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MATTERS OF PUBLIC IMPORTANCE - Mental Health

Speeches in Parliament
Rachel Siewert 24 Nov 2010

Senator SIEWERT (Western Australia) (4.37 pm)—I tend to agree with the essence of this debate, and that is that the Gillard government has failed to properly fund mental health services. While I agree with the fact that we have not been funding our mental health services adequately, I cannot support this particular motion, because of the antics of the opposition. The opposition put a motion to this chamber about one specific aspect of mental health. It does not take a comprehensive approach in addressing men-tal health. As health spokesperson for the Greens, I have a particular passion for issues around mental health. I chaired the inquiry into suicide in Australia and that heightened my awareness around issues of mental health. I have consulted widely. I understand that our mental health services are significantly underfunded in this country.

The Senate has had two previous inquiries into mental health. One of the findings of those inquiries was that we need to have around 10 per cent of our health budget expenditure going to mental health. That puts Australia’s investment behind by about $5 billion a year for mental health. I am a realist and know that we are not going to catch up to that investment of $5 billion overnight. In fact, the Senate committee report on this said that you would need to phase in the investment over a five-year period. That has not happened. We are having this debate in the context of significantly underfunding our mental health investment.

I learnt many things in the consultation process. One of those things is the need for a comprehensive approach in dealing with mental health. I also learnt that early intervention is absolutely essential. Headspace and EPPIC—early intervention centres—are absolutely critical. The Greens fully support those centres, but they are not the solution to everything. They are not the silver bullet that we have been looking for. For example, there are younger people with mental health illness. Headspace says it deals with people between the ages of, say, 12 and 25. In reality, at the moment they are dealing with people between the ages of 18 and 25. So, for a start, those in their very early teenage years need some support. We need to invest in the primary school and early high school years. Of course, a lot of people in Australia over the age of 25 have mental health illness. We need to take a comprehensive approach. What we are saying is that those people will not get any additional services. We know they are missing out. I think it is the case that one in four people in Australia with a mental illness get some sort of support. What we are saying is that those people do not deserve any additional funding.

We know we need better primary health-care services. We need better access to GPs for mental health issues. We absolutely know that when people go into an emergency department, having attempted suicide or threatening to attempt suicide, they need to see someone with mental health expertise. We also know that in this country very few emergency departments have somebody with mental health experience on call 24 hours a day. Quite often people go to an emergency department and then go home either not treated or inadequately treated, and we know people attempt suicide after that. So we know that we need to invest in that area. We know that people coming out of psychiatric care, having been admitted to hospital, absolutely need to be followed up, and we know that people are not being followed up. We know that we need to invest in that area. We absolutely know that we need more step-up, step-down accommodation. We know that we need more mobile support services. We know that we need to invest more in dealing with mental health issues in Aboriginal communities, and that requires a significant level of investment.

The Liberals brought in a motion, which they admitted in this chamber was just their policy. Essentially, their policy was purely about early intervention. The Greens asked the Liberals to give us a costing so that we could look at whether they intended to spend virtually all future investment in headspace, but we did not receive that. When we wanted to amend the motion, there was no agreement. In this chamber I was told to look at Liberal Party policy. So, in other words, the opposition just tried to bulldoze through their policy instead of taking a much more a cooperative approach and looking at how we can seriously address mental health in this country. We could take a more cooperative approach in this place, which is what the Senate has done in the past. We have taken a cross-party approach to mental health, which has been demonstrated by the good work that has been done through the Senate committee process. That has been thrown out to take a purely political approach so that they can— as Senator Moore said—get a few photos on websites, get a few media grabs around mental health and bash up the government and the Greens because we are taking a much more comprehensive approach.

Also, we have altered our approach. We suggested increasing the level of investment in early intervention as well as putting investment into primary health care, which we know is absolutely essential, and into emergency services, which we know is absolutely essential. We suggested a special commission for mental health because we believe this issue is so significant that it needs it. We took to the election the suggestion of putting in place a minister responsible for mental health, and we are glad the government picked that up. We think that is a very good step in the right direction. What we need to do now is see the government’s commitment to mental health. We need to see their investment. We agree with the opposition that we need to significantly increase investment in mental health. There is absolutely no disagreement there.

We do need to be very careful about where we increase that level of investment. We are not going to get the absolute level of investment that we need over the next 12 months or even the next two or three years, so we need to be constructing and focusing our investment on where it is going to meet need. We have absolutely no doubt that early intervention is critical, but we need to take a much broader approach. Yes, there has been a high-profile campaign about early intervention, and that is fantastic because it has focused the public’s attention on the need to address mental health issues. But we cannot invest just in early intervention. And do you know what? I have had so many emails, so many phone calls and so many personal visits where people have said: ‘Please don’t invest just in early intervention. Yes, that’s essential, but we need all these community services. We need community care services and we need better investment in rural and regional areas. If you focus just on early intervention, all those other people will not have their needs met.’ And we know what happens then; people get sicker. We know that homelessness can result from that. We know there are all sorts of consequences if we do not provide the services and support needed to support people through mental illness.

So my plea here to the government is: please invest in the level of resources we need. The Greens went to the election saying we needed an investment of at least $350 million a year. We actually agree with the opposition that it needs to be more, so we have said it should be $450 million a year— but not just on early intervention. We think you can have your cake and eat it too, which is why I beg the opposition to consider our amendments. The costings that have been put forward for the building of the number of headspace and EPIC centres it is estimated we need has to be phased in anyway, so we can phase in investment in headspace and EPIC—and there are other methods of early intervention besides headspace and EPIC. They are very good, but there are others. But we also need to invest in younger children and we need to invest in the over-25s. We can do that and invest in these other programs.

What I am really worried about is that if we just say ‘early intervention’, the government have a ticket to just go: ‘Yes, we’ve invested in mental health; we funded a few extra headspace and EPIC centres. That’s it, we’ve done mental health.’ And they will not have fixed mental health. So, please, let us take a coordinated, comprehensive approach to funding mental health and invest in the services that are desperately needed, not just early intervention. I do not want anyone thinking that we do not support early intervention, because we do. But it has to be part of a comprehensive approach to mental health funding, not a knee-jerk reaction because it is popular at the moment. We need a much more comprehensive approach, and the government need to fund that. We do agree with that part of the motion.

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