Mental Health (Review) Amendment Bill

Second Reading

Adjourned debate on second reading.

(Continued from 19 May 2016.)

The Hon. R.L. BROKENSHIRE (16:06): This bill was introduced to the House of Assembly back on 2 December 2015 by the Hon. Jack Snelling, at that point in time minister for mental health and substance abuse. The Mental Health Act commenced back in 2010. The act conferred limited powers to make orders for community treatment or inpatient treatment, and section 111 of the act stipulated that a report must be laid before each house within four years of the act's commencement. That four-year period ended on 30 June 2014.

The Office of the Chief Psychiatrist kept and managed a database of the issues and carried out the review, looking at issues identified throughout the first four years of operation and other issues identified through consultation. Based on this review, this bill was introduced with amendments, in correspondence with public feedback and updated developments in international human rights law and mental health legislation from other Australian jurisdictions.

I understand that of the recommendations arising from the review the government endorsed 65, which is 90 per cent. They deferred seven (10 per cent), and they will be considered under the next review. A total of 55 of the 65 endorsed recommendations (85 per cent) were referred on to parliamentary counsel for drafting, 11 per cent were referred to the OCP for attention, and 5 per cent referred to SACAT.

The bill seeks to amend the Mental Health Act 2009, including the Advance Care Directives Act 2013 and the Health Care Act 2008. The Mental Health Act relates to the provision of treatment, care and rehabilitation of persons with serious mental illness for the purpose of bringing about their recovery. The act also provides protection of the freedom and legal rights of the mentally ill. The government emphasises that it is important for amendments to be made in regard to mental health legislation over time as things progress, in order to effectively address the changing needs and treatment of those with mental illness.

Family First strongly agrees with the government on that point, as I am sure the opposition and all crossbench members do. You, Mr Acting Chair, show a particularly strong interest in mental health, and I commend the Hon. John Dawkins for his genuine and dedicated effort. It is, sadly, a growing problem in modern society, and it is an issue which we have to be acutely aware of and which needs the full attention of government, clinicians and legislators in the parliament.

The overview of the bill amends the language and definitions; it tidies up some of the language and it provides more contemporary definitions in line with community standards; it looks at rights and introduces new rights and clarifies existing rights; it deals with cross-border arrangements; it deals with the functions of the Chief Psychiatrist; administrative or service provision matters are also dealt with; it deals with the Community Visitor Scheme; it deals with the ECT and other prescribed psychiatric treatment; it removes obsolete and discriminatory provisions; it deals with level 1 Community Treatment Orders; it deals with patient assistance requests; and there is also some other major reform.

The five key areas of change are: to extend Community Treatment Orders from 28 to 42 days; it amends patient transport request requirements to allow the South Australian Ambulance Service and the South Australian police to provide medication to a patient in their home; it amends the Community Visitor Scheme to increase facilities and services; it enhances cross-border arrangements and improves options; and, finally, it improves the oversight and operation of ECT (electroconvulsive therapy) as prescribed by psychiatric clinicians for treatment.

The government has advised Family First that the bill proposes to lift previously restrictive clauses in the act to give mental health services and general practitioners greater freedoms to act in the best interests of their patients and provide less inconvenience to them and their families. An example of that is allowing SAAS or SAPOL, as I said, to assist in the administration of a patient's medication at home rather than in a hospital. I strongly commend this particular part of the act.

These days, when you see an ambulance travelling down the road, you will often see a police car behind that ambulance and most of the time that police car will only have one police officer in it. The reason for that is that the other police officer is in the ambulance securing the patient and protecting the paramedics. Often that is because those people with these illnesses have not had their medication or have become quite agitated when police arrived with ambulance officers to take them to hospital. Sometimes they have had really bad experiences and have, at times, been shackled in emergency departments for, sadly, many days. So, this, hopefully, will help to prevent that. If someone does need their medication, if they do need settling down, it is often better for them to have it done in their own environment.

Family First has a very strong interest in mental health. We work with the broad cross-section of mental health advocates and we commend them for the work they do and the contact they have with us, as members of parliament, to educate us on where needs are for mental health patients and mental health as an important and diverse portfolio.

With those comments, I will finish by saying that I note that in the last cabinet reshuffle we now have a separate minister for mental health and drug and alcohol abuse. I think that is a good move. I think it was too much having the Minister for Health also having responsibility for this area. I am enjoying working in my capacity with the new minister, the Hon. Leesa Vlahos. Family First supports the bill. We have had no negative contributions from the sector and we commend the bill that the government has introduced and look forward to its swift passage.

The Hon. K.L. VINCENT (16:15): I would like to take the floor briefly to speak on the Mental Health (Review) Amendment Bill 2015. I will not rehash the changes that this bill has made, as I know a number of speakers have already done this extensively in this place and the other. I thank the government, including the Chief Psychiatrist, Mr Aaron Groves, for the briefings that they gave me on the important issues that this bill does cover.

It is my understanding, as the Dignity for Disability MP, that stakeholders have been pretty comprehensively consulted on these issues, and certainly the communications my office has had have suggested that the mental health community is reasonably satisfied with the content of this bill. At this point I will certainly make a couple of comments about mental health supports in South Australia in general. As members of this place would know, I, along with some other members, have been a long-time advocate for improved mental health services, including particular services for people with a diagnosis of borderline personality disorder, and will continue to be so while this state continues to lag behind in the services that it can and must provide.

It is time to provide a resourced, stand-alone service in this state for people who have already suffered too much and too long with a very misunderstood and maligned condition. I would also like to note that we are also concerned about the loss of funding to many smaller community mental health support services in this state. The cynic in me wants to say that it is easier to measure, or to get a news story, about a new mental health bed or a new ward opening, but it is not so easy to measure or get a news story up about a person who might have gone to a choir with people with the same mental health condition and had some benefit out of that. That does not mean that that person has not reaped the same benefits, and I think we need to focus more and more on providing supports for positive mental health in community and in home, so that people can go about living their lives with their mental health condition, rather than having to take as much time out to go to hospital.

We are also concerned in Dignity for Disability about the loss of funding to the Intensive Home Based Support Services. This was a great service that has recently lost its funding at the federal level, and it is my understanding that the state government has no intention to step in and fund it. This is very disappointing for many reasons, one of which is that the literature that I have read clearly indicates that, on average, the IHBSS program shortens hospital stays by some 10 days, I think the figure was. It is quite a short-sighted decision, because there is a lot of money to be saved, as well as an improved quality of life, by shortening the length of stay in hospital.

We have also, of course, been vocal about our desire for the newly appointed Mental Health Commissioner to be someone with some degree of lived experience of mental ill health, and I certainly still believe that that is necessary now and will still be necessary in any future appointments. This is because mental ill health is already so misunderstood that I think it would send a strong message to the community to have someone who comes from that community in that position.

Overall, I would like it noted that mental health continues to be the poor cousin to other parts of our health system. It attracts fewer dollars per patient and does not receive dollars commensurate with mental health's percentage of the disease burden. Disease burden is a technical term, not one of which I am particularly fond. Certainly, it needs to be recognised that money can be saved and that there is quality of life when we respect and recognise that people experiencing mental ill health can be the experts in their own lives. They can recover outside of hospital using a variety of supports which may include hospital at least in part, and mental ill health does not have to be a life sentence the way that it still is for far too many in our community. With those few words, and renewing Dignity for Disability's commitment to addressing the stigma associated with mental health and the lack of attention that it receives at a policy level, we commend the bill to the chamber.

Debate adjourned on motion of Hon. T.T. Ngo.