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House of Assembly - Fifty-Third Parliament, Second Session (53-2)
2016-03-22 Daily Xml
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Mental Health (Review) Amendment Bill

Second Reading

Adjourned debate on second reading.

(Continued from 2 December 2015.)

Dr McFETRIDGE (Morphett) (12:27): I am the lead speaker on the Mental Health (Review) Amendment Bill 2015. Looking at the latest figures that are available on the federal government's website, the prevalence of mental illness in Australia continues to be a very alarming figure. Almost half of the total population will experience a mental health disorder in their lifetime. One in five Australians aged 16 to 85 experienced mental health disorders in the last 12 months—that is almost equivalent to 3.2 million Australians. One in 16 had affective mood disorders, one in seven had anxiety disorders and one in 20 had substance use disorders.

Based on these prevalence rates, it is estimated that nearly 1,000,000 Australians had affective disorders, over 2.3 million had anxiety disorders and over 800,000 had substance use orders in the last 12 months. Females are more likely than males to have experienced mental health disorders in the last 12 months: 22.3 per cent compared to 17.6 per cent. Similarly, females were more likely than males to have experienced anxiety disorders and affective disorders.

Males are more than twice as likely to have experienced substance use disorders. The prevalence of mental health disorders in Australia is something that is of great concern to all of us. I know when we put the parent bill through this place in, I think, 2009, I was the opposition health spokesperson and mental health spokesperson, and it was a very enlightening and informative experience to talk to both the practitioners and the consumers of mental health services in South Australia. The review that has been undertaken by the Chief Psychiatrist and provided to this place and for public review in February this year is quite comprehensive. I have worked with a number of chief psychiatrists and I think they have all done a very good job in a very tough area.

The Mental Health (Review) Amendment Bill 2015 has five main areas of change, and I will briefly go over those. They can be read in the mental health review by the Chief Psychiatrist if people want more information. The key changes include that provisions for level 1 community treatment orders are to be amended to increase their maximum duration from 28 days to 42 days. This would make the orders more useful, because 28 days is often too short a period for therapies to take effect.

The second change is that the patient transport request provisions are to be amended to allow mental health services to request the assistance, if it is safe and appropriate to do so, of the SA Ambulance Service and South Australia Police to provide medication to a patient subject to a community treatment order in their own home rather than taking a person to hospital for medication and returning to their own home. I think that is a very good move, and I will talk a bit more about the current pressure on mental health beds in South Australia in a few moments.

The third change is the changes to the Community Visitor Scheme. Provisions and regulations are proposed to increase the facilities and services within the scope of the scheme, with existing budgets and resources to include community mental health centres, community rehabilitation centres and intermediate care centres. The fourth change is that cross-border arrangements are proposed to be enhanced, including by increasing cross-border treatment options and administration of interstate orders.

The fifth and final change is that the bill seeks to improve the oversight and operation of ECT (electroconvulsive therapy) as a prescribed psychiatric treatment. The change is a timely update of this bill so that consumers can receive the best quality treatment possible in South Australia. In fact, the Chief Psychiatrist says in the introduction to his review of the bill and the changes he has suggested:

…the Mental Health Act 2009 commenced operation on 1 July 2010. The objects of the Act are to ensure that people with mental illness receive a comprehensive range of services for their treatment, care and rehabilitation;

And that is what we want for all South Australians. I congratulate the new minister on her appointment. In some ways, it is a bit of a poisoned chalice, because demands are increasing and the pressures on costs are there and delivering services is becoming more of an issue for all Australians. As I have just read from the commonwealth figures, the prevalence of mental health issues is severe.

The second change proposed by the Chief Psychiatrist, that is, treatment of mental health patients in their home, I can say is a very good move because, according to the government's own Royal Adelaide Hospital emergency department dashboard this morning, two patients have been waiting more than 24 hours for a bed and five patients have waited more than 12 hours for a bed, and this is a very common occurrence. I have been a follower of the dashboards since they were introduced by the government. I thought it was quite unusual to bare your soul, so to speak, in your own documents in full colour on the net, because the figures are just damning, and they have been for many years.

Overcrowding of emergency departments has become a chronic problem. It is a grave problem because, as the Australasian College of Emergency Medicine said in 2008, 1,500 Australians die every year as a direct result of delays in emergency departments. Our share is about 8 per cent, and 120 people die as a direct result of delays in EDs in South Australia. That is more than the road toll. We cannot allow that to continue.

The current state of mental health beds across our hospitals this morning was quite deplorable. At 10:41 this morning, according to the government's own dashboards, at the Lyell McEwin Hospital they were five mental health beds short, at the Royal Adelaide Hospital they were 18 mental health beds short, at The Queen Elizabeth Hospital they were 11 mental health beds short, and at the Women's and Children's Hospital in the women's section they were three mental health beds short.

These figures are damning. When you see what is happening with Transforming Health—the shuffling around of services, the downgrading of services—it is going to put patients seriously at risk, and that is not me saying that: that is the real doctors. We are hearing the spin doctors out there saying it is all going to be hunky-dory; the facts are here in living colour on the government's own websites. As I said, as we speak, and I suspect it may be getting worse as the day goes on, there are two patients who have been waiting for a bed in the Royal Adelaide for more than 24 hours. If you look across the other hospitals, you will see a similar situation.

The inpatient dashboard is another dashboard the government put out. If you go and look at that for Glenside this morning, Glenside was in the white zone. There is a traffic light system but, instead of going to red where it is 'Stop, look at what is happening. Don't proceed because there is danger,' the dashboards go to that next zone—the white zone. I call it the white-hot zone. With EDs, that means that the emergency departments are more than 125 per cent occupied. The pressures are just enormous, and it is very common to see our EDs in that white-hot zone.

Today, Glenside is in the white zone. It is overflowing. The acute patient in-services, forensic mental health, intensive care and inpatient rehab services are all in the white zone. They are all way over capacity. If you look at the general 48-hour bed occupancy of Glenside, it has either been in the white zone or the red zone.

The AMA says that a hospital that is at 80 per cent capacity is full. I remember former minister John Hill saying, 'We accept 90 per cent.' He ignored the doctors; he said '90 per cent'. The bottom line is these hospitals are more than 90 per cent full: they are 100 per cent full. They are more than 100 per cent full in many cases. The pressure on our hardworking doctors and nurses is becoming unbearable to the point where we are seeing doctors resigning, and we are seeing criticism of the changes because the doctors are very worried.

I know the new minister will do her very best to try to sort this situation out. This bill proposes some changes which will take some of the pressure off but, on the figures that are given by the commonwealth government there, the pressures are not going to disappear at any moment. They are not going to be able to be solved overnight.

We need long-term solutions. We had the Step Up Step Down Program brought in. We had arguments about the numbers of acute beds versus intermediate beds. The issues are alive and unwell—very unwell in some cases. Making sure we give the very best care we can to our mental health patients in South Australia is something we all should be very aware of because we hear quite frequently tales of politicians who have suffered from depression or other mental health illnesses, and there but for the grace of God go you and I.

We need to make sure that our legislation is working, and this is brought about by having regular reviews. Certainly, listening to people out there, listening to consumers and listening to providers is something we all need to do. In representing our constituents, whether it is with this particular piece of legislation or other legislation, we need to make sure that the state of South Australia is going to be the very best it can be. With people like the Chief Psychiatrist advising the government, and hopefully the government listening to doctors and the health professionals, I hope we can achieve that. I hope this bill is going some way to improving the lot of those with mental health issues in South Australia.

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