Thursday, 14 February 2019
Education and Employment References Committee; Report
I present the report of the Education and Employment References Committee on the mental health of first responders, emergency workers and volunteers, together with the Hansard record of proceedings and documents presented to the committee. I move:
That the Senate take note of the report.
I rise to make some remarks on the report of the Senate Education and Employment References Committee on its inquiry into mental health conditions experienced by first responders.
First responders are the professionals the rest of us turn to and rely upon in our times of greatest urgency and distress. They are the highly trained officers who attend our medical emergencies, who go into burning houses, who stand between us and danger. They protect us and our families. Their presence and skills when we call 000 can mean the difference between life and death. Their working lives are spent navigating extreme circumstances the rest of us—if we are lucky—will rarely encounter. They perform a vital role in the community, and they are training to make critical decisions which will determine the course of people's lives.
But they are also people. They are men and women who are not, and cannot be, inoculated against the known risk of psychological injury caused by repeat exposure to significant trauma. Over the course of the inquiry the committee heard from many first responders and got a glimpse into their world, the things they see and experience. And those things they see and experience are remarkable both in scale and in substance. As put by one first responder, it is not a normal job. It is a job in which you engage with people having the worst, and sometimes last, days of their life, and you do so day in, day out, over many years. It is a job in which you may be required to place yourself in danger or be assaulted whilst trying to save lives. A job in which you witness catastrophic injuries up close, and in which you appear out of the blue to deliver the worst news imaginable to people's families.
Mental ill health is not like a broken arm, or like influenza. It does not announce its presence suddenly one day. The committee heard time and time again that it is hard to pinpoint a moment when a person's mental wellbeing begins to unravel. Instead, many witnesses told the committee that mental health is like a bucket which slowly fills, bit by bit, until it overflows, and it is impossible to say whether it was the first drop or the last which did the most damage. Even in the wider community, the conversation around mental health has only recently started to shift.
The committee had the opportunity to engage with a wide range of professionals in the mental health field, and the evidence they presented was unambiguous: first responders' work places them at an increased risk of developing serious mental health conditions—not least depression, anxiety and post-traumatic stress disorder, as well as an increased risk of suicide. Cumulative exposure to trauma—a core feature of first responders' work—can have a profound effect on mental health. This being the case, it is reasonable to expect that first response organisations should mitigate that risk by prioritising the health and wellbeing of their workers.
Unfortunately, first responders' lived experiences—related to the committee in both public and confidential submissions—tell a different story. They speak of an entrenched stigma around mental health and of a widely-held fear of reporting psychological injury to management. They speak of a culture of intimidation and bullying in some organisations, where those who report mental health conditions are treated like liabilities to be disposed of rather than helped. They speak of an adversarial culture which sees mental health injury as a weakness, rather than recognising the strength and self-awareness required in seeking help. And they tell of a system which treats them with indifference when they can no longer work and confronts them with an almost impenetrable wall of bureaucracy and endless hoops to jump through if they turn to workers compensation to get by. Perhaps the most striking thing to emerge from this inquiry is how much poor management can exacerbate mental health conditions and cripple rather than assist an individual's recovery.
The committee noted the commendable efforts underway in some first-response organisations, which are implementing evidence based programs and initiatives to protect the wellbeing of their staff. We were heartened to hear several organisations admit the mistakes of the past and recognise that genuine cultural change takes time. There is a long way to go—however, we must as a community seize the momentum generated by this inquiry and demand that the mental health and wellbeing of first responders be taken seriously. Initiatives, guidelines and strategies are merely words on paper if they do not translate down the management chain into something palpable for workers. The committee therefore urges federal, state and territory governments and stakeholders at all levels to accept and implement the recommendations of this report without delay.
In presenting this report to the Senate, I would like to recognise the service of first responders around the country, and to thank each and every one of them. I would particularly like to thank the individuals who participated in this inquiry—those who told us of their darkest hours, and those who have suffered the incalculable grief of losing loved ones to suicide—many retelling and reliving their trauma in the knowledge that what happened to them in the past cannot be undone, but that sharing their experiences may help their colleagues and other families in the future. These are people who are hardwired to protect others and we, as a community, have a moral obligation to help them. As the committee concludes in its report: 'The human cost of inaction is too high.'
I put on the record my thanks to the ever professional committee secretariat in conducting at times what was quite a difficult inquiry but a very rewarding one. I also want to put on record my thanks to the other committee members, in particular to Senator Urquhart, who did much of the very heavy lifting in relation to this inquiry and really got down to some of the hard detail analysis of what was required. So my thanks particularly go to Senator Urquhart for this inquiry. I recommend and commend this inquiry and its report to the Senate.
