House of Assembly - Fifty-Fifth Parliament, First Session (55-1)
2023-09-27 Daily Xml

Contents

World Mental Health Day

The Hon. C.J. PICTON (Kaurna—Minister for Health and Wellbeing) (11:28): On behalf of the member for Elder, I move:

That this house—

(a) notes that 10 October 2023 is World Mental Health Day;

(b) acknowledges the importance of raising awareness of mental health issues;

(c) recognises the Malinauskas Labor government’s commitment to supporting and improving mental health services, including providing an extra 120 mental health beds to ease pressures on our hospital system so that people can get the help they need;

(d) commends the government for reversing the former Liberal government’s decision to abolish the role of a full-time mental health commissioner in SA; and

(e) encourages South Australians to look after each other and themselves and seek help if they are struggling.

I am very happy to move this motion on behalf of the member for Elder, who is very committed in relation to mental health and also serves, of course, as the Premier's Advocate for Suicide Prevention. I think we all in this house recognise the importance of mental health, but we do need to recognise that there have been issues in terms of people being able to access the help they need when they have mental health conditions. That is why a very significant part of the investment we are making as a government is about providing additional mental health support, particularly for those people who have acute mental health needs, who need that higher level of assistance in our public hospital system.

We have not seen an increase for a long time in terms of the number of mental health beds that are available across our system, and so, because of that, we do see on a regular basis people who present to our emergency departments needing assistance, who are then classified and determined by the doctors in the emergency department and the psychiatrists as needing an acute mental health admission, but there is nowhere for them to go because those mental health beds are full. There is no other ability for them to get that acute treatment and therefore they get stuck in the emergency department.

That is obviously an awful outcome for them. For anybody to be stuck in an emergency department for 24 hours, 48 hours, sometimes longer, would be an awfully bad outcome, let alone if you were somebody suffering a mental health condition. It is an awful outcome for those people not being able to get that help, but it is also a broader worse outcome for the rest of the health system in terms of it meaning that that access block stops the next person who needs assistance coming in from the waiting room, the ambulance ramp, etc., and so that is why we are investing right across the board.

We listened to the Royal Australian and New Zealand College of Psychiatrists before the last election, as well as the Australasian College for Emergency Medicine, who both put forward very compelling cases that what we needed was additional mental health wards with a focus on rehabilitation, and there are a number of reasons for that. One is the capacity that we talked about. The other element, of course, is that, because of the pressure on those services that we have, there is a pressure that we face in terms of having to turn over patients within them relatively quickly.

But for many patients, having the ability to be in a rehabilitation ward for a longer period of care will actually enable them to get that and not have to be discharged before we have seen the full effect of the treatment they have been receiving. That is why we are investing in three new 24-bed mental health wards: one at Modbury Hospital, one at The QEH and one at Noarlunga Hospital. That is a real generational increase in terms of that capacity across the board.

In addition to that, of course, we are also investing elsewhere in the system. We are increasing the number of mental health beds that will be provided at the Women's and Children's Hospital, and I will speak a bit further about the impact that we are seeing on kids in particular. We are increasing the number of beds that are available at Flinders Medical Centre as part of our $400 million redevelopment there. We made the announcement last week about the expansion that is happening at the Margaret Tobin Centre, including additional psychiatric intensive care beds that are desperately needed across the system as well.

You, sir, I know are very familiar with the fact that we are building a new Mount Barker hospital. Part of the commitment there is to have the first mental health ward and facilities that will be available for inpatient care in the Adelaide Hills, which has been very strongly welcomed by the community, which will mean less pressure on people having to come to the city. In addition, I know the member for Mount Gambier is very familiar with the fact that we are increasing mental health beds in his community at the Mount Gambier hospital as well and providing that additional support. But that is not the extent of what we are doing and needs to be done, because we know that there are a lot of other needs in terms of mental health care.

One of those, as I mentioned earlier, is in relation to children. We are seeing impacts in terms of kids' mental health right across the board at a concerning level. I think COVID is not the only cause, but COVID issues have certainly exacerbated that over the past couple of years. We are taking a number of measures. One is that the new Women's and Children's Hospital will have additional mental health beds.

