Senate debates

Wednesday, 10 October 2012

Matters of Public Importance

Mental Health

3:59 pm

Photo of Stephen ParryStephen Parry (Tasmania, Liberal Party) Share this | | Hansard source

A letter has been received from Senator Fierravanti-Wells:

Pursuant to standing order 75, I propose that the following matter of public importance be submitted to the Senate for discussion:

The failure of the Gillard Labor Government to deliver on its promise of proper reform in mental health.

Is the proposal supported?

More than the number of senators required by the standing orders having risen in their places—

I understand that informal arrangements have been made to allocate specific times to each of the speakers in today’s debate. With the concurrence of the Senate, I shall ask the clerks to set the clock accordingly.

4:00 pm

Photo of Concetta Fierravanti-WellsConcetta Fierravanti-Wells (NSW, Liberal Party, Shadow Minister for Ageing) Share this | | Hansard source

I start my comments on this matter by pointing out that today is World Mental Health Day. It was interesting to see in question time that it was the coalition that led with a question on mental health on this very important day, whereas those opposite left it until the last question. In fact, they were very lucky to actually get their last question on mental health in. What does that tell you? That tells you that for us on this side mental health is a priority, but those opposite left it until the last question of the day. That tells its own story of where their priorities are.

Let us look at what has been happening in mental health in recent years. The government was finally shamed into doing something—and I underline 'something'—on mental health in the 2011-12 budget. That came after sustained coalition pressure and it followed two motions in 2010, one in the Senate and one in the House of Representatives, in October and November respectively. I remind the Senate that the Australian Labor Party and the Greens—the sanctimonious Greens—voted against these motions and therefore ignored the will of both houses even though the motions were passed.

So what was this so-called mental health reform package all about? The package is another that is really smoke and mirrors—an illusion. When you actually read the fine print, it has all the hallmarks of the classic smoke and mirrors so typical of many of the things that this government says that it has done. It has the typical big spend, the big headline of $2.2 billion, but when you look at the fine print it is tainted with the never-never brush of so many of the Gillard promises. We have this net spend over forward estimates which is really $583 million only, but then you have $580 million ripped out of general practitioner mental health services and allied health treatment sessions from the Better Access program. With no consultation whatsoever with the sector, it has caused enormous widespread concern in the sector.

Then, of course, despite the big headline figure, which those across the chamber are very good at talking about, in reality it was only $47 million in spending and $62 million cut in that first year. Regrettably, 18 months on, it is little wonder that those who previously stood alongside the Australian Labor Party are now justifiably critical of the government for its lack of action. After the budget the coalition successfully established an inquiry into the funding and administration of mental health, and this inquiry received over a thousand submissions. All were very critical of the cuts that the government had undertaken. Of course, if those opposite had not squandered billions and billions of dollars on useless things like pink batts and Julia Gillard memorial halls then we would not have had to cut funding to the most vulnerable in this country—that is, the mentally ill.

Let me remind the Senate of the statistics. Sadly, six Australians commit suicide every day and more than 200 attempt to take their own lives—and this is only the official statistic; it does not reflect the statistic in the 2007 National Survey of Mental Health and Wellbeing, which talked about the over 360,000 people who had contemplated suicide that year. One in four deaths among young people occurs through suicide. Suicide is the leading cause of death for 15- to 24-year-olds each year and suicide is the biggest killer of men under 44 and women under 34. Suicide ranks 15th in the overall causes of death in Australia, and we know the many confronting statistics which I have spoken about and which experts have repeatedly brought to the fore in relation to depression, anxiety and bipolar, personality and eating disorders.

One in five Australians need help now. Forty-five per cent of Australians will face some form of mental health problem in their lifetime. As I said, today is World Mental Health Day. The theme, which those opposite could not even get right in their notice of motion, is 'Depression: A Global Crisis'. I remind the Senate that, according to World Health Organization statistics, one person every 40 seconds worldwide commits suicide—a startling statistic. We have seen the many great initiatives in this area over recent months and we have spoken about them here in this place.

So what has happened with this so-called mental health money? Take, for example, the big promise in the 2010 election of $277 million for suicide prevention. Where is the money?

