Bill Debate – Mental Health Legislation Amendment Bill 2025

I rise today to speak on the Mental Health Legislation Amendment Bill 2025. It is, I think, for everybody in this chamber a difficult conversation at times to have when we are speaking about mental health, mental ill health and diagnosable mental illnesses, because we all know – whether it is in our friends and family groups, whether it is through our workplace or whether it is through seeing it second hand – the impact when mental health is not managed well, when there is not access to services and when appropriate supports are not in place, particularly through some of the more challenging times in people’s lives when we have the terrible situation where we are going to funerals of those who have lost hope, who have taken their own lives, when you are attending a funeral and speaking to the family members and those around individuals who have taken their own lives. It is a profound discussion where people are wondering ‘What could I have done differently?’
Mental health impacts everybody, whether it is your own mental health or that of those around you. That is something that has been a source of great discussion and important debate within this chamber certainly over my time, over the last 11 years. It peaked in about 2018 when there was bipartisan support for a royal commission into Victoria’s public mental health system in recognition of the fact that Victoria’s public mental health system was crumbling. There was not a politician who would not admit to that, who would not agree that we needed to do something differently. It was an election commitment. It then became a reality, and it was quite a significant journey for people living with mental illness and ill health, for family members, for clinicians and other supporting practitioners, for everybody in the community. To read through even a snippet of the royal commission’s recommendations gives you great insight into not just how important it is that we get a mental health system in place in Victoria that Victorians need but also the need to look at implementing a better mental health service that gives Victorians the mental health supports that they deserve.
We all understand that when people are starting to go down that journey, whether it is a full diagnosis or whether it is situational depression or anxiety, the earlier that you can provide supports and interventions, the stronger the outcomes and the better the outcomes for the individuals. That is particularly so for young people. However, we are now a number of years down the track after the royal commission delivered its final report. Just by way of a timeline, the royal commission released its interim report in October 2019. Those recommendations went to the heart of what we need to see in Victoria and put in place in order to rebuild Victoria’s mental health system. The majority of those recommendations in the interim report focused on building a mental health workforce that would be there, prepared, ready, trained and able to implement the recommendations of the royal commission. That was October 2019.
We then saw the full final report handed down in February 2021. From that time we have seen an erosion of what the aspirations were, what people living with mental illness, their families, support networks and clinicians were promised and what is actually available in the community. For me, somebody who enjoys dealing with stakeholders at many levels, it has been disappointing to see the journey of hope and excitement – looking forward to Victoria again being the state that has a reputation not just in Australia but internationally of having one of the best, if not the best, public mental health system – perhaps somewhat erode over time. There have been some questions, but everybody has still had faith that Labor would deliver on its promises and implement all recommendations of the royal commission in full and on time.
Unfortunately, in the discussions I am having – and this would have been particularly increasing over the past 12 to 18 months and escalated after this year’s budget – people have lost hope. They see that this was nothing more than an election stunt. Everything that was promised has not been delivered, apart from the mental health tax – let us make sure that is in there – and they do not know where the money is going.
But the key thing is we have got people who are behind this. We have the highest suicide rate on Victoria’s record. We have the longest waitlists or number of people who are presenting to emergency departments with mental health related issues that we have seen. It is getting harder and harder to access mental health supports. We have seen that there is not progress towards doubling of Victoria’s mental health workforce by 2031; in fact what we are hearing is that it is harder and harder for employers to attract and retain mental health workers no matter what their qualification or experience. People are looking to move interstate and working in other states where they see that it is a more positive area to work, having a government actually focused on providing better care for constituents to make sure that they can access the mental health support they need when and where they need it.
But there are also a number of people – whether they are mental health workers, those with lived experience and living experience or the carers of people with mental ill health or illness – who feel that by sharing their story during the royal commission there was an emotional commitment and that what they said had been heard. They feel enormously let down and aggrieved, and they have lost faith with governments that the mental health system in Victoria will ever be fixed. It set people up to fail, when it was held in such a spectacular way. We all went down to the exhibition building, which was unheard of, to see the final report handed down in front of the entire sector and people who contributed to the report in many ways. We are now down at the point where the funding is being cut. Promises have been broken. We still do not know where the money is going. There is no indication of how and when these royal commission recommendations will get back on track.
