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House of Assembly - Fifty-Fourth Parliament, Second Session (54-2)
2020-10-14 Daily Xml
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Motions

Mental Health Funding

Mr PICTON (Kaurna) (11:59): I move:

That this house—

(a) condemns the Marshall Liberal government's 25 per cent funding cut to non-government organisations delivering vital mental health programs;

(b) expresses concern that non-government organisations will be forced to axe dozens of mental health workers as a result of the funding cuts;

(c) notes with alarm these cuts will leave hundreds of clients without support and at greater risk of presenting to emergency departments; and

(d) calls upon the government to reverse these cruel cuts.

I moved this motion at the beginning of the year. That was obviously before we encountered what has been the defining event of 2020, the COVID-19 global pandemic. This is a time in which mental health services, mental health funding, mental health programs and support have never been more important, but what we saw through the course of last year was a significant cut to those mental health programs. Now what we are seeing is demand rising, pressure rising in the system and no response to deal with that significant mental health crisis that we face.

Mr Speaker, as you know, the opposition has undertaken a bipartisan support process in relation to the public health response to the pandemic. We have been led excellently by Professor Spurrier in that regard. However, in relation to the mental health effects, we are going to be dealing with this for a significantly long period of time. We are seeing more and more cases and issues in the community, and we are not seeing an adequate response addressing those mental health challenges.

Last year, the government cut mental health funding to non-government providers who provide services in the community led by experienced, trained mental health workers to keep people healthy and out of hospital, the idea being that these people are all transferring to the NDIS and that we do not need as many of these programs anymore. However, that could not be further from the truth. Not only is the challenge of transferring to the NDIS significantly difficult for many people but also there is significant unmet need in the community.

These programs have huge unmet need that they cannot meet in terms of waiting lists and other people trying to get into these programs but cannot. At the last election, we made a commitment to a mental health services guarantee. We said that we should ensure that mental health clients would not lose access to psychosocial supports if they were ineligible for the NDIS transition. The Liberal Party, now the government, did not make a similar commitment, and we have now seen that there has been what they call a transfer and we call a cut of funding in relation to those mental health programs.

We have seen staff leave, and we have now seen additional pressure on the system. Undoubtedly, that has added more pressure on emergency departments. It has added more pressure on other social services in the community at a time, particularly now in dealing with the pandemic, when we need those services more than ever. I refer to Geoff Harris, the Executive Director of the Mental Health Coalition, who in the newspaper on the weekend, the Sunday Mail, said:

Last year, we saw mass redundancies of community mental health workers…Now our worst fears are being realised.

That goes to the heart of this issue. We saw these cuts taking place, and now we see the demand spiralling out of control. This is Mental Health Week. This is a week when we obviously need to be focusing on the challenges of mental health and making sure that we provide the necessary supports that we can. Never has that been more important than during the pandemic.

In early 2019, we saw that SA mental health organisations were given less than a month's notice that 25 per cent of their funding was due to be cut, totalling $6.8 million. It should be worth noting that, before they were told that, they were previously told by officials in the Marshall government that they would not be facing that cut, but then they were told, with no notice, that they would be. The Marshall government reduced funding on the basis that individuals accessing support with this funding had now supposedly transitioned to the NDIS, but that was not the reality on the ground, with hundreds of job losses predicted and mental health consumers losing access to vital services.

It was only because of sustained pressure from the Mental Health Coalition, from lived experience groups, from unions, particularly the Australian Services Union, and from workers across the different community organisations that we saw that the government reduced some of their cuts but still continued with a significant number of those funding cuts to organisations. It has meant that those organisations have had to cut staff and reduce the number of services they are providing.

These are very important services because they provide an important gap between primary healthcare services, in terms of GPs, psychologists and the like, and acute services, particularly hospital services. These are the services that are providing daily, weekly and monthly support to people to keep them healthy, keep them on track and, importantly, keep them out of hospital or prevent their situation getting worse or, God forbid, keep them from ending up committing suicide. We want to make sure that those people stay healthy, and that is why these workers are so important.

It is also worth noting that the government said all along, 'We are going to have a mental health services plan, and that is going to address all of these issues,' but when we eventually saw the Mental Health Services Plan, which was much, much later than their election promise, the government was not funding any of them. The government is not funding the vast majority of things that its own Mental Health Services Plan released.