I am conscious that a lot of my colleagues wish to speak on a large number of reports, so I will speak very briefly on the report The people behind 000: mental health of our first responders. I also want to absolutely acknowledge on behalf of coalition members the work that first responders do and the pressure it places upon them. It is an extraordinarily difficult, demanding and stressful area of work. Whether it be our ambulance personnel, our paramedics, our firefighters or our police officers, all first responders and all volunteers who work in that environment are doing something that society asks of them. We need people who are willing to step up and do those jobs, but it is an extraordinarily stressful and demanding environment in which they work. It places pressures on individuals. It places pressures on families. That came out very clearly in the report and in the evidence given to the committee.
Coalition members of the Education and Employment References Committee did put in some additional comments to the report; however, I wish to make it very clear that that does not mean that we disagreed with the majority report. It's an area where attention does need to be paid into the future. However, it needs to be recognised that this does fall across our federation to different levels of government, with different responsibilities. Whilst the Commonwealth can play a coordinating role, we must acknowledge the right and responsibility of the states and territories to play their correct part as well.
I also wish to acknowledge, as the chair did, the work of the secretariat. It was a challenging and confronting inquiry at times. I also acknowledge the work done by Senator Urquhart. It was, at times, a difficult inquiry, but I think one in which the very good work of the committee system does shine through. I will end just by thanking all our first responders.
It was in December 2017 over a Christmas drink that a Tasmanian intensive care paramedic and the Vice-President of Paramedics Australasia, Simone Haigh, asked me, 'How do you get a Senate inquiry into an issue?' I responded, 'You talk to a senator,' and away we went. Simone had brought her dog, Oscar, a Weimaraner, to the office that day. Oscar is a wonderful dog, calm for his size—because they are quite a big dog—and very good at finishing his snacks. Simone had inherited another one of her Weimaraners about two years before in the worst of circumstances: Simone's friend and colleague Damian Crump had taken his own life, leaving Linc behind and shattering friends, family and colleagues. Simone explained me that while Damian's passing was a tragedy, he wasn't alone and that too many paramedics and responders have died by suicide or ended their career early because of mental health injury.
I went away determined to look at the incidence of mental health conditions amongst first responders—what support was being provided and what are the key gaps. I found that while there was a significant amount of work underway in terms of research and to improve policies and culture of first responder organisations, quite frankly, it was too slow and too fragmented. Australians who dedicate their lives to the service of our community, who answer us in our time of need, are not being adequately supported when they need it most, and greater national coordination is needed.
The inquiry received 161 submissions from all corners of the country and from Canada. We held hearings in all state capitals and here in Canberra. I want to thank personally all those first responders, their families, their representatives as well as the many, many health professionals, researchers and academics who made compelling submissions and gave evidence at hearings. Most of the submissions were highly personal in nature, sharing intimate details of trauma and bullying and of difficulties with broken systems.
I thank those first responder organisations that made submissions and sent representatives to hearings, in particular those senior leaders who recognised that there is still much more work to be done. I thank the staff of the secretariat—Stephen, Natasha, Kate, Ariane, Matt and Jade—for their work throughout this inquiry. I thank the other senators who participated in this inquiry, in particular Senator Marshall and Senator Brockman.
In policy making, data is the key. The inquiry was privileged to be able to include evidence from the epic Beyond Blue research project Answering the Call that captured the personal experience of over 21,000 current and former employees and volunteers. Beyond Blue found that 10 per cent of first responders have probable PTSD. The figure for the general population is four per cent. Similarly, incidents of high psychological distress and mental health conditions were around double the general population. There is a clear need for greater specialist interventions to support these people who give so much to our communities. The report makes 14 recommendations that seek to: drive greater focus across the country, collect more information on first responder mental health and suicide, increase national coordination and oversight, improve training and support services, and change workers' compensation processes. I trust that the federal government will quickly move with the states and territories to begin implementing these important recommendations. Our first responders can't wait.
I want to pay particular tribute to those first responders and their representatives who provided evidence on their experiences with bullying and maladministration. The committee heard your evidence loud and clear. We elected to focus on positive recommendations to improve workplace culture and support services. We heard time and again that, while first responder organisations have sought to update policies and procedures around mental health and workplace culture, such modern practices are not filtering down through the ranks. In fact, managers may be affected by the nature of their work and environment. Our first responder organisations must work harder to improve the workplace culture. Our first responder organisations and all levels of government must collaborate more—for example, through a comprehensive national action plan on first responder mental health.
I want to touch on the flawed workers compensation processes experienced by many first responders. We heard time and again from first responders and health professionals that the management of workers compensation is just too adversarial, that the cumulative nature of first responder trauma means that it is extremely difficult to prove their trauma is work related and that the current system further traumatises an individual rather than helps them to stabilise let alone get better. I congratulate the Tasmanian government for announcing late last year that it will move to a presumptive framework for PTSD for first responders. This is an important step, and I urge all jurisdictions to follow Tasmania's lead in this space.
We must ensure our first responders can access medical and psychological support, that their workplace helps and supports them and that in that process of getting help first responders are not re-traumatised. We must not let this report gather dust. Too many of our first responders need urgent help and support. I seek leave to continue my remarks.
Leave granted; debate adjourned.