| October 30, 2019
Victorian Parliament - October 30, 2019
Ms KEALY (Lowan) (14:16): It is an enormous privilege to be able to speak on today’s matter of public importance submitted by the member for Ringwood. I do give credit to the member for his contribution today. It is an extraordinarily courageous and bold move to be able to open up and speak of your challenges around your own mental illness. However, when you are elected to this place it is often your own stories which are most compelling to people within your own electorates. That is why we must tell our stories and do so free from any persecution and free from any side commentary. So as I said, I do commend the member for Ringwood for sharing his story.
I do want to acknowledge from the start all the people living in Victoria with mental illness and mental ill health. My office receives many contacts from people—from family members, from people who work within the sector—who are often in extreme distress, who often cannot get the support that they need and who are often facing extremely stressful conditions, and they do not know where else to turn but to come to my office. The number of people who are suffering from acute mental health crises who feel like they cannot go anywhere else and to come to my electorate office in Horsham really is quite amazing. We certainly are a triage desk for many of those people within our community. My staff handles this very well; they do so exceptionally well.
So for those people who are dealing with depression and anxiety, suicidal ideation, eating disorders, postnatal depression, diagnosable mental illnesses and the entire spectrum of mental illness and mental ill health, we are working towards making a difference for you and making your journey through life much more tolerable, to give you hope and most importantly to do it with compassion. We must always put that first. We must always when we are talking about models of mental health look beyond the clinical aspect. It is important that we always treat people with mental illness as people first and foremost. We must always act with compassion, support and awareness—awareness of each other, compassion for our friends, families and for our constituents and support for all Victorians.
Certainly the Liberal-Nationals are fully supportive of the Royal Commission into Victoria’s Mental Health System. It has been an amazing journey I think over the past year to see so many submissions from the wider community, and of people being able to express their experience with Victoria’s mental health system. So frequently this has involved sharing extraordinarily challenging stories of loss, and of not being able to access the services needed. We heard from parents who have had children who have entered into an acute hospital bed—a psychiatric bed—have self-discharged and then self-harmed and taken their own lives. We have a responsibility to make sure that that is not the type of mental health support we are offering for people in Victoria. But when it does happen, we must listen to those family members who want to make change, for people who do not want that experience to happen to other family members, to other people who are challenged with mental health. We must listen to the people who have provided evidence to the mental health royal commission, including the fabulous mental health workers who know that there is a pathway to do this differently in Victoria. We must listen, we must act, we must provide mental health support and services that every single Victorian deserves.
The problem that I see in the state of Victoria at the moment is that we constantly hear from the government these glowing reports that, ‘It will be great when we implement the recommendations from the royal commission’. The problem is that there are people who cannot access the mental health support that they deserve today. I think it is an absolute contradiction to hear any commentary from the Labor government that mental health is such a priority when at the same time we are seeing devastating cuts to the community mental health budget. It is appalling.
Yesterday I heard yet another story of the cuts that have made to mental health in the state of Victoria at the moment. Yesterday I met with Cohealth. Cohealth have had a cut of $11 million over the past two years under the Andrews Labor government, which has meant that they have cut their entire community mental health service. They now have 300 fewer mental health workers providing support services to the people who need it most, who are at most risk of homelessness, of disadvantage and of drug and alcohol addiction, and who would not ordinarily enter the normal public health service. The Andrews Labor government has cut those workers.
As a result, we are seeing huge flow-on effects to other critical areas in Victoria. Our prison system is overflowing, our emergency departments are overflowing, we are seeing ramping happening. It is appalling to look at some of the statistics around our emergency departments. People with mental illness are waiting an enormous amount of time sitting in emergency departments waiting for mental health beds. If we look at that, the rate is now 53 per cent of people presenting are not able to get admitted into beds within the 8-hour time frame.
Why is it appropriate and why are we celebrating around the royal commission when we know today what some of the problems are? If you cut community health funding, you cannot keep people well in the community. It is more likely they will be disengaged from their friends and family, they will lose their jobs, they are at risk of homelessness and, most importantly, they are at risk of even further mental health damage. It is causing lifelong damage to these individuals, and we need to see changes now.
I refer back to an Auditor-General’s report which was tabled earlier this year. It is titled Access to Mental Health Services and was released in March 2019. It emphasises how important it is, and that we simply cannot wait for the royal commission to act, to make some key changes to mental health services in Victoria. I quote:
The Royal Commission into Mental Health will undoubtedly highlight many areas for improvement across the system. However, the need for planning and investment to meet demand is already known and as such work to address this should not await the Commission’s recommendations. Further delay will only amplify the problems the Commission seeks to address.
This is coming from the Auditor-General’s office. There was another report tabled earlier in the year, Child and Youth Mental Health, which echoed similar sentiments.
While we keep on celebrating, we keep on hearing from the government, ‘We’re looking forward to these recommendations from the royal commission because then we’ll make changes’. It is simply not good enough. We are losing Victorian lives as we speak. People are becoming critically unwell, and it is having a huge impact on homelessness in our communities including, as I said, our prison system.