I have never before seen a government release a plan and then simultaneously release the government's response to that same plan. It is either your plan or it is not your plan. You are either doing it or you are not doing it, and here the government are not doing it because they had to release a response to their own plan, outlining that they are not necessarily doing most of what is in the plan.

At the same time, we saw cuts to the MATES in Construction program that we know has been so important in terms of making sure we can reduce suicide rates, particularly in relation to the construction industry, and now they are obviously expanding into other industries as well. That has been a very successful program that sadly faced a cut under this government. We have seen cuts to doctors and nurses in hospitals, we have seen closures of beds in hospitals and we have not seen any extra mental health beds created.

The number of mental health beds we have now is basically the same as it was five years ago, even though demand has gone up and up. The government were warned time and time again that their community mental health cuts would increase pressure on emergency departments—and they did. We have seen that 24 per cent of mental health patients presenting at the Royal Adelaide and The Queen Elizabeth hospitals in 2019 were waiting more than 24 hours in emergency departments, compared with 7 per cent just two years earlier.

That is dramatic, more than tripling the number of people who have been stuck for more than 24 hours in emergency. Only recently we had evidence of a patient, who is sadly not the only one, who had been stuck in the RAH emergency department for 109 hours. Everybody has acknowledged, all the experts have acknowledged, that these are human rights abuses that are occurring, and there is absolutely nothing that is taking place to address it.

We have even had the Chief Psychiatrist having to issue an intervention due to the use of restraint in seclusion. I think that it is important to note that, a lot of the time, restraint in seclusion is happening because the practitioners in the emergency departments do not have options available to them, because a person needs a bed but there are no beds for them to go to.

In a second I will get to what we have seen now in terms of the alarm that has been expressed by the Royal Australian and New Zealand College of Psychiatrists and the College for Emergency Medicine, who have expressed their grave concerns about what is happening right now. In fact, 28 doctors have written their concerns as to what is happening in our emergency departments at the moment.

Adding to all of this has been the additional pressure from the COVID-19 pandemic. I think it should be clear to everybody that this year has been a very stressful year; it has been an awful year for so many people. Even though we have obviously done well on the health response, as I pointed to earlier, there has undoubtedly been an effect on people's mental health in South Australia, and that is continuing in terms of the economic effects of the pandemic that we are seeing.

It has obviously been talked about before that we have the highest unemployment rate in Australia. We have the lowest per capita level of stimulus from the state government in Australia. Even today, we had a devastating announcement of more job losses to go as West End closes its brewery, which has been in South Australia for the best part of 150 years. The toll of these job losses and the economic impacts is increasing and it is only going to increase, particularly as we see a lot of the supports that are there being removed. That is why the response we have seen that has been so lacking is so disappointing, because there are so many people who need that help.

Just last week, I was at Headspace in Adelaide and they were saying that their referrals are up 15 to 20 per cent and that they are seeing a higher acuity of mental health needs from people coming forward. We have obviously seen that significant increase in attendances at the Royal Adelaide, reportedly well over a 10 per cent increase in the number of mental health patients year on year. The government's response has been very little. They announced a phone line for COVID, which has had very few phone calls made to it. One thing there is a lot of support for in mental health is a lot of phone lines, so the addition of a new one, which has had very few calls, is not going to address the need that is there.

There was talk about getting some extra beds at the Adelaide Clinic as a temporary measure. I am told that that did not work and fell through, so those beds never materialised. There has been basically no response from the government in terms of the COVID-19 mental health impacts whatsoever. Their only response is an urgent mental health care centre, which is delayed. They promised it was going to be open in July this year; now it is going to be sometime next year.

They have decided to outsource it to private providers, rather than to the public system that put up a bid, which would have offered more hours of service with a greater range of disciplines involved in that service. Unfortunately, we have seen that being outsourced, including to a company that is based in Phoenix, Arizona, and which has no presence in Australia whatsoever. Given the border restrictions in place, it is hard to imagine how that is going to work.

Compare this with what is happening in other states, where we have seen in Queensland two different packages announced, with $28 million and then $46 million for mental health; New South Wales announced a $73 million package back in April; WA a $56 million package in June; and even the ACT, which is obviously a much smaller jurisdiction, announced $6.2 million in May. All these packages have been announced and we do not have a response here in South Australia.

In closing, I refer to what we have seen from some of our colleges. We have seen particularly a joint letter and press release put out by the College of Psychiatrists and the College for Emergency Medicine, which says:

We can no longer work effectively under the current system and it is fracturing valuable and important relationships, which can only end in disaster.