I believe that no matter what the politics of this are and what side you are on, as parliamentary representatives who live and breathe the impacts of a failing mental health system each and every day – and we hear this through the constituents that we serve – we have an obligation to ensure that Victorians can access mental health support when and where they need it, and I think that there should be support from everybody in the chamber. We need to see more, we need to do more and we need action on the ground, but more importantly we need more workers, we need better access to services in all ways and we need to get back on track the royal commission’s recommendations as a matter of priority, because I do not want to attend another funeral of somebody locally who has taken their own life, I do not want to see a situation where hospitals are absolutely overwhelmed because people cannot access mental health support in the community early on and have then got to the point of trauma where they had to present to an emergency department and I do not want police resources to be taken up having to support people in mental health crisis or with the impacts of poorly managed mental health crises. Nobody wants to see that. Hopefully we can all make a commitment to do better and get the Royal Commission into Victoria’s Mental Health System’s recommendations back on track.
This piece of legislation goes into two main areas, with some other matters also being addressed. The first matter is around transitioning the responsibilities of the Forensic Leave Panel to the Mental Health Tribunal. This has been instigated predominantly by the judiciary, whether it is the Supreme Court or the Victorian Law Reform Commission, and it is around the obligations and the burdens upon the judiciary of attending and their appointment to that panel. We know that the justice system is completely overwhelmed at this point in time, and therefore the Supreme Court has requested that there be an amendment to the appointments to the Forensic Leave Panel so that, rather than the judiciary being appointed to the panel, it would be a legal representative. We asked on notice what that would look like, and I do thank the Minister for Mental Health’s office for providing responses to those questions on notice that we received late yesterday. It is understood that in the new forensic division of the Mental Health Tribunal the presiding member of the tribunal will be a legal member who has been an Australian lawyer for a minimum of five years. The members would be supported in their role with extensive training and operational support and guidance.
The understanding is that another reason the Forensic Leave Panel has been disbanded, and those responsibilities through this legislation will be referred to the Mental Health Tribunal, is because the panel at this point in time is completely overwhelmed. There have been 226 applications representing 113 patients or residents over the past year, which constituted over 41 hearings. This is quite an obligation for the panel to adhere to, and so this is part of the burden of how this is managed in an appropriate way. The Forensic Leave Panel and forensic leave are seen as important steps towards rehabilitation for patients and residents, particularly patients who are in Forensicare facilities, including Thomas Embling Hospital. It is important that the balance is right, that the supports are right, and that this is done in a way that is appropriate and safe and supports the rehabilitation of those patients and residents within these facilities. However, we also need to ensure that the community is safe.
Unfortunately, there have been a number of situations, and particularly over the last week we have been able to read about this in the news, where patients and/or residents on leave, as approved and assessed by the Forensic Leave Panel, have not adhered to the conditions of their leave. On Saturday we saw a report in the Age by Rachel Eddie and Grant McArthur that drugs and violence are rife in psychiatric prison hospitals. It is of deep concern that we have people who are on leave who appear to be taking drugs in the community and are not being tested upon return to these psychiatric prisons. Furthermore, within this report it indicates that illicit drugs were on campus, which triggered an acute male patient in the hospital’s A block to set fire to his room while under the influence of illicit substances. There is an indication that that resident had not been on leave, and that of course means that drugs are being smuggled back into a psychiatric prison for use by other patients and residents. This is unsafe for patients. It is inappropriate to the highest degree. But I also feel for the staff who work in these organisations, and this was highlighted in the royal commission’s findings. Within Forensicare the staff have some of the highest, if not the highest, rates of workplace violence of any organisation across the state. It is a difficult role to work in these environments, and I commend the workers who are doing their best to support people with a diagnosable mental illness who are either a patient or a resident prescribed to be at Thomas Embling or other psychiatric support services such as prisons.
They are doing an incredible job. What they do is appreciated not just by our side of the Parliament but I am sure by everybody. It is a dangerous job. But they need to have supports from government to ensure that they are as safe as they can possibly be. It is clear there are insufficient supports to Thomas Embling Hospital, that the government is not providing support to staff in that facility, but it also is not providing support to the patients and residents within it. When you read that there are people on leave who are, in the inner-northern Melbourne suburbs, wielding a hammer, going on a crime spree, putting the people of Victoria at risk, when they are smuggling drugs back inside and causing harm not only to property but to each other and to themselves and to staff, then something needs to be fixed.