What has happened? Have the programs been rolled out? The answer is no, they have not been rolled out. This government have been extraordinarily slow at rolling out these programs and this is why they are attracting the criticism from those who previously stood by them and advocated, and were so glad to see something finally happening from those opposite in the mental health area.

We have also seen the cuts to the successful Mental Health Nurse Incentive Program. This program has been operating successfully for five years. What have seen a funding freeze. It is little wonder that eminent experts such as Professor Ian Hickie, Professor Patrick McGorry and Professor John Mendoza, the former chairman of the government's National Advisory Council on Mental Health, have been critical of the lack of progress in tackling vital mental health issues. But, like most things that this government does, it has the brush of the never, never.

There is the draft 10-year road map on mental health reform. During the last Christmas vacation period the minister announced the draft for the 10-year plan and gave the sector two weeks during the Christmas break to consult. Why? So they could say that there has been proper consultation. Ten months on and it is still a draft, and we are still waiting. It is little wonder that this draft road map has been so heavily criticised. As Dr Sebastian Rosenberg so aptly described it, it is a road map to nowhere.

Even with the latest iteration, which apparently emanated from the COAG process, the stakeholders in the sector were given only four working days to provide comment to the government on this very important area. That just goes to show the disdain that those opposite have for this area. If they really cared about the mentally ill in this country they would roll out these programs and not at the snail's pace like they are doing at the moment—they would put their heart and soul into it and respond to the needs of the sector, to what the experts have been telling them for years and years, and undertake the reforms that are so badly needed in this area.

Professor Rosen has called this 10-year road map another illusory, false start. Professor Mendoza said:

The Roadmap is yet another PollyAnna document from our Federal health bureaucracy that commits no one to anything.

Professor Ian Hickie said:

As a result of the mess left at the end of the Rudd era, key structural issues in mental health services remain unresolved.

Professor Rob Donovan said that this is a 10-year program but:

… there is no time line for the proposed actions.

It is little wonder that the government has many critics for its failure to take decisive action. (Time expired)

4:10 pm

Photo of Claire MooreClaire Moore (Queensland, Australian Labor Party) Share this | | Hansard source

We have been reminded consistently today that it is World Mental Health Day and also that this month we are looking at the issues around mental health and discussing the fact that we are working together. These debates at this time of the afternoon are always confronting. Instead of having a clear debate about an issue, we get a political attack—even this notice of motion is phrased in such a way that it is just a clear political attack. We saw that this afternoon with the notice of motion on mental health when we tried to pull together a statement that we could use as a group across the parliament to say what is happening in mental health. It was not for us—we have our job, our issues and our concerns; it was for the stakeholders in this country who care about mental health.

I am sorry because I am trying very hard not to make this a one-on-one discussion between myself and Senator Fierravanti-Wells, who is no longer in the chamber. However, her last comments about disdain for people in this community with mental health issues are just not appropriate. We can have our differences—and we do—about policies and about time frames, and we can discuss those. But this Senate, after hours of discussion to develop wording that we can share and could not do so, actually gave the opportunity yet again to someone who is running a particular line to stand up and have another go—another go about a process around mental health that is government policy.

All of the issues raised have the opportunity to be considered and debated. In fact, the government is more than prepared to do so and we want to do so. But it is galling when we look at the history of mental health and the responses of governments in this country to be consistently attacked by the Liberal-National Party when we can say that in 2010 we had a process, a policy and funding into the future for mental health programs. There is this acrimonious process even today when, instead of focusing on the issues, we get into the political cut and thrust.

If we look back to 2006, those of us who were in the chamber at that stage when the then Howard government introduced a long awaited and much supported mental health program into this parliament, there was cross-party support. We had issues about what was in there and we had questions, but the process was welcomed. That has been unilaterally lacking in the process around our 2010 package, which our government brought to the budget and then into parliament and which was passed.

I note Senator Fierravanti-Wells's concern with the statement that she carefully described as cynical and said that it received support across the parliament. It did. It was voted up. Any of the legislation that came through in our package received affirmative votes in this place. I would have thought that that indicated support in the parliament. Nonetheless, it was a good chance again to have on this day a two-minute grab to say how long our government has been around mental health.

There will always be concerns about any mental health policy that is brought in because, as I have said before in this place, no government will ever be able to put enough funding into what is needed for full mental health care in this country. I wish I could say differently but I cannot. We have never pretended that we would have a panacea and a response to all issues. What we set out was our program over a five-year budgeted stage.

