Mental Health (Review) Amendment Bill

Second Reading

Adjourned debate on second reading.

(Continued from 12 April 2016.)

The Hon. T.A. FRANKS (16:52): I rise on behalf of the Greens today to speak to the Mental Health (Review) Amendment Bill 2015. This important piece of legislation is most welcome in this place, and I thank minister Leesa Vlahos' adviser, Juan Legaspi, and Chief Psychiatrist, Dr Aaron Groves, for providing my office with briefings earlier this year.

The Greens believe that access to quality mental health care is a basic human right, and that it is vital that governments invest in better mental health care services. Mental illness, of course, is prevalent in our society. We know from the Australian Bureau of Statistics, National Survey of Mental Health and Wellbeing: Summary of Results Report, that approximately 20 per cent of Australians, some one in five, are affected by some form of mental illness every single year. Those one in five Australians are likely to have experienced a mental illness in the previous 12-month period.

We also know of someone who has been or is a mental health consumer. It affects our families, our networks, our workplaces, our communities and, of course, ourselves. This is why the Greens, at both a federal and state level, have called for better access to appropriate services to ensure that all Australians impacted by mental illness do have adequate supports, whether it is a direct impact or whether it is their loved ones, their colleagues or their families.

We also believe that support should be tailored. For instance, my office, certainly in collaboration with the office of the Hon. Kelly Vincent, has long campaigned for a specialised borderline disorder unit to be established here in South Australia. We have called for this unit based on the success of Victoria's Spectrum model because we know that that is what many in our state need. We know from the Victorian experience that that is something that will work. We have been campaigning for that adequate access for BPD consumers, carers and others with Dr Martha Kent, who is a well-known psychiatrist, and Janne McMahon from the Australian BPD Foundation.

Disappointingly, not only have we not seen movement towards such a centre here in South Australia but we even saw the government members of this place refuse to acknowledge the annual day that has been recognised by the Australian BPD Foundation and, indeed, is recognised in the federal health calendar. Let us hope that we see some leaps and bounds of progress in not only recognition of that BPD day of note but, of course, in progress and supports for those who struggle with BPD.

People who are affected by BPD experience distressing emotional states, difficulty relating to other people and, of course, self-harming behaviours. I have stated before in this place and in the community that when we are speaking about this issue, it is an issue where lives are being lost and families are being placed under enormous stress, and we are not doing our job in this place if we are not supporting those people with mental illness to provide those essential services, not only to keep them living well but to keep them living at all.

I note that minister Leesa Vlahos has attended briefing sessions and met with constituents affected by BPD, and I know that she has shown some interest in this area. I look forward to further collaboration between myself and other members in this place, including the Hon. Stephen Wade and the Hon. Kelly Vincent, and hopefully minister Vlahos, to take this further, particularly on the issue of BPD. I again take this opportunity to call on the Weatherill government to allocate funding for a specialised unit; a small investment now will see us save costs in the long run. The health economics there are quite clear.

Another area the Greens have campaigned for is access to quality mental health care for people living in our rural and remote areas in this state and across this nation. I note particularly the work of former Greens senator, Penny Wright, who was a champion in this area of work and visited many rural parts of our country and undertook quite an extensive consultation with front-line rural mental health workers, service providers, consumers, carers and their families.

She launched a report entitled 'Voices and experiences: Improving mental health services in Country Australia', and that report highlighted the concerns that were rife such as poor access to subacute services, the need for stronger community-based mechanisms, better support for carers who were needed, improved training and education for the rural mental health workforce and front-line workers and, importantly, to reduce the stigma relating to mental health and accessing mental health care. The Greens will continue to campaign on the area of access to mental health services for rural, remote and regional areas in our state and we will continue to champion work done to reduce the stigma around mental illness and to promote positive mental health.

The bill before us was introduced by minister Snelling on 2 December 2015 in the other place. When consulting with the mental health sector I have been advised that this was one of the best consulted pieces of legislation relating to that minister's portfolio. By way of background, there was a review of the Mental Health Act which saw the Office of the Chief Psychiatrist receive 45 written submissions from a diverse range of individuals and stakeholders. There were 23 consultation sessions held with stakeholder groups.

A total of 301 matters were put up for consideration throughout the consultation process. The review considered these issues against current developments in mental health legislation, policy and best practice across Australian jurisdictions, and made 72 recommendations for legislative change. The government has endorsed the progression of 65 recommendations and has deferred seven to be reconsidered during a review which I am informed will be held in 2020.

The changes in the act relate to definitions and language, to rights, to obsolete or discriminatory provisions, administrative or service provision matters, and the proposed bill before us today clarifies the functions of the Chief Psychiatrist. Further areas of change relate to major reform to level I community treatment orders, to the Community Visitor Scheme, to cross-border arrangements, and to ECT and other prescribed psychiatric treatment and reform that relate to patient assistance requests. With regard to the level I community treatment orders, this will be amended to increase their maximum duration from the current 28 days up to 42 days. I have been advised that this would make the orders more effective because the current 28 days is proving too short for therapies to take effect.

The changes relating to the patient transport request provision will allow mental health service providers to request the assistance of the South Australian Ambulance Service and South Australia Police to provide medication to a patient who is subject to a community treatment order in their own home. This was one of the recommendations put by the sector to address the current pressure on mental health beds in our state. It addresses the issue currently where a patient needs to be taken to hospital for medication and then returned to their own residence. The review found that it is traumatic for the person and often for their family if the patient needs to be transferred to hospital in order to receive medication. It is also quite resource intensive, and needlessly so for mental health services, particularly the SAAS, SAPOL and hospital emergency departments.

The bill makes amendments to the Community Visitor Scheme. One of the recommendations in the review stated that community-based services and facilities should be included in the scope of the Community Visitor Scheme through the regulations. It is proposed that facilities and services should be increased to include community mental health centres, community rehabilitation centres and intermediate care centres.

The review also recommended that the term of appointment of the Principal Community Visitor position should be five years, as it was argued that the term currently in the act is shorter than most statutory positions, and the bill here today reflects that recommendation. I certainly welcome that and note that, as a policy officer for the Mental Health Coalition of South Australia prior to my election, the Community Visitor Scheme was one of the areas that I assisted in lobbying government and opposition in this place to introduce, and I certainly welcomed that.

We were the last state to have such a position. Again, where we used to lead on social reform, we now lag, but at least we got there on this occasion. One of my first private member's bills was around this particular act and ensuring that carers did not fall foul of the law if they took in a family member who was under the jurisdiction of an order.

This bill also makes changes to the cross-border arrangements. For example, the bill seeks to improve the rights of patients by ensuring that the patient receives a copy of the appropriate treatment order and a statement of rights when receiving treatment in South Australia. It also provides options for the treatment of people who are subject to a community treatment order in SA but are located in other jurisdictions. The bill seeks to make changes regarding electroconvulsive therapy (ECT). For example, it clarifies consent and makes changes to the notification required under the bill. All ECT consent must be notified to the Chief Psychiatrist. The bill seeks to improve patient rights and enhance service delivery.

The Greens welcomed the review and we appreciate the enormous efforts of the Office of the Chief Psychiatrist in order to bring this piece of legislation before the parliament. We support this bill and look forward to both supporting the second reading and the debate at the committee stage. We also thank particularly the Mental Health Coalition of South Australia and other stakeholders who have aided our understanding and position on this bill and the development of this piece of legislation before us. I commend the bill to the council.

Debate adjourned on motion of Hon. J.S.L. Dawkins.