We have a situation at Thomas Embling where there is a significant expansion being undertaken at this time. However, at the same time, the government are cutting staff. They are cutting two senior alcohol and other drug specialists within Thomas Embling when it is clear there is a drugs crisis within Thomas Embling Hospital. It is the most inappropriate time that budget cuts should expose staff and leave staff more vulnerable and speaking out, concerned that their already extraordinarily high rates of workplace violence will just lead to more issues. It is clear the government has an obligation to support all prisoners in their rehabilitation, including rehabilitation from drugs and alcohol, but cutting the exact experts that are employed for that reason just means the problem will get worse. It will be worse for patients and residents, and it will be worse for the workers at that facility.
It will make leave much more difficult when you have got situations where there are crime sprees occurring, putting Victorians on the street at risk. We have got people who have absconded while on day leave and who just have not returned, and then the call goes out. There are insufficient staff to provide appropriate levels of supervision. And it is concerning that while there may be a condition of leave, through the forensic leave panel, that there be drug testing, they must agree to drug and alcohol testing. What happens if they do not? It is not happening routinely. When you have got an issue of drugs being smuggled into Thomas Embling Hospital and it is not a routine occurrence that you test people, that you check whether they have drugs when they come back into the building – because a metal detector will not detect drugs – it just beggars belief. The more you unfold some of this, it shows not that the legislation is flawed but that the system is flawed, and we need to provide more supports to mental health across the board.
The second element of this legislation is around the transition to an IT system whereby we will have a centralised portal for mental health records that will be accessible by some but not all public health services. This is something that we inquired about during the briefing. We were provided with some information around it in that currently it appears that hospitals will have access to those mental health records. The system will also have a relationship to Ambulance Victoria because, as is provided to us, Ambulance Victoria is a health service identified by the royal commission as requiring better access to information to effectively deliver services. Ambulance Victoria will have access to this electronic health information system; however, Victoria Police will not have access to this system. This is important, because at this point in time in Victoria the Labor government have walked back their commitment to move to a health-led response for mental health crises. The first iteration of the Mental Health and Wellbeing Bill 2022, as handed down by the then Deputy Premier when the mental health portfolio was important to Labor, outlined that all responses to emergency mental health crises would be health led.
Twelve months later the government walked that back, and we now have a police-led response in Victoria to mental health crises. This was something that the royal commission had identified, because it is not the best outcome for patients that a police officer turns up to a mental health crisis. There is the option for other services like an ambulance to be called in to respond to that, but the first legislated approach must be from Victoria Police. This is why the royal commission did not recommend that Victoria Police be able to access these types of records – for the one reason that they did not recommend that Victoria Police should be the first to respond to a mental health crisis. This is a very big oversight for the Labor government, and it must be drawn in parallel. If police are going to be the first responders, they need to have access to the mental health record – that is all there is to it. They must have that information, otherwise it is a less than safe situation for police and a less than safe situation for that person who has that record. It is very simple logic if you are going to keep a police-led response. Certainly from the police that I have spoken and on my understanding and that of everybody within the mental health sector, it is a far better response to have a health professional speaking to someone in a mental health crisis.
It is far better to have someone with mental health expertise, and paramedics are trained in that area. It simply does not make sense to revert it back to police and to take away what is recommended by the royal commission, so I urge the government to reconsider. Fortunately, who will be able to access the system can be prescribed at a later date, and I urge the government to reconsider that Victoria Police will be excluded from that.
There is a side issue when it comes particularly to the stigma of mental health. People are concerned to put their mental health situation on the record if it may be exposed and accessed by people broader than their immediate clinicians. This is something that was of great importance to me that I asked about. There will be a standard system in place in terms of being able to retrospectively check who has electronically accessed records. The government has also indicated that there will be a level of role-based access control. So basically if you are not of a certain role, you will not have access to mental health records. I think that is appropriate, but it is very important that the government ensures that those securities are in place. I would hate to think that we have an ongoing issue where people feel there is a stigma around mental health and that they will be treated differently, particularly if they have a diagnosable mental illness as opposed to a situational mental health issue such as depression or anxiety, and that it will make them vulnerable so they do not access support for that reason. I therefore urge the government to ensure those controls are comprehensive but also that they are well circulated throughout the community so as not to be seen as retrograde.
