Legislative Council: Wednesday, November 16, 2022



Post-Traumatic Stress Disorder

Adjourned debate on motion of Hon. L.A. Curran:

That this council—

1. Acknowledges that 27 June is Post-Traumatic Stress Disorder Awareness Day;

2. Notes that PTSD affects around 3 million Australians at some time in their lives including over 10 per cent of military and emergency services workers and volunteers; and

3. Encourages the community to understand the causes of PTSD and support those who suffer from it.

(Continued from 7 July 2022.)

The Hon. R.P. WORTLEY (00:20): Today, I rise to indicate the Labor government's support of the motion put forward by the Hon. Ms Curran MLC. I would like to commence, as advised by the Office of the Chief Psychiatrist, with an acknowledgement that there is a growing body of evidence that emphasises that the word 'disorder' within post-traumatic stress disorder (PTSD) is no longer relevant and I will therefore use the term PTS (post-traumatic stress). This approach confirms that a person may recover from their experiences and it is not a disorder that may potentially be experienced for life.

The statistics regarding PTS are concerning, but the important message is that with greater awareness, positive action can be taken that may prevent the development of PTS or prevent PTS becoming more severe or prolonged. Awareness raising across the population can help to ensure that people who do have PTS reach out for help or that those close to them are aware how to reach out for help on their behalf. This reinforces the approach that reducing and managing the incidence of PTS is not just up to people who may have symptoms, but that their family, friends, close confidants, colleagues, managers and organisations can all assist.

PTS is a set of reactions that follows intense, traumatic events. It is estimated that about 5 to 10 per cent of Australians will suffer from PTS at some point in their lives, where the main symptoms may be marked by the following:

reliving experiences (nightmares and flashbacks);

avoidance of things that remind the person of a trauma, such as people, places or feelings that bring back reminders of the trauma;

hypervigilance or having trouble sleeping or concentrating with agitation, restlessness or poor sleep. They may be easily startled or constantly looking for danger; and

negative thoughts and feelings like fear, anger, guilt, feeling flat or experiencing emotional numbness.

In some instances, people who experience PTS symptoms may not realise that they have a problem or that it can be treated, and the goal of PTSD Awareness Day is to address this. PTS is more common than generally realised, which is one of the reasons the PTS Awareness Day is promoted.

The aforementioned statistic, which indicates that 5 to 10 per cent of Australians will suffer from PTS at some point in their lives, may actually be higher in some specific groups. Examples of these groups include military veterans, emergency responders, people have been through natural disasters, Aboriginal or Torres Strait Islander people who have experienced trauma and losses, asylum seekers and refugees, and people who have been the victim of a sexual assault/childhood sexual abuse, or a victim of crime.

Exposure to a potentially traumatic event (PTE) is a common experience. Extensive community surveys in Australia and overseas reveal that 50 to 75 per cent of people report at least one traumatic event in their lives. PTEs include any threat, actual or perceived, to the life or physical safety of a person, their loved ones or those around them. PTEs include but are not limited to events such as war, torture, sexual assault, physical assault, natural disasters, accidents and terrorism.

Offering practical and emotional support to people after trauma can be critical. A sense of community is thus crucial after a natural disaster. The University of Adelaide, Flinders University and the University of South Australia have each contributed to research that has advanced the understanding of PTS and its treatment.

Additionally, our public and private mental health services both offer treatments for PTS and complex PTSD following any traumatic event, such as childhood trauma; exposure to family violence; interpersonal assault, including physical assault, sexual assault and/or domestic violence; and single incidents, such as motor vehicle and workplace accidents. Also, services have developed for those who have been exposed to trauma through their occupation, such as police, ambulance, firefighters, veterans and active service duty personnel.

Therefore, awareness of PTS across the population is crucial. While the number of people who have improved awareness is increasing, there remains a significant number of people who may still be reluctant to come forward. This may be due to several factors, such as shame and stigma, feeling that they will be perceived as weak or having a lack of understanding of their experiences and symptoms. I would therefore encourage people who are unsure, have concerns or acknowledge that they may have PTS but are reluctant to seek help for whatever reason to reach out for support and hopefully commence their journey towards recovery.

Additionally—and a key component of approaches within suicide prevention—if a person feels overwhelmed by their experiences or has thoughts of harming themselves, they should reach out for help wherever it is available and look to contact their general practitioner, mental health professional, non-government organisation or specific telephone support line. Examples of these are Lifeline, Suicide Call Back Service and Men's Helpline.

Nationally, the Australian Blue Knot Foundation is the National Centre of Excellence for Complex Trauma. The foundation advocates for and provides support to people who have experiences of complex trauma and those who support them personally and professionally. Their website is www.blueknot.org.au.

Within South Australia, mental health services have encouraged the use of trauma-informed care across all facets of health. There is a statewide Trauma Informed Practice Working Group and Community of Practice, which reviews and considers practices and procedures that are reinforced within the Chief Psychiatrist Standards to ensure a trauma-informed approach is consistently implemented and supported.