We saw a letter that has been released publicly from 28 different doctors who have put their careers on the line, raising their concerns in relation to what is going on in mental health. They say:

Current efforts to reform CALHN Mental Health Services are unlikely to lead to [significant] change:

And later:

The Emergency Department continues to be forced to 'ramp' on a daily basis [with consequences for all patients, SAAS and the community]; it is not difficult to see how this could largely be avoided by resolving Mental Health access-block.

The impact of Mental Health access-block on staff:

Daily, ED nurses and doctors are forced to provide care that they know is suboptimal, and at times, unethical. In addition, they work with a continual risk of violence or assault that increases with the time patients spend in the continual light and noise of the ED.

I urge the house to support this motion. We cannot have any more cuts. What we need is more investment to address this crisis, which is out of control at the moment and only set to get worse as we face the full economic impacts of the pandemic and what that will mean for people's mental health services.

Dr HARVEY (Newland) (12:15): I rise to speak on the motion moved by the member for Kaurna and indicate that we will not be supporting the motion. There have been no cuts to mental health services funding. There has been a transfer of some funds, but not a cut. The intergovernmental agreements that established the NDIS were predicated on state funding transferring to the commonwealth to help fund the NDIS, a decision of the former Labor government.

Ms Hildyard: What about a person with mental illness who doesn't have an NDIS plan?

The SPEAKER: Order! The member for Reynell is on two warnings. The member for Newland is entitled to be heard in silence, as the member for Kaurna was. The member for Newland has the call.

Dr HARVEY: The transfer of funds was part of a binding agreement with the commonwealth signed by the former Labor government, with an agreed level of funds transferring from the state to the NDIS to provide the NDIS with the funds to provide services for mental health clients transitioning to the NDIS.

Based on the data provided by non-government organisations to the SA Health contracts team in 2016, it was estimated that 25 per cent of clients of eligible SA Health programs would transfer to the NDIS. It was on this basis that $6.8 million of current SA Health funding was transferred to the NDIS from 2019-20. The confirmed eligibility of clients is currently more than 30 per cent. Furthermore, unlike historical state funding, access to the NDIS is not capped, so any client referred to the NDIS who is eligible will receive funding.

It is important to note that the proportion of funding transferred reflected the proportion of clients who actually transferred to the NDIS from eligible programs. NDIS transition has a differential effect on programs, with some programs having a significant number of customers transferred to the NDIS with substantial packages and other programs having a lower percentage transfer with lower value packages. This means, for example, if only 3 per cent of your clients transfer to the NDIS, then only the funding for those clients would transfer to the NDIS.

The NDIS is a major reform changing the way disability services are funded and delivered across Australia. These funds have enabled customers with severe and enduring mental illness to transition from state-funded mental health programs, including individual psychosocial rehabilitation and support services, housing and support, day and group programs, and mutual support and self-help programs, to NDIS-funded psychosocial support services.

There were approximately 1,700 SA Health-funded customers in the section 55 NDIS dataset. The dataset is a snapshot of people receiving state psychosocial programs in late 2017, early 2018, which SA Health was required to provide to the NDIA under the NDIS Act. SA Health-funded psychosocial programs include individual psychosocial rehabilitation and support services, housing and support, day and group programs, and mutual support and self-help programs.

It should be noted that some of the original section 55 customers have exited the programs for a variety of reasons, and new people who require psychosocial rehabilitation services have entered these programs. As at 15 August 2020, of these 1,700 consumers, 688 (40 per cent) have been deemed eligible for the NDIS; 286 (17 per cent) have been deemed ineligible or had eligibility revoked; 673 (40 per cent) have an approved NDIS plan; and 710 (42 per cent) have been cancelled by the NDIA, i.e. did not respond to an NDIA letter, phone calls or disengaged for other reasons.

There is no intent to cease SA Health funding NGO mental health programs. They are a fundamental and highly important component of care across the mental health service delivery continuum. NGO mental health program contracts are being rolled out for the 2020-21 financial year. An example of the Marshall Liberal government's strong collaborative approach with the NGO sector in South Australia was the recent awarding of the $14 million urgent mental health care centre contract to Neami National, a respected and long-serving provider to South Australians living with mental illness.

The provision of an urgent mental health care centre in the Adelaide CBD featuring a model of care codesigned with mental health consumers is an example of the commitment the Marshall Liberal government has to working with the mental health community to deliver innovative care and support options.