I would like to speak to another aspect which was raised in others matters, and it was interesting because it was not actually mentioned in the second-reading speech of this legislation and it was not mentioned in the bill briefing either. That is one of the matters related to broad other matters for amendment within this legislation, and that is specifically in relation to a clause which requires a psychologist or the prescribing authoriser for restraint to go back and check on that person who had restraint put on them to ensure that they are okay. That is really something that should be in play and is a reflection that we have had situations whereby people who have been put into a position of restraint have then had impacts which were not foreseen, and in some cases it is death. It is something that unfortunately is a reflection of the understaffing within Victoria’s public health system, and this is of concern to me. It is of concern to me because we cannot implement the royal commission’s commitment that we eliminate restraint and seclusion practices within 10 years – that is by 2031 – if there is no workforce to support patients to get the best possible care.
And yet we are in a situation where, while there is a slight amendment and a tweak within legislation to ensure in law that there is a responsibility to go back to those patients who have had restraint applied, we still have the situation where there are not enough workers. There are so many issues around workforce. In fact Victoria’s Mental Health and Wellbeing Workforce Strategy 2021–2024 has not been renewed. We are now in a situation where Victoria does not have a mental health workforce strategy, which goes to show just how committed this government is to rebuilding Victoria’s mental health workforce. The government had committed to implement the recommendation of the royal commission to double Victoria’s mental health workforce by 2031 – we are nowhere near that. We are absolutely nowhere near that. I do not even think we have got any additional workers, which just shows that all of these commitments, all of these promises were something that happened before an election. When it comes to Labor, what they say and what they do are two different things, and it is Victorians that pay the price.
Now, this is not something that is just a fly-by-night where things shift – ‘We’ve got shifting sands and it’s very, very hard because we haven’t got a lot of money because we’re spending it all on the Suburban Rail Loop and not delivering on the mental health services that we need in Victoria’. What we have got in Victoria is a mental health levy. It is the one thing that we have seen Labor commit to. The first thing that they did was to implement a mental health tax. We have got a bizarre situation in Victoria where private hospitals that deliver mental health services have to pay a mental health levy, which means that they cannot provide as many mental health support services. What irony that we have a situation where a tax is actually reducing access to services. And when people from the sector and people like myself, the Shadow Minister for Mental Health, ask the question of the government – whether it is at the Public Accounts and Estimates Committee or through other mechanisms through Parliament – ‘Where is the money being spent?’, we cannot get an answer. Even leaders within the mental health sector, like Pat McGorry – Pat has done an enormous amount of work, particularly around youth mental health in the state – are calling out, ‘Where is the money going?’ It should be explained. There should be transparency about it, there should be accountability, but more importantly, it should be all directed into expanding services and particularly youth mental health services.
This is something we are hearing right across the board. I have heard this from Mental Health Victoria – and I will go back to the mental health and wellbeing workforce strategy. Mental Health Victoria is concerned that the Mental Health and Wellbeing Workforce Strategy 2021–2024 has not been evaluated, acquitted publicly and updated. There is insufficient investment to address retention, safety and diversification of workers, making it hard to imagine government will meet its target of doubling the workforce by 2031. The mental health and wellbeing locals have been completely abandoned. In my electorate of Lowan, we were promised one for Horsham, for Ararat and for Hamilton, and yet we are not even on the list of the Better Health website that shows where the future plans for where these locals will go; we do not even make the list, even though it was promised back in 2023.
This government has completely lost its way when it comes to implementing the royal commission’s recommendations. The government have got the money; Labor have got the money. They implemented the mental health tax. But then you have Mental Health Victoria and leaders within the mental health sector saying they cannot see where the money is going because it is not expanding the workforce and it is not expanding access to services. They are just seeing all of the terrible statistics around mental health getting worse and worse and worse. Let us not forget that these are not just statistics, they are not just numbers, these are Victorians. These are the people that are paying the price for Labor’s abandonment of mental health royal commission reforms.
We desperately need to see the recommendations and the reform of Victoria’s mental health system get back on track. We need to support the workers, who are doing an outstanding job and doing their very best to deliver the mental health supports that Victorians absolutely need and deserve, at the right place, at the right time and when they need it. We are not seeing that from Labor. We are just seeing spin and lies. We are not seeing transparency on where that tax is being spent, where the royal commission recommendations are at, what is being put on hold, what is being implemented and what is being scrapped altogether. Victorians deserve to know. Victorians deserve to understand what is happening with Victoria’s mental health reforms, because at the moment they are deeply disappointed with a Labor government that has let them down.