Michael Forshaw (NSW, Australian Labor Party) Share this | Hansard source

I rise to make a few comments with regard to this comprehensive report that has been tabled today, recognising that in the short time available it will be impossible to do justice to it. I believe it is one of the most important reports tabled in this parliament for many years. It was certainly one of the most important inquiries that I have been involved in. The report runs to 17 chapters and hundreds of pages covering the evidence and submissions that were presented to the committee inquiry.

This report that we have tabled today is a first report. It comprises the bulk of the report plus what we would describe as the primary recommendations. We have released the first report and the initial recommendations ahead of the final reporting date that was established by the Senate to ensure that our proposals and findings are available to the federal and state governments in the lead-up to the coming COAG discussions.

It is a unanimous report. As I said, it catalogues the enormous input from many groups and individuals who appeared before us in public hearings and/or made written submissions. The inquiry visited all states and territories and took evidence from groups, individuals, state and territory governments and professional groups. Effectively we heard from all of the participants involved in dealing with, experiencing and treating mental illness.

Many people showed enormous personal courage in making a submission or appearing before the inquiry. Anyone who knows anything about mental illness knows how hard it is for people to talk about it. Notwithstanding the improvements in recent years and I think the greater understanding that is developing in the community regarding mental illness, there is still a large stigma attached to it. It attaches not just to those people who suffer mental illness but to their families and carers as well. I think it exists because at the end of the day most of us, if we have not experienced a mental illness, find it difficult to understand what it involves. I will come back to that at the conclusion of my remarks.

The essential message of this report is that we as a society and our health system have not served the mentally ill well. Some argued that we have failed. Many argued that it is a crisis situation. We certainly know that one in five Australians on average will at some point in their lives experience a mental illness. Fortunately for many, if they do experience one it will be a mild case of depression, but for many others it can involve a lifelong illness. That can be depression, bipolar disorder or schizophrenia. We all know the types of mental illness that people in our community have to endure.

I want to deal quickly with a couple of the key aspects of our report and recommendations, recognising that it is simply not possible to cover it all in one short speech. It is widely accepted today that the move to deinstitutionalisation, particularly following the Richmond report in New South Wales, was not a complete success. I would not say that it was a complete failure, but it certainly has left a lot to be desired. It is well recognised today that, in closing the institutions and many of the major psychiatric hospitals in this country, state and federal governments failed to provide the community based services that were supposed to replace those institutions.

Many people today cannot get access to affordable and adequate housing. Community based medical services, particularly CAT teams, are stretched to the limit. There is a lack of proper employment assistance. We know that there is a growing link between poverty and mental illness. We also know that comorbidity—that is, combined illnesses such as mental illness and drug or alcohol abuse problems—is on the increase.

There are huge pressures on the hospital and acute care system. We heard evidence constantly of people being unable to get proper care and access to an acute bed when it was needed because of the logjams that occur in emergency and accident centres around this country. We heard evidence very early in the piece that the first call is often on our police services, who find themselves increasingly involved in taking people who might be suffering a psychosis to the emergency and accident centre at a hospital and then being stuck there for long periods of time. We are aware also of the pressures on carers and families.

Our primary recommendations go to asking governments to significantly increase the funding for mental health services so that it reaches a figure of between nine and 12 per cent of the total health budget by 2012. We submit that that should be primarily directed to community based services. We make very detailed recommendations about the sorts of areas in which we believe those services should be improved and new arrangements established. We envisage the establishment of a better mental health in the community initiative which would lead to the establishment of around 300 to 400 community based mental health centres throughout the nation.

The other aspect I want to quickly turn to is that there is still a need for an adequate and appropriate acute care system. We find today that the acute care beds of psychiatric units are invariably located in public hospitals. In many cases, certainly in ones that I have visited, they are not appropriate and are inadequate. People who need an acute care stay for a mental illness are generally not going to be confined to bed. They need space and room. It is ultimately about stabilisation and hopefully rehabilitation and recovery, and many of those facilities are not adequate. We are finding that the beds are not available in many cases. People go in through the A&E—the accident and emergency—service and they go back out the door again because they cannot get an acute care bed. So we are also urging that there be moves to improve that sector of mental health services delivery.

There are so many more issues that we could talk about—and I am sure that, in future remarks in this chamber, we will get a chance to deal with them—including: the workforce, human rights, issues that particularly affect Indigenous people or young people, the difficulties that women face in prenatal and postnatal depression, and the relationship between mental health and the criminal justice system. Those issues are all covered in our report.

I want to finish by saying that the best and most apt comment I ever heard about mental illness was said to me by my mother, who suffered from severe depression all her life. She once said to me, ‘Mental illness is the most painful illness of all because it is the pain you cannot explain.’ She did not mean any disrespect to anybody suffering from any other illness, but her comment adequately summed up what is at the heart of the issue. People suffering from mental illness often cannot explain that illness to others in ways we understand. Hopefully our report will assist people who suffer from mental illness, so that they can have access to appropriate and better services and can ultimately recover to lead fulfilling lives in our community.