Secondly, in the current hospital we have employed additional specialist nurses for mental health services at the Women's and Children's Hospital to help provide additional care and help manage what we are seeing in very escalating numbers of kids who require mental health presentations at the emergency department. We are also putting in place additional resources in terms of extra psychologists and extra psychiatrists for the Child and Adolescent Mental Health Service (CAMHS), which is very much needed because there are many kids who need that additional level of support who have been unable to access it.

Importantly, we are also putting resources into our schools. The Minister for Education is a very big supporter of additional wellbeing measures in our schools, and we now have 100 extra staff—mental health and learning support staff—who are going through our schools. They are being hired at the moment; a number of them are in place already. That will help provide a real preventative end of the system to make sure that people can get the care and the initial support and, hopefully, do not have to confront those other elements of the system as well.

In addition to this, for adults we are also putting in place additional funding for community mental health services. That is likely to have a particular focus on regional areas, where people face even greater challenges in terms of being able to access community mental health services. That is being worked through at the moment.

We are also putting in place additional resources that particularly help people when they are leaving hospital to get ongoing support in a Hospital in the Home model. This has been a model that has operated in the central Adelaide region for some time, but we are expanding it so that these beds—20 additional bed equivalents—through Hospital in the Home services will be available in the northern suburbs and the southern suburbs to help ease a lot of that pressure that we see in terms of those services.

So right across the board we are putting in place additional services. At the same time, we have been increasing the funding going to our NGO providers as well. We obviously have more work that needs to happen there, and we are particularly also working with the federal government in relation to issues that we see in terms of NDIS. There is also more work, of course, that needs to happen in relation to the mental health workforce, in a similar way that needs to happen across other areas of our health workforce as well.

We also need to put in place some of the systems that help the system, and the state more broadly, in terms of increasing the focus on mental health. One of those is the mental health commissioner, which the member for Elder rightly raises through this motion. We saw that the mental health commissioner full-time position was abolished. We are now restoring a full-time mental health commissioner with dedicated staffing support. We have appointed an excellent, internationally renowned mental health expert who will be starting very shortly and has been very well received by people across the board.

In addition to that, the other key thing we need to do in relation to mental health is listen to people with lived experience of mental health. We are fortunate in South Australia that an organisation started up over the past few years—not because of the government but because of some exceptional leadership in the lived experience space—which is the Lived Experience Leadership and Action Network (LELAN).

We have committed to providing ongoing funding to LELAN to make sure that they can provide that service as a peak body representing people with lived experience and so that in the design of these services and the design of the work that we are doing as a government, but also more broadly across the system, the voice of lived experience can be heard very loudly. We know that is critical to making sure that we can address the needs that we see.

I would like to also acknowledge the work that the member for Elder and the other members of the Suicide Prevention Council are doing. I thank John Dawkins, who was the first Premier's advocate who led the work for this to be legislated. We are now a real leader internationally in terms of having the Suicide Prevention Act here in South Australia. The member for Elder, in her work as the Premier's advocate, has also been visiting people right across the state, and the Suicide Prevention Council has been doing excellent work, and I know just last week visited the member for Chaffey's electorate which, I understand from the member for Chaffey, was very well received by members of his electorate as well in focusing on these issues.

I endorse the motion that has been moved by the member for Elder. I hope that this is a day in coming weeks that can be celebrated and commemorated across our community in South Australia and that it can increase the focus of what we need to do in relation to taking action on mental health. There is a lot happening, there is a lot that is going to be coming soon and we know that this is an area where more and more needs to be done.

In closing, I should mention the other element I did not touch on, that is, the work we are doing with the federal government in relation to additional services to be provided to the community as well. There are additional Head to Health services being rolled out. This is going to be very welcome for people to be able to access that support in the community, as well, for those services. This is something that we have seen obviously in the Urgent Mental Health Care Centre in the city.

