Penny Wright (SA, Australian Greens) Share this | Link to this | Hansard source

I rise to speak tonight in relation to the consultations I have been conducting throughout country Australia about the delivery of, and access to, mental health services in rural, regional and remote areas. As the mental health spokesperson for the Greens, I am undertaking these consultations to talk to real people on the ground about the state of mental health services in their region. It has been a thoroughly enjoyable process so far, although the news is not all good by any means.

This consultation process will inform the development of the Australian Greens policy on country mental health services. So far, I have toured country Western Australia, Newcastle in New South Wales, South Australia and Tasmania and over coming months I will be continuing my further consultations in New South Wales, in Victoria and in Queensland. Previously, I have spoken about the engaging discussions I have had with many consumers and organisations in Western Australia. Tonight I would like to report back on recent consultations in my home state of South Australia and my meetings last week in Tasmania. But before providing that report back I just want to revisit the reason that the Greens are focussing on the mental health services in country Australia.

The Australian Greens believe that access to quality health care in Australia, including mental health care, is a basic human right.

With approximately 45 per cent of Australians aged between 16 and 85 years experiencing mental ill health at some stage in their lifetimes and 20 per cent of Australians experiencing mental health issues in any particular given year, mental health policy does go to the heart of our nation's wellbeing and touches all of us one way or another. So it is vital that adequate funding and attention are given to all aspects of mental health in all parts of Australia.

One of the Greens key priority areas is developing a policy response to the unique mental health issues faced by people living in regional, rural and remote Australia. Approximately seven million Australians, or 32 per cent of our population, actually live outside our major cities in regional and country towns of varying sizes and varying remoteness. Rural Australia makes a significant contribution to the nation's social and economic development. For example, in 2005 the gross value of agricultural and horticultural production was $35.6 billion. Despite this, over recent years, rural communities have been neglected through a lack of investment in infrastructure and essential services. A damaging consequence of this lack of support is a considerable health investment deficit in rural Australia which equates to approximately $2.1 billion a year. An aspect of this health deficit that is of particular concern to me, with my mental health cap on, is the limited access people living in country Australia have to mental health services.

People living in country Australia generally experience mental ill health at levels equivalent to people living in urban areas. But the harsh reality is that they encounter higher risk factors for mental ill health, including unemployment, lower socioeconomic status, poorer levels of education and reduced access to the very mental health services they need. The lack of available mental health services and limited access to existing services in rural areas is particularly challenging and this tends to exacerbate the situation so that the burden of mental ill health is proportionately higher for people living in country Australia.

So we have a situation where people living in regional, rural and remote Australia have at least an equal need for health care, including mental health care, but their access to these services is substantially less than for those in major cities. It is essential that we develop effective and strategic public policy to address these issues, and the Australian Greens are committed to doing this. My consultation process has been an opportunity to shine a light on these issues and it has certainly been worthwhile, enabling the Greens to develop a strong and collaborative dialogue with country communities so that we can work together to find solutions and create better outcomes for everybody living in those communities.

On my tour of my home state of South Australia, I visited mental health service providers, advocates, consumers and carers in Barmera, Berri, Renmark, Murray Bridge, Whyalla, Port Lincoln, Port Augusta and Mount Gambier—all over the state. These meetings were extremely worthwhile and each time I learn a great deal from people who are working on the ground and people with direct experiences of mental illness.

In Renmark, Murray Bridge and Whyalla, I heard from stakeholders, both service providers and consumers, about the important role that neighbourhood centres play in creating connected and socially inclusive communities in country towns. While these centres are not a mental health service as such, they play an exceptionally important role because they actually promote individual and community wellbeing.

For example, in Whyalla the Joan Gibbons Neighbourhood Centre operates five days a week and provides essential assistance to families and individuals, and a place to belong for anyone who appreciates that. Some people attend the centre to volunteer or receive help in financial management and budgeting, cooking skills, knitting, assisting kids with homework, and teaching or learning reading and writing skills. A computer room and community garden provide opportunities for visitors or participants in the centre to work, share their skills and passions, and to connect with each other. They offer shared meals and exercise and sports programs.

These neighbourhood centres or community centres provide people with somewhere to get support, to contribute their own strengths and skills and feel good about that, and to experience connection and relationships within their community. They bring together members of the community on a shared footing.

A continuing theme throughout these consultations was the lack of flexibility in funding and service delivery. A number of organisations and consumers have raised this with me. In particular, there is the absence of and difficulty in providing outreach services, and that is a significant issue for country people. A number of people also expressed concerns that many services in their towns are based on models developed for urban areas and are not appropriately tailored to rural areas and the needs of rural communities.

I was in Tasmania last week and had the privilege to meet with people in Launceston, Hobart and rural Tasmania. In my Launceston meetings, I heard about the need for specialised mental health workers such as mental health nurses and peer support workers in the hospital emergency department, which is currently turning away too many people in need or forcing them to wait long hours, exacerbating the condition that brought them there in the first place and increasing their distress.

I also heard about community based services like Aspire and the Richmond Fellowship, who provide inspiring peer support workers to share their experiences of mental ill health in a positive way to empower others. They are working tirelessly to provide essential mental health services to the Launceston community. I also visited the Melton-Mowbray district and met with Rural Alive and Well Tasmania, which is currently providing an excellent mental health service focused on suicide prevention. RAW Tas, as it is known, made a conscious decision not to sit back and wait to be contacted but has a proactive approach to service delivery, with mental health workers visiting people in their homes often on the basis of concerns raised with them by others. They have undoubtedly saved lives and are rarely turned away.

In Hobart, I attended two forums hosted by the Mental Health Council of Tasmania and Mental Health Carers Tasmania. At those forums, I heard a great deal of support from key stakeholders for the expansion of outreach services throughout Tasmania due to the uniquely regional nature of that state. I also heard about how important it is to create community connectedness and to focus on nonclinical community based treatment. In this regard, as in South Australia, there was significant support for community neighbourhood centres as a great model for enhancing community connectedness for people who are experiencing disadvantage or marginalisation.

One continuing theme that I have come across throughout my consultations around Australia is the need to address the social determinants of mental ill health.

That means that in addition to providing clinical and non-clinical based care we must, as a community, also address the underlying issues that contribute to mental ill health, such as homelessness, joblessness, poverty and low educational outcomes.

I will be continuing my tour until the end of this year and I look forward to talking and listening more to people in rural, regional and remote Australia about mental health services in their community. By the end of these consultations I will be identifying gaps in service delivery so we can determine what is needed to build healthier, more resilient communities, where people with equal need have access to equal services.