Moreover, as a result of extensive consultation with mental health service providers, the South Australian government recommitted almost half of the funds already transferred to the NDIS to ensure that they could address ongoing need and workforce sustainability across a wide range of mental health programs. This has resulted in a significant cost pressure, and South Australia is seeking recompense from the commonwealth for the additional funding.

The state government, in collaboration with the commonwealth government, has invested approximately $100 million towards new initiatives and mental health services for South Australia. Development of the NDIS has enabled a growth in the NGO sector in South Australia, including further development of those organisations providing care to people with psychosocial disability.

The Marshall Liberal government is committed to ensuring South Australians with mental illness or psychosocial disability and their families and carers can access support, services and care whether they are eligible for the NDIS or not. As I said earlier, we will not be supporting this motion.

The Hon. A. PICCOLO (Light) (12:21): I would like to make a few comments in support of the motion. I think that, while well intentioned, the speaker who just rose to his feet has missed a very important point. He used a whole range of language to hide the fact that over the past 12 months there has been a huge increase in the demand for mental health support and services. I am sure that every member in this chamber would report that to be the case in their own electorates and communities.

In my current community of Gawler, and as I move around the Barossa I am certainly seeing it there as well, access to mental health services and supports is at crisis point on many occasions. In fact, a not-for-profit organisation came to see me only a few weeks ago, seeking additional funding to meet demand. They do not have the resources to see all the people they need to see in a timely fashion. People often have to wait two, three or four months to receive mental health support, and repeat appointments can be months away. Those services are critical to the health of the people who need them. They are critical to their wellbeing and for some—and this is not overstating it—are a matter of life and death. They need that support.

The pandemic has had an enormous impact on our economy and, through that, a huge impact on the people who have been hurt by this economic downturn. I am talking about small business owners who have lost their businesses. The other night, I was speaking with someone who had lost their business forever, and we talked about the impact it has had on them and on their family. This is not just a question of losing an income; their whole life plan has changed, and this has a huge impact.

We have seen the lines of unemployed outside of Centrelink offices. Those people often represent families; they have children and partners at home who no longer get support. This is at a time when governments are sadly cutting back on those support services and, very sadly, are providing further tax benefits to those at the wealthy end of our society.

Another group I would like to talk about, who have come to my attention in Gawler and in the Barossa, is young people. This pandemic is having an impact on young people. It is causing stress and uncertainty about their education, uncertainty about their higher education, uncertainty about gaining possible work experience, uncertainty about getting apprenticeships and uncertainty about their future. This is causing quite a bit of stress and anxiety.

So at a time when demand for services is increasing exponentially, we are sadly cutting back on services. That is one group. Another group I would also like to talk about is the carers—and I think perhaps both speakers touched upon it. They are caring for people with mental health issues. This week, if I am correct, is National Carers Week, and I met with some people in the Barossa recently who provide support services to carers and also to people suffering from mental health and other health issues.

We have a group of young people who are acting as carers for a sibling or an adult, a parent, and these young people are missing out on their childhood which is very distressing. But it is even more distressing when the supports for them and their family member have been reduced. Now is the time we need to make sure we are looking after the most vulnerable in our community. It is sad that, in a time when there are additional pressures on families and individuals, we are cutting back services.

One of the examples, which I think one of the earlier speakers gave, was regarding the cutbacks to funding for the MATES in Construction program. It is a very successful program and particularly important because one of the highest rates of suicide is in the construction industry. That is just a fact: one of the highest rates of suicide in society is in the construction industry. We have a peer-based program which has been very successful in reaching predominantly young men and men who have mental health issues or who are at risk of suicide. They are now having their programs cut at a time when they need to be supported the most, yet unfortunately the government has pulled the rug from under their feet.

This is an important motion because it highlights what is happening on the ground, not what is happening in balancing the books or various accounting entries between the commonwealth and the state. This is important because it is what happens to real people on the ground today. It cannot be masked by various agreements between state and federal governments because people's experience is real today. The experience of young people with mental health issues, the experience of adults who have lost their employment and are experiencing pressure at home, people who have lost their businesses are all real people who quite legitimately expect support from our society and our community through the government.

With those comments, I support this motion because it highlights what is happening in my electorate of Light, but it is also happening in the adjoining electorate of Schubert from what people have told me to date.

