Mental Health (Review) Amendment Bill

Second Reading

Adjourned debate on second reading.

(Continued from 9 June 2016.)

The Hon. S.G. WADE (16:09): I rise to speak on the Mental Health (Review) Amendment Bill 2015. This bill is a result of a review undertaken by the Office of the Chief Psychiatrist during 2013 and 2014, as required by section 111 of the Mental Health Act 2009. The review made 72 recommendations. The government endorsed 65 of them, and another seven were deferred. The review found that the act required amendment and updating rather than a major overhaul.

This bill seeks to implement the recommendations through 63 legislative amendments to the Mental Health Act 2009: 26 of these are by way of clarification and 37 enhance and reinforce clinical best practice. The key changes include, firstly, increasing the maximum duration of level 1 community treatment orders from 28 days to 42 days, so that therapies may have more time to take effect and that orders may therefore be more useful.

Secondly, patient transport request provisions are to be amended to allow mental health services to request the assistance of ambulance or police officers to provide medication in the home of the person rather than needing to take the person to a hospital. Thirdly, the bill increases the facilities within the scope of the community visitor scheme to include community mental health centres, community rehabilitation centres and intermediate care centres. Fourthly, cross-border arrangements are proposed to be enhanced, including by increasing cross-border treatment options and administration of interstate orders. Fifthly, the bill seeks to improve the oversight and operation of ECT and prescribed psychiatric treatment.

There is broad sector support for this legislation. The bill is a product of a thorough consultation process. The quality of the briefings and supporting materials provided to parliamentarians were unsurpassed in my experience in this place. I thank the minister and acknowledge the hard work of the Office of the Chief Psychiatrist and the chief psychiatrists themselves who undertook the review.

Nonetheless, the Aboriginal Health Council of South Australia has requested that references to Aboriginal health be included in the guiding principles. I have written to the minister highlighting the concerns of the Aboriginal Health Council and seeking the views of the government on the suggestion that we should amend this bill. The parliamentary Liberal Party is committed to ensuring that Aboriginal and Torres Strait Islander people are appropriately supported in addressing both the physical and mental health challenges they face.

Whilst this bill is supported, there is still a huge need to be better in the delivery of mental health services to those experiencing mental illness, those who live with and care for them, and the community generally. Even today, we see the consequences of the government's service delivery failures in our hospitals. This afternoon at 2.30, according to data published on SA Health's own dashboards, there were 11 people in the Royal Adelaide Hospital and The Queen Elizabeth Hospital emergency departments waiting for an inpatient bed. These are people who have been seen by an emergency department specialist and whom the specialist has decided need to be admitted to the hospital.

At least seven of those 11 people stuck in the RAH and TQEH EDs have been waiting for an inpatient bed for more than 24 hours. That is the situation today, more than five months after the government broke its promise that from 1 January 2016, no-one needing mental health care would have to wait in an emergency department for more than 24 hours. That is the situation today, but sadly it is not an anomaly; it has become the norm. Indeed, all too frequently the situation in our EDs is much worse.

In March this year, the InDaily journalist Mr Bension Siebert highlighted the government's poor performance in terms of the treatment of mental health patients when he reported that in the previous week three mental health patients had been languishing in the RAH emergency department for five days. Let me pause to remind members that the target is to have all South Australians receiving their emergency department care within four hours. These South Australians were waiting in the ED for five days. Another patient had been waiting for a bed for four days, and another five patients had been in the ED for three days.

The reality is that the mental health sector's greatest need is not legislation, it is services. This legislation will only be effective if the services that underpin it are properly funded. This government are reckless administrators who spend hundreds of millions of dollars on bloated bureaucracies and consultancies with overseas consultants, and overspend on projects.

Every dollar that is wasted in health is another missed opportunity to ensure that unwell people get the health care they need. This government is well overdue in delivering on its 2014 election commitment to establish an independent mental health commission. This government promised $9 million at the last election to set up an independent mental health commission; I need not remind the council that the election was March 2014, more than two years ago. Labor's costing documents at the last election indicated that the expenditure would start in the first financial year.

In October 2015, the government appointed Dr Stephen Christley as the interim Mental Health Commissioner. In March 2016, Dr Christley advised the National Mental Health Commission Leaders Forum that the appointment of a permanent commissioner was imminent, with a commission budget of around $2 million and a staff of six to 10 people.

I ask the government: what has happened to the other $7 million that it promised at the last election? We know from estimates that an appropriation of $2.5 million has already been spent—on what, is unclear. The former minister admitted during estimates that it was not spent on the Mental Health Commission and it is only possible that it was spent on mental health. The appointment of Mr Chris Burns as Mental Health Commissioner has been announced, and I understand that we will finally see the position filled in July this year.

The government said, at the last election, that it planned for the Mental Health Commission to drive the development of the state's mental health plan through to 2020: South Australia's Mental Health and Wellbeing Policy 2010-15 has expired; further, South Australia's Suicide Prevention Strategy 2012-16 expires this year, and this lazy Labor government is only now establishing a commission, a little over a year and a half from the next election.

A Marshall Liberal government would be committed to ensuring that the state's Mental Health and Wellbeing Policy, as well as the Suicide Prevention Strategy, is up-to-date and consistent with world's best practice. A Marshall Liberal government would be committed to ensuring that mental health is adequately resourced, as we rebalance our health resources.

On 1 December 2014, the National Mental Health Commission provided the federal government with its report on mental health programs and services, entitled 'Contributing Lives, Thriving Communities—Report of the National Review of Mental Health Programs and Services'. Volume 4 of that report details mental health need and Australia's response, and the report makes it very clear that there is an enormous unmet need with respect to mental health care. I quote from that report:

It is estimated that 45 per cent of Australians aged 16-85—that is, 7.3 million people—will experience some form of mental disorder in their lifetime. In the past year alone, one in five Australians have experienced symptoms of a mental health problem.

The report stated:

The most recent available estimates show that in 2010 mental illness accounted for about 12.9 per cent of Australia's total burden of disease, which is a combination of premature mortality and years lived with disability. Mental and behavioural health problems are the second-highest cause of healthy years of life lost globally as well as in Australia, accounting for almost one quarter (22.3 per cent) of this total burden. It is estimated that about 327,000 years of healthy life are lost each year in Australia due to mental illness.

Further:

Internationally, it has been found that the costs of lost productivity to the economy consistently dwarf the cost of direct service provision by a factor of two to one.

In the face of the Labor government's failure to deliver balanced, effective mental health services, a Marshall Liberal government will be committed to delivering quality and appropriately resourced services.

Debate adjourned on motion of Hon. G.A. Kandelaars.

The Hon. K.J. MAHER: Mr President, I draw your attention to the state of the council.

A quorum having been formed: