SUICIDE PREVENTION

Adjourned debate on motion of Hon. J.S. Lee:

That this council calls on the Minister for Mental Health and Substance Abuse and the state government to address the failure in handling mental health patient, Mr Damian Kay, by adopting the recommendations of the State Coroner, Mr Mark Johns—

1. that the Department of Health should ensure that training in the assessment of suicidal risk should be provided both to medical undergraduates and doctors working in emergency departments;

2. that a junior doctor or a mental health nurse should not discharge a suicidal patient, particularly one brought in by police under section 57(1)(c) of the Mental Health Act 2009, from an emergency department, without having sought advice from a senior medical colleague, either an emergency department senior registrar or consultant, or a psychiatric registrar or consultant on call;

3. that a minimum set of information should be obtained before discharging a suicidal patient from the emergency department. It would also be appropriate wherever possible to obtain information both from family members and from current treatment doctors or other therapists. This sometimes might not be possible until the next day when an individual presents to the emergency department overnight; and

4. there should be assertive follow-up of suicidal patients. They should be offered by community mental health services, with expectations about timely face-to-face follow-up. Follow-up should be routinely offered to such patients and community mental health teams should be assertive and persistent in their attempts to see them face to face.

(Continued from 19 September 2012.)

The Hon. G.A. KANDELAARS (22:36): The government of South Australia is committed to leading the community's efforts to tackle suicide through awareness, prevention, intervention and support for those affected by suicide. The South Australian Suicide Prevention Strategy 2012-16 offers a way forward for reducing the impact of suicide by providing a suitable and coordinated approach to service delivery, resources and information, and targeted suicide prevention and postvention initiatives, activities and programs.

SA Health will work collaboratively with all government departments, the non-government sector, business and community groups to achieve the strategies, outcomes and objectives. The minister's Suicide Prevention Advisory Committee, in collaboration with the Office of the Chief Psychiatrist, will oversee the strategy, which will include regular monitoring of the progress on actions outlined in the implementation guide.

SA Health has a well-established process for responding to the recommendations resulting from the Coroner's findings of inquest. SA Health's preliminary position is that it supports the principle of the recommendations of the State Coroner, Mr Mark Johns. SA Health will consult with clinicians and others in addressing the details of these recommendations.

SA Health will, in accordance with this process, formally respond to the Coroner, reporting in detail on actions taken by SA Health within six months of the release of the Coroner's findings and recommendation. This will ensure that the recommendations are considered and implemented where appropriate, with expert input. This well-established process for responding to the recommendations should be undertaken, and therefore the motion should be deferred. I seek leave to conclude my remarks in the new year.

The ACTING PRESIDENT (Hon. K.J. Maher): Is leave granted?

An honourable member: No.

The ACTING PRESIDENT (Hon. K.J. Maher): Leave is not granted.

The Hon. J.S.L. DAWKINS (22:39): First, I would like to commend the Hon. Jing Lee for bringing this motion to the parliament. As someone who has been working in areas similar to this for a number of years, I applaud anybody who is prepared to raise these issues. When I started doing this work there were many people in the community who had a natural resistance to us talking about suicide and mental health matters at all. That resistance is breaking down but all of us, as leaders in the community in this chamber and in the other chamber, need to continue to raise those issues, so I commend the Hon. Jing Lee. As she said when she moved the motion, she moved it with a very heavy heart and I think anyone who speaks about such tragic circumstances does speak with a very heavy heart.

However, as I indicated in my matter of interest remarks earlier in the day, having been to several events recently where there are families bereaved by suicide getting together to support each other it is very important that we address these matters. These people need support but they also need our best efforts to allow them to support each other. I must say that in some of the events that I have gone to, I have attended and left them with a very heavy heart, so I do understand the honourable member's remarks. If we save one life from suicide then we have done a good job but we must save many more than one life.

The honourable member's motion refers to the Coroner's report into the death of Mr Damian Kay. I would also like to refer to a previous report and public remarks by the Coroner (Mr Johns) in which he recommended that the statistics of suicide be published in the daily paper just as we read about the statistics of the road toll, because the number of suicides in South Australia that are recorded as suicides is far more than the road toll. I think we all realise that there are some that are recorded as part of the road toll that are actually suicides but the police cannot absolutely determine that they are suicides, so they go on the road toll rather than the suicide toll. That is something Mr Johns said that I will always remember and it is a pity that it has not been heeded.

I was interested to hear the Hon. Mr Kandelaars talk about the government's strategy—mental health and now suicide prevention strategy—and I am delighted that it has consulted, that it has an advisory group and that it has come up with a strategy. What I am yet to see out of that strategy is a demonstration of practical support for community groups. The strategy only happened because some of us in this parliament felt so strongly about suicide prevention that we moved motions in this house and the House of Assembly.

I moved a motion in this house last year and the member for Adelaide moved it in the House of Assembly. While the government fiddled around with the words on the member for Adelaide's motion downstairs, that was passed and certainly one was passed here. As a result of that, I think the government suddenly realised that it needed to do something. I welcome the fact that it has done it but there is a great big document there. There are also a lot of other documents that are printed and a lot of money, I must say, that is wasted on some of those documents. Some are quite good, but there are many that are a waste of money because people need to talk to real people from the community and not have a book thrust in their face.