We are now seeing a similar service operating in the Salisbury area, another community drop-in clinic is now operating in Port Pirie, as well, and we are about to see additional Head to Health services operating, including a combination of state and federal government assistance into that program. I note that that includes two specialist services, one in relation to children, particularly focusing on children who are too young for the current headspace model. We know that, sadly, there are a number of young kids who do need that mental health assistance, so having that additional Head to Health centre focused on young kids is going to be really important.

The other service is in relation to Aboriginal and Torres Strait Islander people to have a focused mental health service that will be dedicated to them. I received an update from the department and the Chief Psychiatrist in relation to those matters just yesterday. We are hoping that over coming months we will be going through the tender process for those initiatives. They are going to be at key population groups where we know that more needs to happen and more support needs to be provided. I endorse the motion to the house.

Ms PRATT (Frome) (11:42): I seek to amend the motion introduced by the member for Elder as follows:

Delete paragraph (d) and insert in lieu thereof:

(d) commends the former Liberal government for establishing the highly valued Urgent Mental Health Care Centre.

While I thank the member for introducing this motion that affords us all the opportunity to address the importance of raising awareness of mental health issues, it must not be an occasion where we gloss over the challenges to life-saving treatment and where we allow the government to pat itself on the back for a job well done. In seeking to amend the motion, it is an opportunity, hopefully, for there to be some recognition of bipartisan amendment, allowing us to recognise efforts that were made on both sides of the chamber in the past four years. This work on investment in mental health services will never be done, and sadly there is still much to do.

The mental health journey extends from birth to death and the entry points to experiencing mental distress are infinite and require a system that is nimble, tailored and kind. Sadly, what we currently have is a system that is in freefall. It is difficult to navigate and it is failing rural people. We know that because just this month SA Health responded to a review of rural mental health services in South Australia that was triggered by a coronial inquiry into the tragic suicide of a young man from the Riverland.

What it highlights is that services in regional SA are inadequate, to say the least. This report was completed back in May this year, but it took the department another four months to determine a response, which parliament has only just received. The review is a damning read. The number one recommendation stemming from the review of the coronial inquiry into a rural suicide was:

The state government should consider allocating responsibility for rural health and mental health within its Ministry portfolios.

SA Health agreed in principle only that the second recommendation be supported:

…a 10-year rural mental health service plan and workforce strategy should be developed, supported by a funded implementation plan with…progress reporting to parliament.

On page 50 of that same report into rural mental health services, which was triggered by a coronial inquiry, it states that, when it comes to the number of psychiatrists per capita, internationally Adelaide might be on par with countries like Norway and France, but if you live in South Australia you are much worse off than Mongolia. This review pays special mention to the parents of Theo, Jack and Poppy Papageorgiou, who have continued to advocate for answers and accountability from the system in the name of their son, Theo, who tragically took his life.

I have an opportunity as we address the very important motion that the member for Elder has brought to the chamber, where we recognise that on 10 October we will mark World Mental Health Day. Of course, we want to raise awareness, but in doing so I have an obligation as the shadow minister to raise awareness of the lack of services, particularly across South Australia. The government now has form for sitting on reports and research that really are better released so that the service sector can meet the needs of South Australians.

The example I refer to now is the unmet needs report, which was commissioned by the former minister, Stephen Wade, of the other place. We know that report was completed sometime back in February, but it took many months for it to be released. I would argue that delay was reckless by the government and seemingly a strategy to avoid any fiscal or budget responsibility because we saw through estimates the minister conceding that no additional funding was added to the mental health portfolio for this financial year. I would certainly argue that is a missed opportunity.

I hope the member for Elder in her important advocacy work has not been sent in by the government to do their dirty work rewriting history because they certainly have a reputation for closing down sites and reducing beds. When we look at a historical time line of mental health services across South Australia, it is just a litany of missed opportunities and deliberate downsizing. I can sadly point to sites across the city, including Glenside, which was closed on the government's watch; the closure of the Repat, which I am sure we all remember; and, most recently, the permanent closure of the Southern Intermediate Care Centre at Noarlunga.