The other night I heard, and I have seen it attacked in the media by the LNP, that this is somehow an erroneous process because we put the funding in over a five-year period. It was publicised: each of the figures was there; there was no confusion across each budget line. Over a five-year period we put out what our initial plan—over $2 billion—was going to be. Somehow, because that was not done over four years, that gave the people who wished to have an attack a reason to say that it was not fully funded.

In terms of funding cycles and commitment to budget, governments set out the expectation of funding that they will put into the program. Sometimes they meet it, sometimes they do not, but at every stage there must be accountability and transparency, which is why we have the Senate estimates process. It is why we have a minister who is open and on record saying that anyone who has a question on these issues is welcome to contact the office to be involved. It is why we have ministerial advisory councils and a consumer advisory council on mental health—a wonderful issue and one of my favourite types of the program. It is funded into the future, is allocated this year and is already starting its work. It is a core component of our mental health program. There was no confusion over the way the funding for this process would operate. The figures are in the budget papers, open to scrutiny, and they can and should be scrutinised.

Another of the key issues we put forward was the National Mental Health Commission. There were consistent attacks from people across the chamber on the way that we were presenting a commission: it was not good enough; it was not effectively structured; who was going to be on it? Not, 'How was it going to work?' But the commission has been set up; it is working. Its first report card on mental health in this country—determined independently by them, not including input by government, but the first-ever independent assessment by a mental health commission—will be brought down at the end of this month.

This is a very important time for mental health in our country. This will not be a slap-dash, tick-and-flick exercise. This will be a confronting document owned by the community, looking what is happening with mental health in this country. I hope it will stimulate more debate in this place, hopefully not with an attack to say why the government has failed but rather about what is in that report. How has the program of mental health funding been working—our plans, our strategies that were put out in the budget papers last year? What difference are they making? No policy program can be only on paper. People who live with mental health issues—their families and their carers—assess the way that things are working and assess what is the change for them

There will be some good news, I know. But I also know that there will be some confronting statements back to us saying what has not been working the way they hoped it would be. That will be the document's feedback. That will be the assessment by our mental health commission, which was a core—disputed—component of our mental health package that will give us the steps to the future.

Recently, we have heard it consistently asked: what is happening with the roadmap to recovery? I am on record that I do not like the title—it is as good as an annual report—The ten year roadmap for national mental health reform, but the roadmap is taking time to develop. There is no surprise about that. It is the first time there has been such a process and, as well, it is not the Commonwealth government's document. The clear indication of this roadmap is that it is a document which engages all the players who have a commitment to this process, most particularly, governments—state and federal—and we all know there is difficulty pulling those people together to come up with a clear commitment. They have made a commitment at the threshold stage about where we should be going with mental health 10 years into the future. However, tying down the accountabilities and the budget will take more time. We are not putting it out or having an agreement until that is tied down. That will involve more consultation, which is still going on. It has been to COAG and needs to go back to COAG.

There has been widespread opportunity for people to be involved in this process. We have heard Senator Fierravanti-Wells talk about her two-week process. The roadmap has been through the websites and since that process started over 1,000 people have put through information about what they felt should be in it. There has been ample opportunity through the Mental Health Council of Australia, through targeted consultation processes, for people to have a say. It could well be that people want more time. They may have missed the timing. Whatever, the opportunity then is to get back into the system and talk to the department about what those concerns are. It does not mean that people will be excluded. In fact, the core aspect is that people must not be excluded.

For too long in our community, in our parliament and in debates people who know about and are involved in mental health have not had a voice—they have been excluded. That cannot continue. That will not necessarily mean that there will be open agreement on every issue. I am absolutely intrigued that Senator Fierravanti-Wells spends so much of her time quoting experts, experts whom we respect and know. Professor Mendoza, Professor Hickey, Professor Rosenberg, Professor Rosenfeld—all men for that group, unfortunately, but there are many people in the area who are women, who I have had the privilege to know and work with for over six years. Their opinions are deeply valued.