I would also like to say that I am disappointed that the Hon. Mr Kandelaars tried to circumvent this debate and tried to stop it because the Hon. Ms Lee has moved this, as she said, with a very heavy heart but with the greatest of integrity and compassion. She gave an indication some time ago that she wanted to bring this to a vote tonight, and I think to try to do as the honourable member did was disappointing. I am not in the habit of denying leave, but in that circumstance I was very happy to do so.

In relation to the honourable member's motion and the remarks of the Hon. Mr Kandelaars, it is worth bringing to the chamber the recent Australian Medical Association mental health bed crisis statistics, which say that South Australia is lagging behind the modern world in its provision of acute mental health hospital beds; that South Australia averages significantly fewer beds than the Organisation for Economic Cooperation and Development (OECD) averages, which is 70 beds per 100,000 people.

The European Union averages 44 beds per 100,000 people, and South Australia averages 21 beds per 100,000 people in the 18 to 64 age group, while the national average is at 24.2 per 100,000 people. South Australia is the only state with the number of beds reducing rather than increasing. The Flinders Medical Centre lost funding recently; 12 mental health beds (or 30 per cent of its capacity) were lost, putting pressure on Noarlunga, where there is already overcrowding.

SA Health's response to the AMA statistics was to say that 20 mental health beds are to be built by mid-2014 (which still leaves a significant forensic overflow impacting on emergency departments for the next two years) and that this state is currently aiming to reach the national average or better.

In conclusion, I think I should just remind members that on this side of the parliament we have been committed at the last two state elections—and we are committed by way of policy—to making sure that community groups across this state, whether they be experienced in suicide prevention work or other organisations that are prepared to sponsor that work, are provided with seed funding to ensure that they can get the sort of coordinated community-based, culturally appropriate early response systems and suicide prevention programs out into the community in wide-ranging areas across the state. We are committed to that.

We believe in the community gatekeeper role. I think that the Hon. Jing Lee's motion goes to the fact that we can do more as community gatekeepers. We can never stop all suicides, but what we must do is to try to stop as many as we can. Who would know—if we had more of these community-based groups out there, volunteers, people from all walks of life, trained and able to be used to point people in the right direction and give them pretty good advice, Mr Damian Kay and many others might still be alive today. I support the motion.

The Hon. J.S. LEE (22:49): I thank the honourable members of this council for their interest in my motion to call on the Minister for Mental Health and Substance Abuse to address the failure in handling mental health patient, Mr Damian Kay, by adopting the recommendations by state Coroner Mark Johns. I thank the Hon. Gerry Kandelaars and the Hon. John Dawkins for their contributions.

As the mover of this motion, I would like to take this opportunity to make some concluding remarks and to emphasise the premise of this motion once again. The aim of Mr Jarrad Kay's campaign by bringing up the matter concerning the death of his brother, Damian Kay, is not about blaming or bearing any ill feelings towards the young medical officer who discharged Damian Kay from the hospital, it is about bringing justice and improvement to the health system.

For those who have read the state Coroner Mark Johns' findings into the suicide death of Damian Kay (38 years old), you will clearly see that it is due to the failing of the South Australian health system, through lack of training and supervision, which failed Damien Kay by placing him in high risk of self harm.

Health professionals have a duty of care to their patients. This duty of care involves the provision of information as well as treatment. I would like to bring to members' attention 'duty of care'. It is commonly accepted that duty of care means the extent to which a health care provider must reasonably ensure that no harm comes to a patient under the provider's care.

In one of the advocacy briefs prepared by the National Mental Health Consumer and Carer Forum they elaborate on the meaning of 'duty of care'. The advocacy group pointed out that a duty of care is extended to governments, their bureaucracies, service organisations and individual service providers. All of these organisations have a duty to take positive action to ensure that the provision of health care services are of a proper standard.

Delivering a proper duty of care requires the provision of a transparent level of accountability. Governments are accountable not only for their successes in mental health care, but also for their failures with people with a mental illness, many of whom are the most vulnerable in our community, as in the tragic case of Damian Kay.

I wish to place on the record my thanks and gratitude to my esteemed colleague the Hon. John Dawkins for his contribution today supporting this important motion. The Hon. John Dawkins has been a passionate campaigner for mental health issues, which has recently seen him being appointed as the shadow parliamentary secretary for mental health and suicide prevention by the Leader of the Opposition. I am really grateful for his important mental health policy work which demonstrates that South Australian Liberals are committed to providing an approach focused on education, early intervention, communication and reporting. Today, with the great work of the Hon. John Dawkins, the Liberal's suicide prevention policy gets a big tick.

I am a greater believer that where there is a problem or a system failure, which is clearly what happened with regard to the handling of Damian Kay as a mental health patient, it would be in the best interests of members of parliament to address the problems. The Kay family's intention is to use the Coroner's report to bring up this important matter in parliament with the hope of raising further awareness of suicide prevention in the community and, by this motion, to call on the minister and the government to implement the recommendations of the Coroner and bring improvement to the health system in South Australia.

I am disappointed with the response of the government because although it recognises there are problems, there is little compassion and willingness to concede the findings. I trust the other honourable members can see how important this motion is. When dealing with mental health issues there ought to be a sense of urgency. Suicidal intents are not always obvious because most of the victims are living in darkness. Therefore, I ask all members of parliament to consider the duty of care in all of us and I urge everyone to support this motion.

Motion carried.