The Hon. D.G. PISONI (Unley—Minister for Innovation and Skills) (12:27): I certainly concur with the sentiment of the debate. It is a very difficult time at the moment for many South Australians. Many associated with this place have been to some degree financially cushioned in the last seven or eight months, but there are many others who have not.

I know from my previous profession in small business that you feel the slightest bump in the economy, particularly if you are in the business of discretionary spending. Buying things people do not need tends to be the first thing they delay or stop doing. If they have less money because their hours have been reduced or, alternatively, they have been stood down or they have lost their job completely, obviously they are not going to be going out to dinner. They are not going to be buying items for the house. They are not going to be hiring contractors. They may even have to put off the lawnmower man, for example. These things have a domino effect right across the economy and right across individual lives.

I was motivated to stand and contribute on this mainly because of the incorrect comments from the member for Light about MATES in Construction. I want to remind the member for Light—although I do not think he was in cabinet at that time—that MATES in Construction actually wrote to the Deputy Leader of the Opposition in 2017 asking for $200,000 to support the MATES in Construction program. I have been advised that the minister did not respond to MATES in Construction. He flicked that letter of inquiry off to another department, which then said no, that the program did not warrant any funding, so there has not been funding to MATES in Construction.

The fallacy that the CFMEU and their mates in the Labor Party have been running on this is just that: it is a fallacy. There was a one-off $10,000 grant that I think the CIBT gave to MATES in Construction. Bear in mind that MATES in Construction is a multimillion-dollar national charity. We are actually talking to MATES in Construction about a fee-for-service for rolling out that program to not just construction apprentices but all apprentices, because we know that apprenticeships can be stressful for young people in particular. That is why we have seen a decline in the modern years.

It certainly has changed a lot since I did an apprenticeship, but that was a long time ago, when in South Australia only about 56 per cent of apprenticeships were actually completed. Obviously, there are issues getting those apprenticeships started and then, of course, getting those apprenticeships finished. We are very supportive of any process that supports apprentices in their mental health, in their mentoring and in their pastoral care to help them get through that process.

Also, I think a lot of people tend to underestimate the commitment that employers, particularly in small businesses, make with that commitment to on-the-job training. Obviously, they are trained by the professionals through a registered training organisation for their technical training as part of the apprenticeship, but when they are implementing that technical training on the job that is when supervision is important and on-the-job training is important.

As a government, through our Skilling South Australia program, we have supported apprentices by supporting the supervisors and the people who work with apprentices in their business so they have the skills and the confidence to train apprentices, to make sure, first of all, that those apprentices are being supported and also that they are getting quality on-the-job training so they end up sticking it out, getting their trades and working in the trade, in the industry, or deciding to move on to further education beyond that.

We certainly encourage that. We certainly encourage people to continue that educational pathway through vocational education. We are seeing more and more businesses now coming on board with the paid training model we have seen in South Australia. We are ahead of the nation by 20 per cent when it comes to apprenticeship and traineeship growth in South Australia. That is because many of the new training contracts have been in new areas, or areas that have been around for a very long time, such as the social care area, where there has not been a paid training process.

Of course, this affects women in particular. You cannot deny the fact that it is an industry dominated by women, just as the construction industry is an industry dominated by men. There are, obviously, more women moving into male-dominated areas, but there are still some very female-dominated areas that have been left behind after 16 years of Labor when it comes to skills and recognition and career pathways, in the healthcare sector, outside of the hospital system, in other words, the social care sector.

Whether it be for NDIS providers or whether it be for aged-care providers, there was no paid pathway, not until the Marshall government was elected. There are 300 successful pilots. This morning I had a meeting with a number of aged-care providers and those interested in the sector to see how we can get the best outcome for the federal government's $1.2 billion apprenticeship and traineeship wage subsidy program to supercharge paid traineeships in this area. It is important that we are all very mindful of people’s mental health. It affects every family. It certainly affected my family 10 years ago, which ended in tragedy.

It is an issue that we are all very aware of, but it is frustrating when there are those who have a voice in public who will use issues like MATES in Construction, for example, for political gain without actually understanding the history of the way in which MATES in Construction is used, the relationship they had with the CITB (which was a single year funding of $10,000) and the fact that they themselves, when they were in government, were offered the opportunity to have a partnership with MATES in Construction. The minister responsible did not even bother responding to MATES in Construction and flicked it off to the public sector, which then, through the department of SafeWork  SA said that, no, they were not interested.