Not only are their opinions deeply valued but they are also encouraged and welcomed. Indeed, if their opinions are critical, we must hear their message. No-one is saying they cannot have a say. No-one is responding publicly to them by saying, 'You are not allowed to have these comments—you must agree with the government.' Mental health is a dynamic area. There will be a range of professional opinion. In fact, we often joke when we are having meetings in this area about how, when we have a group of people concerned about this area, particularly those with professional qualifications, it will be surprising if we can get agreement across all of them.

What we do have is an open commitment to the process. There is concern that things may be taking longer. However, that is what happens in the process; things are put out, decisions are made, programs are funded and then it is open for people to say whether they support it or not. That is a positive action in our program which we value rather than dismiss, and these comments are definitely not feared. They will not be closed down and people will not be rejected. In fact, their comments are part of the ongoing discourse, and I can guarantee that those people I have named will continue to be involved in the discussion. They are not turning their backs and refusing to continue in what is their professional area for which they have trained and in which their expertise is acknowledged and celebrated in our process.

We stand by the programs we have put forward. We have funded them, and I will not go into detail in this limited time about the various priorities the government has put out—they are on record. We had the commitment to youth and the headspace program of which we are all so fond has been nurtured and funded by this government and our program. The EPPIC centres, which caused great debate about whether they were the appropriate way to move forward, have also started their development.

We have heard that it is wrong for people to de-fund any element to make savings in the area of mental health. I reject that. In every form of government program there are very tough decisions made about how you fund into the future. There were decisions made—again, not hidden but on record—about changes to the Better Access program, and we spent a fair bit of time in this place discussing that. It is fair to say that we do not agree, but in terms of the government program we believe that money can be redistributed and that different ways of supporting people can be implemented.

We wish that every program could be funded. That will not happen, but the savings we have made, which are clearly identified and which were the subject of a significant Senate inquiry, and there on record and we are working with people into the future to see how their needs and their expectations will work with the government program.

It is important that governments of all flavours continue to be committed to working on mental health in this country. It is a commitment from our government that we will continue to do so. We do not believe that we take a cynical or disdainful approach—in fact, we care and we need to be involved into the future.

4:25 pm

Photo of Penny WrightPenny Wright (SA, Australian Greens) Share this | | Hansard source

As the Australian Greens spokesperson for mental health I am pleased to participate in this debate on the matter of public importance. It is an opportunity to highlight the extremely important issue that is the reform of mental health in Australia. We know now that one in five Australians will experience mental ill health in any given year and, against a backdrop of what is acknowledged to have been decades of neglect of mental health funding and the mental health sector, there is clearly an important need for reforms to be undertaken by all governments in Australia—federal, state and local governments.

What could we achieve if we had genuine commitment to this? I am interested in seeing this issue transcends politics because I think it is far bigger than that. Most Australians would understand that with mental health touching on the lives of so many Australians, if not them individually or their families, carers and friends, it affects our productivity, the workforce and our general sense of wellbeing in the 21st century. With all of that being so pervasive in Australian society most Australians would expect that their elected representatives would be able to transcend politics and work together to find common ground to advance promotion of mental health in Australia, and to actively work to mitigate the worst effects of mental ill health.

Today marks the 20th anniversary of World Mental Health Day. It was first initiated by the World Federation for Mental Health in 1992 by Richard Hunter. Mr Hunter saw World Mental Health Day as a focal point around which global mental health advocacy could gain maximum public attention. It is a good opportunity to give consideration to the current state of mental health globally and, importantly, in Australia, and to the way we can improve the situation.

World Mental Health Day provides an opportunity for us all to work together to raise public awareness and to encourage education about mental health issues worldwide. There has indeed been a lot of positive change over the past 20 years. Just this morning, the Executive Director of the Mental Illness Fellowship of Australia, David Meldrum, was speaking on Radio National. He gave his view that there has been a generation of work around breaking down the stigma surrounding mental illness. Fortunately, in his view, the public debate around mental illness has become a lot more open. That is certainly an experience I would agree with, and I think many people in Australia would understand that there is now a lot more literacy and willingness to speak about these issues.