A Train the Trainer trauma-informed practice program for staff across mental health, SAAS and Correctional Services was provided through the Office of the Chief Psychiatrist in 2016 and continues to be strongly promoted across all health. Training is available in all the local health networks and through the SA Mental Health Training Centre. In addition, the OCP liaises with Wellbeing SA to provide consultation on trauma-informed approaches in policy review and development. This has included the incident management and open disclosure policy and the alleged sexual assault policy.

All metropolitan and many country hospital and community mental health services have expertise in evidence-based treatments for PTS. In addition, there are specialist anxiety treatment services, such as the Centre for Anxiety and Related Disorders at Flinders Medical Centre and the Centre for Treatment of Anxiety and Depression at Thebarton. All these services can be accessed via the Mental Health Triage line, 131 465.

The Jamie Larcombe Centre, based at Glenside, provides specialist treatment to current and past members of our Defence Force and has an internationally recognised PTS trauma recovery program. People in country areas can access the Rural and Remote Mental Health Service by calling 131 465. There is also phone and online counselling available from SA Regional Access. The website is saregionalaccess.org.au.

In addition to these services, the coordination of specialist mental health and wellbeing services is important. For example, the Disaster Management Branch of SA Health and the Office of the Chief Psychiatrist, in partnership with Wellbeing SA and other key stakeholders, have coordinated bushfire mental health recovery programs. Most recently, this has involved providing increased mental health supports in communities impacted by the Cudlee Creek, Adelaide Hills and Kangaroo Island fires in 2019 and 2020. Another example of a coordinated and shared effort is the COVID-19 mental health response virtual support network. It was established by the previous government during April 2020 to support South Australians during the pandemic.

COVID-19 has impacted on the mental health and wellbeing of individual communities and of many in the workforce, particularly frontline workers. The Office of the Commissioner for Public Sector Employment and the Office of the Chief Psychiatrist implemented new strategies for our frontline workers, including increased numbers of peer support programs and an increase in the number of sessions available in the Employee Assistance Program.

To summarise, this is an important matter in private members' business today. Even though the rates of PTS across all areas of the population remain a concern, there are positive messages we can promote. We can take action for the community and for different groups to reduce the impacts of distress, other responses to trauma and disruption of life.

For all South Australians who have experienced PTS, the most protective thing we can do is to create awareness about PTS and overcoming the stigma around it. With greater knowledge and awareness, more people with PTS will be able to access services. With greater knowledge and awareness, the community can become aware of how to get help and support on behalf of someone to aid the person in getting the help that they need as soon as possible.

In closing, I would like to pay the respects of both myself and this council to those who experience PTS, to those who care and live on a daily basis with those who experience PTS and to the wider communities of South Australia for their resilient efforts around the shared experiences and trauma of recurrent natural disasters, including the continuation of COVID-19.

This government is committed to ensuring that the people of South Australia continue to receive the best possible community response and mental health services. I thank the Hon. Ms Curran for bringing such an important matter to the attention of this parliament.

The Hon. S.L. GAME (00:32): I rise in support of the honourable member's motion. I wish to contribute to this excellent motion by moving the amendment standing in my name:

After paragraph 3 insert new paragraph as follows:

4. Recognise the valuable contribution service animals bring to the lives of those recovering from post-traumatic stress disorder.

Service dogs, therapy dogs, assistance dogs and companion dogs: whichever title you use, they are a helpful friend for those living with trauma. These companion animals encourage interpersonal connection, help people regain confidence and can help ease anxiety and other conditions, which encourages participation and rehabilitation back into society.

Over several months, whilst consulting on issues such as mental health, children in care, veteran affairs, the housing crisis and school student absenteeism, I have met numerous assistance dogs. I heard firsthand from owners and handlers about the daily benefit they bring. Dogs not only bring companionship but have a special ability to read emotions and provide stress relief. They may act as a confidant and friendly ear. There is research and evidence that the human-animal bond brings a positive psychological response, increasing oxytocin, improving sleep patterns and promoting serotonin, all of which have a positive impact on the recovery journey.

I am thankful to the honourable member for bringing forth this motion, and I commend her work and interest in this area. I also extend my support to the service dogs and trainers making a genuine impact in the lives of those living with post-traumatic stress.

The Hon. L.A. CURRAN (00:33): I thank the Hon. Mr Wortley and the Hon. Ms Game for their contributions today. From the outset, I would like to indicate that today the opposition will be supporting the Hon. Ms Game's amendment. I would also like to acknowledge that PTS, as the Hon. Mr Wortley and the Hon. Ms Game have noted, comes in all shapes and forms. I welcome the Hon. Ms Game's amendment.

It is an immense privilege to be able to serve in this place, but with it comes great responsibility. The ability to be able to continue to raise awareness about PTSD and break down a stigma around mental health is so important. For those who suffer from PTSD, it can often happen silently and be all-encompassing. It can be incredibly lonely and isolating, despite the prevalence of it throughout our society. We in this place must continue to raise awareness and continue to do all we can to assist those who are impacted both directly and indirectly. It is with this that I commend the motion to this house.

Amendment carried; motion as amended carried.