That is a fact. You cannot change that element. That happened in 2017. If you want more information, go and see the Deputy Leader of the Opposition. I am sure she can justify why she had no interest in funding MATES in Construction back in 2017. We are working with them. We have money for MATES in Construction, but we actually want a relationship with MATES in Construction that delivers outcomes that the government can monitor.

Ms HILDYARD (Reynell) (12:36): As others in this house have reflected, Sunday was the start of Mental Health Week right across the world. It was World Mental Health Day. It is a day that is really important for me and my family as is the rest of Mental Health Week.

On that day, I reflected on a number of things, and four things in particular. Firstly, I reflected on the factors that others have spoken about in that this year more than ever people are confronting mental health challenges as they deal with isolation, job loss, the loss of their small business, and the deep emotional pain of not being able to attend a family funeral or to connect with family members in other ways.

It has been a very difficult year for many, and it has led to an increase in the number of people experiencing anxiety, depression and other mental health challenges, which I understand has resulted in around a 15 to 20 per cent increase in referrals to mental health services, and also an increase in presentations to emergency departments by people experiencing mental health challenges.

On that first point, I also reflected on Sunday that, as a community, we have got better at having conversations about mental health, and there are many organisations that encourage us to do so. I know that here in this parliament we speak about things like R U OK? Day, and many of us do what we can to encourage those conversations, to encourage people not only to check in with their loved ones and other people in the community to find out how they are going but also, I guess, to encourage people to have conversations about mental health just as we have conversations about physical health.

I reflected on the year that we have had and how we are connecting with each other in this difficult time. Secondly, I also reflected on the incredible challenges that people who deal with long-term serious mental illness continue to confront. That is an issue very, very close to my heart with one of my very close loved ones having dealt with a serious mental illness for more than 30 years now.

My sister and others in our community who deal with serious mental illness find it incredibly difficult to participate in different aspects of community life; some of the things that many of us take for granted—whether that is getting on a train, walking to the shop, making a phone call or simply going outside—can present really difficult challenges.

Also, as is the case with my sister and many other people with serious mental illness, they also have confronted at different points in their life the challenges that come with presenting to emergency departments when suffering from severe episodes in their mental illness journey. Certainly my family knows the horror of those moments of waiting in emergency departments and also the horror that comes with the use of physical and other restraints in emergency departments.

When I was thinking about this, as I do always, not just during Mental Health Week, I was thinking that we still have such a very long way to go in terms of our community conversations about serious mental illness. As I said, whilst I think we have progressed in some way in terms of engendering conversations about mental health challenges, I do think that we still have some way to go in terms of eradicating the stigma that is often associated with serious long-term mental illness.

The third thing I thought deeply about, as I so often do, is who is there for people when they experience mental health challenges as so many people have this year, and who is there for people with serious mental illness? The member for Light spoke about the incredible role that family carers play and I absolutely pay tribute to every single one of them. I also pay tribute to the incredible workers who work at the coalface of need in community organisations in every corner of South Australia.

Those workers, many of whom are Australian Services Union members, many of whom I am proud to call friends, are workers I had the privilege of representing for many, many years. In the course of representing them when I was with the Australian Services Union, I visited numerous worksites where community mental health workers worked. I absolutely distinctly remember that every single time I went to one of those workplaces I would often start our conversations by asking them what they loved about working in the sector and why they did the work they did.

One hundred per cent of the time those workers would talk about their desire to walk alongside people with serious mental illness and people who were facing mental health challenges, to be with them, to help them traverse their journey, to provide support and to provide what they needed to empower them to actively, equally participate in every aspect of community life and in our economy, without stigma. They were crucial to those people walking their journey and I absolutely pay tribute to them.

I note that those opposite, particularly the member for Newland, spoke a lot about customers—I think that is how he referred to people. Mental health workers work with people with mental illness because they care about them and because they want to make a difference. It is those workers who are telling many of us in this place that it is becoming impossible to continue to provide that support, that service, that compassion when they are faced with a 25 per cent funding cut to the community organisation that they work for, that delivers the particular mental health program.

It is becoming impossible for them to be able to continue to stay and do that work with those funding cuts in place and that is an absolute tragedy. As I said, these workers are deeply committed to making a difference, to working with and for people with mental illness so that they can fully participate in community life. Also in my own community—and the member for Light spoke about this—yes, those opposite quoted figures at us, but the reality is that I like many others in this place have people coming to my office desperate for services, desperate for support. Because of these cuts, those services and supports are no longer there and that is an absolute tragedy.