This open discussion is important because mental illness touches us all in one way or another. It is well understood that one in five Australians will experience mental ill health this year alone, and approximately 45 per cent of all Australians between 16 and 85 will have a mental health condition at some stage during their lifetime. Significantly, mental ill health is the third major morbidity and disease burden in Australia behind cancer and cardiovascular disease. That is a statistic that will surprise many; certainly, cancer and cardiovascular disease are acknowledged to be severely debilitating for many Australians, for the Australian economy and for our sense of wellbeing, but I think it will still surprise people to know that, sadly, mental ill health comes in third place to those.

These numbers mean that mental health policy goes to the heart of our nation's wellbeing. When it comes to numbers there can be no pussyfooting around: we have to look at the numbers of dollars available to address these statistics as well. Goodwill and fine intentions are not enough; we actually have to look seriously at what money as a community we are prepared to devote to ameliorating the mental health burden in our health system.

The total health burden of mental health in Australia is now 13 per cent, but as yet dedicated mental health funding is still hovering around six to seven per cent, so it is actually half of what we would require if we were going to fund mental health services proportionately to the mental health burden. If we are to genuinely tackle the serious challenges posed by poor mental health in Australia then we must be aiming to ensure that the amount of funding provided for mental health services, programs and policies accurately reflects this burden so that the funding is commensurate with the need. To achieve this we must have a commitment by government to increase mental health funding year by year until the proportion of mental health funding from the health budget reflects the true cost of mental ill health to the Australian community. To do otherwise is a false economy, because there is a clear established link between mental ill health and physical ill health—physical conditions like diabetes, cardiovascular disease and so on are clearly linked and that is why there is a greatly concerning gap in life expectancy between particularly those people who have persistent and severe illnesses and the average Australian population.

The Australian Greens acknowledge that there was a solid commitment made to mental health by the government in the 2011-12 budget with about $1.5 billion allocated in the five-year package for new initiatives or the expansion of existing initiatives. Unfortunately progress on the implementation of programs has flagged as part of this investment has been slower than we might have liked. Concern by some stakeholders has been raised with the Australian Greens that this funding might not ultimately be the health budget centrepiece that it was originally regarded as, given the context of chronic underfunding of mental health services over previous years.

One area where we have been consistently seeing difficulties in accessing mental health services and the quality and range of those services is in rural, regional and remote areas of Australia. While people living in country Australia generally experience mental ill health at levels equivalent to people living in urban areas, they encounter higher risk factors for mental ill health including unemployment, lower socioeconomic status, poorer levels of education and reduced access to mental health services. People living in country Australia receive less than half the total number of mental health services of people living in metropolitan areas. Male farmer suicides are reportedly as high as one a week and it is likely that official statistics do not reflect the true number of these incidents. There are other factors arising from the loss of identity or income, including in changing employment patterns and industries, that reflect environmental and economic pressures that we will be continuing to face in Australia in the 21st century. The lack of available services and difficulty accessing existing services exacerbates the situation and ultimately means that the burden of mental illness is proportionately higher in country Australia.

Over the past few months I have been touring Australia and I have met with mental health service providers, consumers and carers who I call the experts in mental health care. I have heard about many of the gaps in service delivery, problems with accessing mental health services and the good initiatives that are working really well but are stretched due to lack of funds and resources. One of the things I have consistently heard about is the importance of outreach services. This is particularly relevant in situations where there is great geographical isolation. Also many people who experience persistent and severe mental illness do not have access to their own independent transport so they become increasingly isolated and unable to access what services are available. I recently came across an outreach service called Rural Alive and Well in Tasmania which decided not to sit back and wait for people to approach them but to do advocacy, counselling and referral to further support in a bid to reduce suicide in the Midlands of Tasmania. At a time when many are doing it tough support like that is invaluable.

It is absolutely non-negotiable—and few people would argue that it was—that adequate funding be given to mental health in Australia and that equal need should mean equal access no matter where people live. Given the recent sizeable investment in mental health in Australia it is time to evaluate whether the funding is improving the delivery of mental health services in Australia. So it is imperative that we identify current unmet needs and gaps to service delivery and work to improve these. That is what the Australian Greens are in the process of doing, particularly at the moment in relation to rural, regional and remote areas. The Australian Greens will keep working collaboratively in a non-partisan way towards increasing awareness of mental ill health in Australia in the interests of reducing stigma and promoting wellbeing which will be of benefit to all of us.

