-for-profits and for-profits collectively and collaboratively so that we have a whole-of-community, whole-of-government response to mental health and wellbeing. The need for more mental health support is urgent in many areas, particularly for those living outside of major capital cities, yet there are long waiting times, leading to poorer health outcomes. Some communities are still waiting for headspaces that were promised prior to the 2019 election, such as headspace Wyong in my electorate on the Central Coast. I've been told several times that it is coming soon, and I hope so, given the impact of the pandemic, the surge in demand and the growing need. Climate change and natural disasters are impacting young people in my community and in communities across Australia. The need, as we know, is urgent. The need for implementation is urgent. The time for action is now.

In closing, I would like to thank the many individuals and organisations who made submissions and gave evidence to the committee, my fellow committee members and the secretariat. I now urge the government to act promptly on the recommendations on behalf of all of Australians.

10:11 am

Photo of Fiona MartinFiona Martin (Reid, Liberal Party) Share this | | Hansard source

I move:

That the House take note of the report.

Photo of Rob MitchellRob Mitchell (McEwen, Australian Labor Party) Share this | | Hansard source

The debate is adjourned and the resumption of the debate is made an order of the day for the next day of sitting.