Of course, the minister on his feed is going to be talking about investment in the tertiary clinical inpatient beds in hospitals, and we welcome that investment, but South Australia is so far behind when it comes to the beds we require for identified needs. When we talk about psychosocial services, 20,000 South Australians are estimated as needing access to these services, so there is much more to be done. If the workplace culture at James Nash House is anything to go by, minister, the sector is certainly still in trouble. They felt so bullied and undervalued that they were compelled to write to the Premier, begging for intervention.

The Liberal legacy, when we look at this time line, is from 2018 to 2022 under the careful watch and guardianship of the former minister, Stephen Wade: the opening of Northgate House, the opening of the Psychiatric Intensive Care Unit (PICU) at the Royal Adelaide Hospital and the statewide Borderline Personality Disorder Collaborative services opened on Greenhill Road. We saw short-stay mental health beds allocated to the Royal Adelaide Hospital, the Neuro-Behavioural Unit at the Repat—which the Labor government were destined to close—and of course, the jewel in the crown, the Urgent Mental Health Care Centre, which is loved and lauded by everyone who works there and, happily for those who are in distress and are needing that service, they are finding compassion and support.

The minister referred to John Dawkins, whose very thorough and compassionate advocacy delivered to this parliament, to the state, the nation-leading Suicide Prevention Act. The Liberal government continued with that advocacy to deliver a much-needed suicide register. Managing COVID was a challenge, but through that time the Marshall Liberal government understood the importance of wellbeing and supporting a community to develop resilience. We saw Wellbeing SA established and the Open Your World campaign. The establishment of that agency was certainly an earnest commitment to prioritise prevention in South Australia.

I give special recognition to leaders within Wellbeing SA, Ms Lyn Dean and Professor Katina D'Onise; they are due recognition in this chamber, and the other side seem to be silent. Their combined wisdom and strategic insight certainly have been the driving force behind Wellbeing SA's commendable accomplishments, and their personal and professional departure from Wellbeing SA is our loss. The list of achievements under Ms Dean's guidance is extensive, but certainly through her leadership in Wellbeing SA and COVID-19 management, the Open Your World initiative would sit at the top of that list. When it comes to the Suicide Register, I recognise the work that Professor D'Onise implements in safeguarding that vital data. To capture suicides is essential but very sombre work.

I thank and acknowledge the extraordinary people who volunteered to join a suicide prevention network around our state. There are about 50 or so, and I am certain the member for Elder will touch on her work involved with them. It is a proud association that the former Liberal government had as well, and I am proudly associated with the Wellbeing Trailblazers SPN situated in the Clare Valley for the Mid North.

The Premier's Advocate for Suicide Prevention has most recently visited the electorate of Chaffey for, I think, a statewide convention, and I thank her for her endeavours in supporting the SPNs, but I implore her to keep pushing into regional South Australia because that is where we need to see investment and support the most. Our farming families and communities are facing pressures when it comes to cost of living, a hot summer coming, and wine, wheat and wool prices in freefall.

While I would argue that this has been a useful conversation, I think there is much to do. Where sunshine is the best disinfectant, when it comes to mental health this Labor government has blocked out the sun.

Mr BELL (Mount Gambier) (11:53): I rise on the motion introduced by the member for Elder and commend her efforts regarding her advocacy for mental health within South Australia and her electorate. Mental health is such a complex topic, as the stigma behind it, especially for men's mental health, is so prevalent, despite almost everyone being affected in one way or another. Recognising World Mental Health Day opens the door for future conversations on mental health by reducing its stigma and encouraging every day to be a day when somebody can talk and raise awareness about mental health.

Living in a regional area, as we have just heard, it can be intimidating to share and speak freely about mental health, which is why I would like to draw attention to the hardworking individual in my electorate, Luke Thompson, who has taken upon himself to create a podcast, Let's Talk, designed to break the stigma around mental health. As written in The Border Watch, our local paper, Luke said, and I quote:

I thought there was a gap and I always wanted to start a podcast after I was diagnosed with depression and anxiety but didn't know how to go about it.

I have always been very open about my diagnosis and people started messaging and coming up to me, telling me how they battle with [their own] mental health.