4:35 pm

Photo of Sue BoyceSue Boyce (Queensland, Liberal Party) Share this | | Hansard source

I am in the rather unusual situation of wanting to support the statements of all the senators who have spoken before me. People are quite right to say that the issue of mental health should not be politicised. That does not mean we should not hold the government to account for slow implementation and poor policy-making. That is something we certainly need to do. I am delighted to have this opportunity to recognise this 20th World Mental Health Day. It is interesting to note that it is only the 20th World Mental Health Day. Many other physical diseases are great fundraisers and have organisations with household names that have been going far, far longer. The stigma of mental illness still prevails and is only slowly being rolled back, but we need to do more.

Mental health is often an invisible problem. It is more prevalent, as many other speakers have said, in rural and remote areas than in metropolitan areas simply because of the huge amount of unmet need for psychological and psychiatric services. The level of unmet need is particularly high for Aboriginal and Torres Strait Islander people and suicide rates in our Indigenous communities are 26 times those of the general population.

You have already heard that in Australia one person dies from a suicide attempt every four hours. The figure from many of the hearings the Standing Committee on Community Affairs has had is very conservative, because many suicides are reported as something other than suicide. The family does not want that report and police, coroners and others are reluctant to make that assessment unless they have some very strong evidence that it occurs.

The headspace program, which of course was an initiative of Professor Patrick McGorry, former Australian of the Year, and others is now seeing about 20,000 young Australians a year but they estimate that there are still 350,000 young Australians who need help and cannot get access. In this situation the government has developed a 10-year roadmap—we do not need help in 10 years—and emasculated the Better Access program, which was doing a fantastic job of giving people who needed low-level mental health services the opportunity to get well. I think it is worthwhile looking at some of the comments in the motion on World Mental Health Day that was proposed in the Senate today. It makes the point that mental illness is experienced across the lifespan, with many illnesses emerging before the age of 25; that people affected by mental illness can recover to live a happy and rewarding life with adequate and high quality services and broad community understanding and support; that there is a need for a holistic and broad range of services and support for those with mental illness, including community-based services and services delivered by both the Commonwealth and the states and territories; and that policies and services must recognise and respond to the impact of mental illness on families and carers. I would suggest that the government's current delivery of its mental health reform package does not do those things; it is not holistic.

The decision to cut back the Better Access program to a maximum of 10 consultations, no matter what, is damaging people right now in Australia and will continue to do so. The Better Access program was in many ways a victim of its own success. It was introduced by the Howard-Costello government. In its first year in 2007 2.7 million services were delivered under the Better Access program; in 2008 it was 3.8 million and in 2009 4.6 million—almost a doubling in three years. That would have continued because of the massive reservoir of unmet need in this area.

I was somewhat interested to hear Senator Moore suggest that the Minister for Mental Health and Ageing, Mr Mark Butler, is open to hearing about issues and problems in the area. The Alliance for Better Access, a group that has come together to try to fight to get some understanding from this government about why they should not simply emasculate the Better Access program, has been trying to see Minister Butler for over 12 months. In August they were told that he did not need to see them. So much for his open access and desire to talk to everyone who wants to get involved in this area.

I would like in the short remaining time I have to talk about some of the cases, from many emails received in my office, that are going to be affected. One senior practitioner in rural Queensland has sent me an email saying:

Regional centres have profound unmet health needs as it is. The cuts to Better Access will prove fatal for some.

This is not an exaggeration. The end of treatment when treatment must continue is even worse perhaps than not having started treatment. This practitioner goes on to say:

Last week I was contacted by this patient who I have treated for five years on and off who has a diagnosis of complex post-traumatic stress syndrome and is one of the most profoundly traumatised people I have treated in over 15 years of practice. This patient presented with a credible and involved suicide plan, had been giving away belongings and had written goodbye letters to the select few supports in her life including her psychologist.

In other words, she was ready to kill herself. My correspondent goes on:

The fact that she had been cut off from any further help from Better Access was the last straw. It then took us over 18 hours to find a hospital bed for this poor woman.

How can we allow a situation involving dozens and dozens of cases of people who have no other source of hope to continue. That is why in this situation we criticise the government's implementation. It is as poor here as it has been in so many other areas.