I note also the role the NDIS plays in providing mental health services and support was also spoken about. When the NDIS was introduced by the then federal Labor government it was absolutely all about creating huge social reform—the biggest social reform we have seen in this country since Medicare—and the NDIS is focused on providing choice and control to individuals to determine what services and supports they need to traverse their particular journey in life.

Before the last state election our Labor government absolutely steadfastly committed to ensure that funding for mental health services would continue in the way that they were funded prior to the election, because we knew—and it is a fact, and these cuts are now proving this—that we had to take account of the fact that only 22 per cent of people with serious mental illness have an NDIS plan. Services are being defunded or having their funds cut on the premise that somehow this money that comes through people's NDIS plans will make a difference, and this is not true. These organisations have a shortfall in terms of their ability to provide programs.

To come back to a personal point about that, in my own family, with my sister's NDIS plan, yes, she can now access particular services and supports through that NDIS plan, but the problem is some of those services are at risk of no longer being there because of the cut made to them, because not everybody who comes to that particular program or service has an NDIS plan in place. These cuts are absolutely harming people in our community when they most require support. I absolutely commend the motion to the house.

Mr BELL (Mount Gambier) (12:46): I rise to support this motion and talk a little bit about our family's experience with mental health. We have a family member going through the mental health system in Mount Gambier, a regional part of our state, and that experience has been nothing short of horrific and debilitating, certainly for my parents, and something on which we need to keep shining a light and having a focus. So I view any cuts to this service as a very unfortunate move.

To talk through getting on to an NDIS system, it has taken my family member 15 months, with very little support, apart from family support. This is a person who has had a diagnosed disability since she was born. The inconsistencies when visiting specialists, or the lack of resident specialists in this area, lack of staffing at our mental health facility, lack of being able to access a mental health bed, have been very traumatic and a great disappointment to me looking at the system.

Drug cocktails are prescribed by one doctor and discredited by another doctor. The effect that has on the person is in terms certainly of weight gain, mental stability and a zombie-like state. You then have another doctor tell your parents that in fact you are on the wrong cocktail of drugs, or that this is counteracting another drug you are on, which is horrific when you look at it from a health system viewpoint.

It is something that would not be tolerated in any other field of health. Imagine a person with cancer getting one type of treatment and then another doctor coming in and totally overruling that doctor's recommendation and diagnosing something completely different, giving mixed opinions and advice. It seems to be Rafferty's rules at times as to the best way forward. Couple that with parents who are ageing and trying to do the best they can to support their child through a very difficult time.

We have a long way to go. I firmly believe that we need to shine a brighter light on this, from both a professional point of view and, of course, a funding point of view. Then we couple with that the disadvantage of being in a regional setting and the attraction of suitably qualified professionals to that area within the health profession. It frightens me when off-the-record conversations are had with me as the local MP that people with mental health issues are being discharged from the emergency department before the 24-hour period comes up, because then it triggers an alert and they would rather see them discharged into the streets without an adequate bed being available at our local hospital.

The attraction and retention of suitable professions I think needs a bipartisan approach, and it is certainly one that would have my full support. You can throw as much funding at it as you like, but if you do not have suitably qualified staff you are not going to improve outcomes in regional centres. I do not want to see regional centres being a training ground or a dumping ground for some in the profession who may not have the standards that I believe we need in this area.

We have many skilled people in our region, and in the Limestone Coast we are very lucky to have groups like Lifeboat and the Junction before an acute stage is reached. That is an area where we need to be doing a lot more work. Why is it that we wait until somebody is at an acute stage before intervention or assistance is offered when, in actual fact, our focus needs to be right back on early intervention?

We have amazing, dedicated and passionate volunteers, people like Matthew Brookes from Lifeboat and Nel Jans from the Junction. I have been fighting for funding for these guys for a number of years and it always falls on deaf ears. They end up running the centres on a volunteer basis, yet if you look at the savings from a state government point of view, the savings from a community point of view and the detriment from a personal point of view, early intervention is critical and is something that we need to focus on.

Our region is very proactive in raising money for mental health. Maureen Klintberg, Presiding Member of the Mount Gambier and Districts Health Advisory Council, was a driving force behind the 2017 Bollywood Ball. This event raised $40,000 for the Mount Gambier hospital upgrade. Community fundraising is fantastic, but it should be used as a top-up and not as the only source or the major source of funding for projects and programs.