This [podcast] is about getting people to open up and normalising mental health.

We go through this and it is normal, mental health is not a taboo subject anymore.

Luke's podcast has encouraged local regional people to speak and learn different ways to manage their mental health battles without feeling like it is an unwinnable war. His initiative to destigmatise mental health, especially regional men's mental health, is highly commendable and should be shared further outside Mount Gambier and the greater Limestone Coast region.

Recently, we saw the unveiling of concept plans for the proposed upgrade to the mental health unit at the Mount Gambier and districts hospital. This will include six short-stay beds and two specialist community drug and alcohol rehabilitation beds, as mentioned by the health minister a minute ago. As a regional hospital, these types of commitments are vital for adequate country living and community health.

Without the additional mental health beds, our hospital will be exceeding capacity, unable to support those struggling with mental health in time of urgent need; restricting the care of someone else in need of medical attention as standard beds are being used for mental health beds; or forcing unnecessary and expensive travel to metropolitan health facilities as there is no assistance locally. It is an important issue and, although there are still challenges with availability and funding for the Mount Gambier and districts hospital, every mental health bed is one step closer to better regional health.

On a slightly more lighthearted note, I would like to reiterate my praise for Adam Todd, Adam Richards, Jesse Plunkett, Celeste Raymond, Shane Raymond, Matt Roscow, Luke Thomson and Aaron Davis who, I mentioned earlier this year, established a Switch the Headspace Match for Mental Health. This football match was designed to do two things: raise awareness and funds to reduce the stigma around mental health and to educate the wider South-East community on mental health, aiming to encourage those who may not have traditionally sought mental health support and give them the ability to reach out.

The footy match, which featured ex-AFL stars Dane Swan, Leon Davis, Shane Mumford, Jordan Murdoch, Brodie Murdoch, Winis Imbi and myself—

Members interjecting:

Mr BELL: —I am kidding. But I did play for a small bit to a crowd of over 3,000 people and the game raised over $30,000 for the Limestone Coast Headspace.

This initiative, as amazing as it is, sadly started due to the increasing suicide rate of young people in our township. Those young boys knew that if what they needed to do to save a friend's life was to destigmatise and talk about the challenges and effects of mental health, then that was what they would do. Their advocacy for talking about mental health and reiterating that it is not weak to speak or to get mental health support is highly admirable and brave. I am sure it has helped more people than they will ever know. Therefore, I commend the motion to the house and thank the member for Elder for bringing this important topic to parliament.

Mr TEAGUE (Heysen) (11:58): I rise to commend the motion in its amended form to the house, and I will have a bit to say about that in a moment. I commend the member for Frome for really bringing to the fore the catalogue of actions taken by the former Liberal government and, in particular—as the member for Frome has described it, 'the jewel in the crown'—the Urgent Mental Health Care Centre, the subject of the amendment. It was indeed a significant achievement.

To address the government's paragraph (d), I acknowledge the government has taken a step to appoint a full-time mental health commissioner in SA, but let's be really clear: this is important. This is not a matter of being unnecessarily partisan. In my view, it is counterproductive if not disingenuous to link the establishment of the full-time mental health commissioner in terms of abolishing something and replacing it with a full-time role.

Let's be clear: when John Mannion was appointed by the former Liberal government as a commissioner—John Mannion is a man I know well and respect; he is a man of my community and he brought with him the years of experience as executive director of Breakthrough to that role—he joined co-commissioners Heather Nowak and David Kelly. That is well known. So we go from a model that in the experience of those years has led now to the recent appointment of a single commissioner, and if that is a step in the right direction, well, shoulders to the wheel.

But let's be clear about the fact that in the course of the former government there were multiple mental health commissioners, and I might just say in that regard, in connection with a rationale that was stated at the time, that the role of a mental health commissioner is to work with the community on a strong focus on early intervention and prevention as well as building resilience and mental wellbeing, and that includes continuing to facilitate partnerships across all levels of government and community.