4:43 pm

Photo of John FaulknerJohn Faulkner (NSW, Australian Labor Party) Share this | | Hansard source

I welcome the opportunity to debate the government's record in the area of mental health reform, which I acknowledge is particularly relevant today on World Mental Health Day. As we know, Mr Acting Deputy President, mental illness does not discriminate. It affects the lives of many Australians from all backgrounds. It also impacts on the lives of friends, family and work colleagues of those affected. One in five people and one in four young people will experience a mental health issue in any given year.

But only 25 per cent of 16- to 24-year-olds who experience mental health issues will get help. Sadly, we know that mental illness disproportionately affects the lives of our most vulnerable—people from lower socioeconomic backgrounds, particularly the homeless, migrant communities, regional communities and Indigenous Australians and Torres Strait Islanders.

The government's $2.2 billion mental reform package over five years is delivering real assistance and real improvements to the lives of those thousands of Australians with mental health issues. What this means is that the government has been able to deliver vital programs—and I thought today in my contribution I would give five examples. Firstly, headspace, the National Youth Mental Health Foundation, is tackling mental health issues early for our young people, particularly in regional areas and on the city fringe, with new centres being opened in Werribee, Liverpool and Rockhampton—bringing the total number of operational services to 40, with a further 30 announced sites in development. At the end of the 2011-12 financial year, more than 67,000 young people had been assisted by headspace, with more than 700,000 occasions of service delivered. Secondly, there is KidsMatter. KidsMatter is a mental health and wellbeing framework for primary schools and early childhood education and care services that promotes mental health and early intervention for children. As of the end of July this year there were more than 815 primary schools around the country participating. Thirdly, the government has made big investments in online mental health support with online services such as eheadspace, and myCompass. Fourthly, the mindhealthconnect portal went live on 29 June this year, on time and to schedule. In its first month of operation, more than 37,000 unique visitors had accessed the portal. That is an average of 1,258 Australians each day seeking a range of information on mental health matters. Finally, the National Mental Health Commission is up and running—again, on time and on budget. The commission has met seven times to develop Australia's first ever national report card on mental health and suicide prevention. The commission met with more than 400 key stakeholders, carers, and consumers in every state and territory. The government does have a strong commitment to working closely with key stakeholders such as community and advocacy groups, states and territories, local government, NGOs and communities to provide support to those vulnerable members of our community at mental health risk.

In May this year I attended an event marking the 20th anniversary of Suicide Prevention Australia. That organisation has been very important in ensuring that we remain vigilant and continue to prevent suicides and attempted suicides and support those whose lives have been affected by suicide. The development and funding of initiatives like the Taking Action to Tackle Suicide package and the National Suicide Prevention Program are critically important to organisations like Suicide Prevention Australia.

Last year the government established the Aboriginal and Torres Strait Islander Suicide Prevention Advisory Group to guide the development of Australia's first national Aboriginal and Torres Strait Islander strategy. There has been $24 million provided to boost the capacity of crisis hotlines such as Lifeline and to help train front-line community workers in suicide prevention through the Mental Health First Aid program. Safety is being improved at suicide 'hot spots', where community prevention activities for high-risk groups are being supported and suicide postvention outreach teams to schools are being funded.

Together with a range of organisations, the government has been focusing on building national suicide prevention sector networks. It has also been creating and disseminating suicide prevention information and doing other a range of other very valuable work through its joint membership of the National Committee for the Standardised Reporting of Suicide. The government's $2.2 billion five-year mental health reform package and its continuing support for organisations such as Suicide Prevention Australia are making a real difference for vulnerable members of our community and, more broadly, for public health in Australia.

I think that on a day like World Mental Health Day it is important to stress that nationwide mental health reform needs ongoing bipartisan political support. It deserves ongoing bipartisan political support, something that this sector has called for for many, many years. Previous governments, I acknowledge, have made significant inroads in mental health reform, and I believe that the current federal government's package is another significant step in providing the quality services and support that are so critical to so many of the most vulnerable in our community.