There is an event happening this month in Mount Gambier called The Full Monty: six local men are getting their kit off for charity. The member for Mount Gambier was not asked to participate for pretty obvious reasons. The proceeds will be divided amongst NGOs in our region, and these charities will include Lifeboat, the Junction, the Mount Gambier and District Suicide Prevention Network and the Mount Gambier and Districts Health Advisory Council.

It is wonderful that our community is so proactive in this space, but this grassroots fundraising also needs to be backed up by state government support. A key priority in the South Australian Mental Health Services Plan 2020-2025 speaks of:

Equity of access to services: ensuring people in South Australia have equitable access to services wherever they live, including people in rural and remote communities.

As we speak here today, the state budget is less than a month a way, and the Minister for Health and Wellbeing needs to ensure mental health is a key focus of health spending going forward. Each region of South Australia should be treated individually, as the Limestone Coast has differing needs, staffing levels, services and funding requirements to other regional parts of South Australia.

There is not a one-size-fits-all approach to mental health, and I believe a region-by-region approach is required. I am calling on the state government to ensure South Australia's regions are a focus of spending on mental health in the upcoming budget.

The Hon. G.G. BROCK (Frome) (12:55): I will be very quick because I know we want to get this to a vote. I am very, very passionate about mental health, and I support this motion wholeheartedly. I also reinforce what the member for Mount Gambier has indicated. I have had personal experience with mental health issues myself, and also I have lost family members because of mental health issues. That is one of the reasons I have a notice of motion on 12 November about having a select committee.

At this particular point, I do not think we have seen the full impact of the COVID-19 pandemic. Certainly, the NGOs do a fantastic job with the money available, and I know that they have had their funding cut. But the issue is we need to get people on the ground who are there to give preventative attention to these people who are experiencing these mental health issues. It is a very personal issue. A lot of people do not want to talk about it, they do not want to mention it, but we have to get them in the early stage before they get into the position of creating extra medical requirements and also, God help us, mental issues.

That is why I will be working very closely with Lifeline in the next couple of months to get a Connect centre in Port Pirie to be able to get those people to come in and talk to people before that. I will also be doing that with the Clare Valley. I will 100 per cent support this. I know there may be other speakers, but I certainly endorse this motion by the member for Kaurna and I reinforce the member for Mount Gambier's comments made earlier.

Mr PICTON (Kaurna) (12:57): I thank all the speakers on this very important motion. This is World Mental Health Week. We should be taking a stand. We need to be doing more. One in five people in South Australia will encounter mental illness in their life. That is a significant number of people. In all our families, in all our communities, we have friends who have been touched in terms of their mental health and we need to do more. We cannot have a situation where, right now as we are debating this, 77 people are stuck in emergency departments waiting for a bed—and a large percentage of them will be mental health patients.

We cannot have a situation where, as the member for Mount Gambier was saying, we have such a disparity in terms of lack of treatment options available, particularly in regional South Australia. We cannot have a situation where we are cutting our community services that are keeping people out of hospital. We cannot have a situation where every other state is investing significant amounts in dealing with the pandemic, but we are not doing it here in South Australia. Let's agree to this motion, agree to more mental health funding, address the issues in our community and the issues coming out of the pandemic. I endorse this motion to the house.

The house divided on the motion:

Ayes 20

Noes 21

Majority 1

AYES
Bedford, F.E. Bell, T.S. Bettison, Z.L.
Bignell, L.W.K. Boyer, B.I. Brock, G.G.
Brown, M.E. (teller) Close, S.E. Cook, N.F.
Hildyard, K.A. Hughes, E.J. Koutsantonis, A.
Malinauskas, P. Mullighan, S.C. Odenwalder, L.K.
Piccolo, A. Picton, C.J. Stinson, J.M.
Szakacs, J.K. Wortley, D.
NOES
Basham, D.K.B. Chapman, V.A. Cregan, D.
Ellis, F.J. Gardner, J.A.W. Harvey, R.M. (teller)
Knoll, S.K. Luethen, P. Marshall, S.S.
McBride, N. Murray, S. Patterson, S.J.R.
Pisoni, D.G. Power, C. Sanderson, R.
Speirs, D.J. Tarzia, V.A. Treloar, P.A.
van Holst Pellekaan, D.C. Whetstone, T.J. Wingard, C.L.
PAIRS
Gee, J.P. Cowdrey, M.J. Michaels, A.
Pederick, A.S.

Motion thus negatived.

Sitting suspended from 13:03 to 14:00.

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