There is a virtue in an approach that says multiple commissioners who are continuing their work—in John Mannion's case through his important work with Breakthrough, which continues, and I commend and thank John Mannion and all those involved at Breakthrough—is virtuous. But you had multiple commissioners. If there is an approach that says, 'Okay, we will be better off having a single full time,' let's see that working out, but, goodness, there is no need for engaging in the kind of partisan rhetoric that is associated with abolishing a role and replacing it with another. We can do better than that.

If I just pause there for a moment, we are here addressing private members' motions in the parliament. This is parliament's work, and parliament ought to have respect for the subject matter, and it ought to have respect for the process, but parliament ought to have self-respect about this. It is one thing for government to engage in messaging, spin and media pronouncement and so on, but it is another thing for parliament to go about the work that it does, analysing and interrogating matters that then parliament is considering putting its name to.

I might come back to that a bit over the journey as well. It is very important in this context that parliament demonstrates self-respect in the debate it is having and no less than on this very important subject matter. I am far from an authority on this particularly complex and difficult area. I was honoured briefly to serve in the last government as chair of the government's issues group on suicide prevention and in that role through several months in 2020 was engaged with the council and with John Dawkins in his role as the Premier's advocate.

That was an opportunity to work with the chief executives of the departments and together to work on how to improve on this difficult area, with a particular focus on the public sector and working closely with the Premier's Council as one of its working groups. One of those areas—and it perhaps goes to paragraph (e) of the motion, which is uncontroversial and not the subject of amendment—was in working towards reducing and removing the stigma that is associated with mental health, particularly with suicide and with the opportunity to seek help.

That, like other areas of social and community policy, is one that is complex. It does not come with easy answers and we know that the experience in the community does not lead us in a straight line towards knowing how to solve it. There is a stigma, there is a mystery, and we have to work towards being able to advocate more openly and we have to work towards being accountable for reducing incidences of self-harm and those terrible occasions where people take their lives.

Harking back to that short period in that role, I might just highlight in this regard one of the more outstanding of such community networks, being the Strathalbyn suicide prevention network, one of lots of networks around the state. The member for Frome has highlighted the need for action in our regions. Strathalbyn, being one such region close to the metro and perhaps touched by some of the issues that might be identified in metropolitan Adelaide but also very much in the character of the struggles that affect those in regional and rural areas of the state, really led the way in terms of being closely connected to community, having a mixture of those with what we describe as lived experience, those family members who have lived through the horrors of what it is to have a family member take their life, through to clinicians and those associated with the Strathalbyn hospital and healthcare services in the area.

It is really an exemplary example of what such a network can do to build its way into the ordinary day-to-day life of people in the local area. The boundaries have changed and Strath is now in the safe and capable hands of the member for Hammond, who continues that work and is very familiar with the work of that community over a long stretch, and so I am sure we join together in commending their work. I do for those reasons commend the motion as it has been amended by the member for Frome.

Mr TELFER (Flinders) (12:08): I rise to speak about a subject matter which is close to my heart. Obviously, those of us who have connection with community are all well aware of the challenges that we are facing as a society and as small communities with mental health and the way that we manage it, especially in regional areas. In my electorate, we have communities that are spread far and wide, and it is sad to admit that the supports that are in place for our regional communities in particular are absolutely inadequate for the need that we are facing at the moment for mental health supports.

I know that the tyranny of distance in South Australia can be a hindrance for so many different service deliveries and I, for one, anytime I get on my feet here, am trying to represent the needs of those communities in essential areas such as health care. Mental health care, in particular, is one that is especially pertinent. The rate of suicide in regional areas is higher, and campaigns have been run previously—as has been mentioned already—to try to remove the stigma from mental health challenges in regional areas amongst farmers and amongst community members and get people to realise that it is only by having supports in place that you can help yourself, through your connections, to get through some of the more challenging times.

As I said, it is especially pertinent within our farming community. We know the pressures farmers face with the way they need to balance business, family, the constantly changing seasons and the uncertainty that brings those businesses, as well as the generational expectations people can feel upon their shoulders. In regional communities, we have seen the rate of suicide amongst farmers at a really worrying level, and that is why I want to highlight the need for supports to be in place in regional communities, in particular, and my electorate of Flinders especially.