4:53 pm

Photo of David FawcettDavid Fawcett (SA, Liberal Party) Share this | | Hansard source

I rise to speak on this matter of public importance on mental health, and I welcome the comments by Senator Faulkner that it is an issue where there is bipartisan concern, and that previous governments have made substantial and, might I add, effective commitments in this area. I think that is the point where government speakers have missed the heart of this MPI from the coalition's perspective. We share the desire to do something and we share the desire to make sure it is bipartisan. But that does not absolve us from our responsibility to hold the government to account when they are not delivering on their promises, or when they are not working effectively with the funds that they have committed. This is an area where we cannot fail. We cannot fail the many individuals and families who entrust us to come to this place to use their taxes effectively to provide the support that our community needs.

Almost 45 per cent, or 7.3 million, of Australians aged between 16 and 85 report that they would have met the criteria for a diagnosis of a mental health disorder at some time. One in five Australians will experience a mental illness this year. Anxiety disorders affect some 14 per cent of people aged between 16 and 85; they are the most common disorders. It is perhaps not until you know someone who has been affected by that that you realise how debilitating it can be for them, for their families and for the work that they do, and why we as a community need to support them.

Mental health accounts for nearly 13 per cent of the total burden of disease in Australia, but only about six per cent of the health budget goes to mental healthcare services. The coalition, in holding the government to account, was successful in initiating a Senate inquiry looking at the funding and the administration of mental health services. I bring those two points out deliberately because it is great to have a vision, and this government has been very good about putting forward its vision, but vision without dollars is hallucination. One of the things where people are hurting is that this government talks, as Senator Faulkner did then, about $2.2 billion over five years, but the question is: when is that money being spent? The bulk of it is in year 5, and there have been cuts to programs—successful programs—in the meantime that have hurt people.

The package of measures announced in 2011 had that headline figure, but only $583 million of that $2.2 billion is to be spent over the forward estimates in the four years. In the 2011-12 financial year, the total amount spent was only $47 million. The government cut mental health funding by ripping $580 million from GP mental health services and the allied health treatment sections from the Better Access initiative. Some 1,500 submissions to the inquiry were received. I have had phone calls and emails from many people in South Australia talking about the impact that this has had, both from families and from providers who recognise that mental health is often not something that can be cured just overnight. It requires ongoing and consistent support and a relationship to be built up between the person providing the service and support and the person who needs it.

A survey of 404 GPs that the AMA did found that the proportion of doctors bulk-billing patients for preparing mental health plans had dropped from 78 per cent prior to the cuts to only 38 per cent following the cuts. The Better Access program had provided care for more than one million people before the program was cut, and the AMA's conclusion was that the 2011-12 budget cuts were clearly all about the budget bottom line and did not actually have improved outcomes for mental health patients as their priority.

In terms of administration, not only is there a problem there with the funding but the other criticism that the coalition has is of the way that the government is going about it. Senator Faulkner made the comment then that the Labor Party works closely with all the stakeholder groups. But I have to say that, in the Senate inquiry looking at the way it undertook changes to the Better Access program, one of the very clear messages that came through from the stakeholders was that there had been scant consultation. The government relied heavily on a Better Access evaluation which has been widely criticised for deficiencies in both its methodology and its data set.

The coalition is concerned about the consequences of a shift from Better Access to the ATAPS, and that they have not been fully considered. This is particularly worrying given the challenges that the ATAPS are facing, which are highlighted in the ANAO report. Fundamentally, there is the question as to whether the ATAPS structure is going to be sufficient to meet this demand.

I would like particularly to talk about some of the challenges that people in rural areas face. I have spoken in this place before, in June this year, about things like the Mental Health Nurse Incentive Program. People in South Australia—from Clare, for example—highlight the value that this program has provided in providing local access to mental health care that prevents people deteriorating to the point where they need to go to Adelaide to seek deeper care. And yet, despite the widely recognised success of this program around Australia, this is one of the programs that have been capped by the government as opposed to being built on.

Good leadership theory tells you that if you want to succeed you build on your strengths. This has been one of the areas that have been a strength as well as the Better Access program, and I would encourage the government to seriously look at removing that cap and boosting these programs that are helping rural communities.

The other area of implementation is making sure that the bureaucracy does not get in the way. During a recent visit to the Riverland, when I was speaking to a GP who delivered headspace programs, she talked about the frustration of being restricted to providing the service in one location where most of her clients were young people who had no ability to travel there from regional towns. She was happy to travel and provide the service but the system would not let her. This government needs to improve and deliver its promise on funding better mental health outcomes.