Forensicare’s annual report was enlightening: people are waiting an average of 406 days to get the custodial supervision orders that were ordered by the court so that they can get the mental health support they need. People are waiting in prison for well over a year to get the mental health support they need.
If you look at any KPI across the mental health system, you see that things have been getting critically worse since the Andrews Labor government was elected. We simply cannot keep on accepting this government saying, ‘We believe in mental health support because we are having a royal commission’. You have got options to make a difference and act today and change Victorians’ lives today. The fact is that your cuts to community mental health in particular have been so significant and so drastic and are affecting so many issues. Ambulances are at the bottom of the cliff essentially is what I hear from the mental health sector. It is not good enough. If you look at some of the key KPIs around community mental health support services, we have seen a 20 per cent cut by Labor in community mental health since they were elected. This has resulted in a reduction of 15 per cent in the number of bed days available to community mental health clients, so we have dropped from about 74 000 to around 62 000 a year. On the client support units, we have gone from 661 000 in 2014–15 to a cut by almost 50 per cent by Labor, to 338 835 in the 2018–19 year.
On the clients receiving mental health support, from when the Andrews government was elected in 2014 the number has dropped from nearly 12 000 to less than 6000. More than 50 per cent of people who were getting support five years ago cannot access those same supports today. That is absolutely diabolical. You are not talking about just numbers, about the number of people who can access a mental health bed, about the number of people who can access community mental health support. These are people who are struggling with mental illness. While we may have the words to be able to say, ‘We feel very, very sorry for you’, let us actually make a difference.
I do pick up one of the lines which I thought was compelling from the member for Ringwood: the story lines must become budget lines. We need to make sure that they are positive budget lines because what we have seen from Labor so far are just enormous cuts, particularly in the community mental health sector.
We are also seeing disastrous results when it comes to how people manage their own mental illness. Of course that comes through in how people self-medicate and the numbers of people who are using drugs and alcohol to deal with their mental health issues. We always need to make sure that we focus on early diagnosis, followed by early treatment and providing ongoing support, for people with mental illness to give them the best possible outcomes for successful and amazing lives where people reach their full potential. We are not seeing that if we do not have those supports available, if we are not able to provide early treatment and early diagnosis, if people are not able to get the support they need in their local community. In my electorate of Lowan, it is 2 hours to the nearest psychiatric bed. It is simply unacceptable to see the rates of occupancy in those beds. So often people cannot even get into a bed. But we are not looking at changing this at the moment. We are still waiting for these royal commission findings. As the Auditor-General has said, we simply cannot wait:
Further delay will only amplify the problems the Commission seeks to address.
So I do urge the government: please, please put your words into action, because mental health is something that is important to each and every one of us. We all know somebody, if it is not ourselves, who has suffered from extreme mental illness or from mental ill health. If we do not put our best foot forward and actually act to make a difference to these people’s lives, the problem is not going to get any better.
We are expecting the interim report from the royal commission into mental health to be delivered in November. It is something that of course we will welcome, but again, let us not wait. The final report will be in October next year. There have been so many people who have been affected by mental illness in the state of Victoria and their friends and families and their employers, experts in the area and workers; I think there have been over 8000 submissions now. It has been absolutely overwhelming, but let us see some key injection of funds in the near future.
More importantly, when we talk about the royal commission, I refer again to the ongoing statement from the government that, ‘We’re going to implement all recommendations’, and of course that is something that we would want to see; we have put so much work into it. The government has been hiding behind the royal commission so avidly and hiding its budget cuts behind the royal commission, we do need to make sure it does not have the same result as we have seen for Victoria’s 10-year mental health plan. Once that was agreed and published and celebrated by the Labor government, it was just shelved and forgotten.
We cannot do this. We have had so many reports, reviews and recommendations around Victoria’s mental health system over the past five years that Labor has ignored. Do not ignore the recommendations from the royal commission into mental health. Make a commitment to properly implement it and make sure that the Department of Health and Human Services does its job in implementing it. There were so many references in the two Auditor-General’s reports tabled earlier in the year, Access to Mental Health Services and Child and Youth Mental Health, which referred to DHHS’s complete ignorance of and inability to manage the implementation of those recommendations. Frequently there had been recommendations made in previous reports about which the government had said, ‘Yes, we’ll do it’ and they never came to fruition. You are only further hurting people in Victoria if you continue to allow the department to get away with not doing its job and improving services for people with mental illness. That is something that is a key criterion. It does not matter what you say; you will be judged on what you do.
I do again urge the government to put their money where their mouth is. As the member for Ringwood said, let us make sure that the story lines become budget lines. Let us see a reversal of the significant cuts to community mental health that we have seen in the state of Victoria since the Andrews Labor government was elected but, most importantly, let us listen, let us act, let us make sure that we are providing mental health support and services that all Victorians deserve—because we are certainly not seeing that under the Andrews Labor government.
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