Motions

Unmet Needs Report

The Hon. C. BONAROS (17:38): I move:

That this council—

1. Recognises the final report commissioned by the Office of the Chief Psychiatrist on 'Unmet mental health service need in South Australia that could be met by the NGO sector' (Unmet Needs report), dated February 2023.

2. Acknowledges the findings and recommendations of the Unmet Needs report, including:

(a) 19,000 South Australians with severe mental illness require psychosocial support services each year but are not having their needs met;

(b) an estimated $125 million per annum is required to address the shortfall; and

(c) addressing the unmet needs in the South Australian mental health system would significantly reduce the demand for hospital-based emergency services related to mental distress and lead to reduced ramping and wait times.

3. Recognises the 19,000 South Australians identified in the Unmet Needs report represent a substantial increase compared to the Productivity Commission’s estimated 11,000 South Australians in 2020, highlighting the results of years of mental health policy failure from successive governments.

4. Notes the 2023-24 state budget provided no additional investment in psychosocial support, with the state government indicating it was awaiting the findings of the Unmet Needs report before making any decisions.

5. Notes the 2024-25 state budget similarly did not provide the necessary increase in funding towards psychosocial support.

6. Notes there has been no formal state government response to the findings and recommendations of the Unmet Needs report.

7. Calls on the Malinauskas Labor government to provide a formal response to the findings and recommendations of the Unmet Needs report by no later than 1 September 2024.

This motion is in response to the ongoing apathy with which this government is treating the state's mental health crisis. It speaks to the findings and recommendations of the 'Unmet mental health service need in South Australia that could be met by the NGO sector' report (Unmet Needs report), which I understand was finally provided to government in February 2023. It was commissioned by the Office of the Chief Psychiatrist and it outlines a host of damning evidence detailing the serious lack of psychosocial supports for South Australians in need.

The report was released publicly many months after the ink dried, following repeated efforts and pressure from stakeholder groups and interest groups. Many, many months later we are still waiting for a response from the government. There are 19,000 South Australians, likely more, who are still waiting for a response. At least 19,000 South Australians with severe mental illness require psychosocial support each year, but are failing to have their needs met. An estimated $125 million each year is required to address this unmet need. They were the findings in the report.

The follow-on effects of addressing this unmet need include reduced ambulance ramping and ED wait times. We have fleshed this out in this place a thousand times. We know that if we deal with mental health in the community through appropriate psychosocial supports and therapies and programs, people do not end up on a ramp and people do not end up in an emergency department. That is the one single factor that has absolutely crippled our health system and contributed to our health crisis.

To not even attempt to address this shortfall is, with respect, an utter disgrace, because the moral dimension is clear: these are our people who we have a duty to provide for. In the language of many decision-makers in the state, they could not fit in Cooper's (formerly Hindmarsh) Stadium. I have heard anecdotally that they would likely probably fill Adelaide Oval. It is undeniably written in black and white in the report that there is a mental health crisis in this state, one which we were warned was going to get worse in the next three to five years following COVID.

What did the government do in the 2023-24 budget to address this? Delay a response. Fast-forward another 12 months to the 2024-25 budget and what did the government do to address the need, which had undoubtedly increased? Again, provided no additional investment in psychosocial support services. We have seen delay after delay after delay.

According to the Australian College of Emergency Medicine, our state has the highest percentage of patients presenting with mental health and behavioural problems in the nation. That report was published in 2022, so it was well known before even last year's budget that the efficacy of our emergency departments was being compromised by a negligent approach to mental health. This is not a report that has been done by anybody, this is a report that was commissioned and done by the state's Chief Psychiatrist. That is whose findings and recommendations the government has not responded to, to date. The government—

The Hon. T.T. Ngo interjecting:

The Hon. C. BONAROS: My colleague interjects, sadly for him, and says that this is a federal issue, but he could not be more incorrect. In fact, given that we have had that helpful interjection, I will enlighten my colleague in that there have been discussions about sharing the load between state and federal. The NGOs themselves said, 'Hey, state government, you put up 65, the feds can put up the balance. You can share the load between you.' Even to that proposal, where we are sharing the load between state and federal, in a jurisdiction that this state does have responsibility for, the state government still has not replied to this unmet need.

I hope that no-one notices, because it is not in vogue, but I am not going to say ambulance ramping too many times. I am sure that there are others in this place who will, in due course, but I will remind those sitting next to me that a major contributor to our overflowing emergency departments are presentations requiring psychosocial supports, are presentations of mental illness that could have been prevented had those services been available in the first place.

We have heard from the president of the Mental Health Coalition of South Australia, who has said publicly, who has expressed publicly on behalf of the 30 or 40 NGOs that the coalition represents—not one or two, or three or four, or five or six, at least 30 or 40, and who hold seats federally in the same sort of roles—his disappointment with a state government that was only too happy to pass the report onto the federal government, only to then suffer collective amnesia.

The Mental Health Coalition has urged the government to get the ball rolling by investing 50 per cent of the nearly $125 million in the 2023-24 Mid-Year Budget Review, rather than wait for the feds to do anything. The coalition's president's frustration laid out the farcical nature of the government's inaction. He said, 'While we are after leadership, what we are getting is political theatre.'

A response that points to a generational investment in something other than mental health is not a good enough response. Sending the report to the commonwealth with no agreements on funding and time frames leaves the burden in our community, a burden which we know is faced by at least 19,000 people, not to mention the ripple effect that has on everybody around them.

Oftentimes what hits the media is the person who commits a significant crime, and the headline in the paper is 'mental illness', and that is what people think mental illness is. It is the ambulance at the bottom of the cliff; it waits until things are so critical that there is nothing to be done other than pick up the person from the bottom of the cliff. But we are talking about stopping people climbing that hill that leads to the cliff in the first place.

The Unmet Needs report is completely unambiguous in inserting that the state and commonwealth governments need to work together—this is not a federal issue—to fund the necessary reform. Needless to say, handing over to the commonwealth and neglecting to even issue a formal response is astonishingly poor form. It is disrespectful to the Chief Psychiatrist of this state, who has pulled together this work and made these recommendations and findings.

It also underscores Mr Creedon's public sentiment that, while solving this crisis does require both jurisdictions to fix the problem, we are deeply disappointed with the pass-the-buck attitude that we have seen, especially since the crisis has been known since 2019, and we still have no agreement between governments and there is no relief in sight and no date when services will hit the ground. They are comments Mr Creedon has made available publicly in addition to other comments he has made before bodies in this place.

I will conclude my remarks shortly, but I remind members that this is again 19,000 South Australians we are talking about, at least, so they do not forget, because, frankly, that is how they have been treated by this government. They have been forgotten, been left behind and been hung out to dry. Perhaps the Malinauskas Labor government should take a second to consider whether there is anything crucial they have forgotten to include in their budget before boasting about forecasted surpluses—something along the lines of a report released last year sitting around, gathering dust on a desk somewhere in this building, with no response apparently imminent.

With those words, I look forward to the support of this place in directing the government to provide a formal response to the Unmet Needs report by 1 September this year, and that gives the winter break for all concerned to consider how to meet the unequivocal needs of so many South Australians.

Debate adjourned on motion of Hon. D.G.E. Hood.