I know there have been moves in the right direction, but those moves often get stifled. There was an announcement a number of years ago about the opening of mental health beds in Port Lincoln. It was made with much fanfare at the time—off the top of my head I think it was the Weatherill government that made that announcement—and it was a step in the right direction but, unfortunately, my understanding is that those mental health beds have never been staffed, there have never actually been the supports in place in Port Lincoln.

For people in Port Lincoln, which is some seven or eight hours' drive away from Adelaide, and people who are farther flung out in the Far West who are 10, 11, 12 or however many hours away from Adelaide, that is their source of mental health support. That is really worrying, and it is a subject we should not shy away from when making decisions around resourcing mental health supports across our state, especially in regional areas.

I want to highlight—as I have done already in this place—the good work that has been done. I recognise that the member for Elder, in her capacity as the Premier's Advocate for Suicide Prevention, has visited my area a number of times, and I also want to highlight the great work that Mentally Fit EP does as an organisation under the umbrella of West Coast Youth and Community Support.

Mentally Fit EP was established in 2014 to try to change the narrative and negative communication around mental illness on Eyre Peninsula and to really advance the skills in our community in mental health to try to support others going through the challenges I have mentioned that are being faced. The organisation was set up by two women, in particular, who had a passion for mental health, Jo Clark and Kirsty Traeger, under the umbrella of West Coast Youth and Community Support.

Kirsty was someone I knew from Cummins from when we were young and was someone who had herself experienced mental health challenges firsthand. This drove her to help others in our community with similar experiences. In 2015, Kirsty travelled to Adelaide to accept the South Australian Event of the Year for the Port Lincoln 2015 Mental Health Week activities. Unfortunately, she tragically passed away in a car crash.

That really left a hole, and created uncertainty in that organisation, but I commend the amazing and passionate volunteers and community members who took that vision and really expanded it across Eyre Peninsula and who continue to try to remove the barriers for people searching for health and support for their mental health challenges. They run a number of fantastic events to enable and upskill people within our community to help provide the supports, and those people searching for that support within our community know that is a source of knowledge and empowerment for them.

I want to highlight the great work that West Coast Youth and Community Support are doing because mental health is not discriminatory. It happens across all ages. It happens across different categories of people. Whether you are rich or poor, whether you are a man or a woman, whether you are young or old it does not matter: mental health challenges can hit each and every one of us. West Coast Youth and Community Support are doing great work on southern Eyre Peninsula in particular but expanding out to the whole of my electorate. This is the time when I always encourage government decision-makers, people with their hands on the purse strings of government at whatever level, to really make sure they are investing appropriately in these sort of supports.

I want to also highlight the great work that Beacon of Hope suicide prevention in Tumby Bay in particular—my home town—are doing. Once again, it was born out of grief, out of the loss of someone close. The people who are involved in these networks bring passion to trying to highlight that there are opportunities for support, that there are ways to get through mental health challenges, and it is through community that this is most effectively done. The team are continuing to run events, provide support and even simple things like having available a drop-in capacity or someone who can be a shoulder to lean on and a help through some dark times.

I think it is really important and, as we would all reiterate in this place, if you as an individual—and we all know because we experience it ourselves—are going through those times, you need to reach out to your support networks, which will be available. They are harder to access in regional areas and that is why it is so important that that investment continues to happen.

I also highlight the great work that has been done in Ceduna by the Ceduna Youth Hub, a place that I visited only a short period of time ago. It is working with children of all ages to provide that community that support. As I said, mental health challenges do not discriminate by age and especially affect young people who are searching for direction in life, for meaning in life, for support in life. These sorts of essential services that the Ceduna Youth Hub provide get kids through some of the more challenging times. Peter and the team do amazing work. In my visit there, it was a real blessing to see that some of the people who are now working in that space at the Ceduna Youth Hub were the very young people who looked for support and help 10 years before.

This is what regional communities bring to the table. The thing that really does hit home for me in regional communities is that we all have connections to different individuals. We all have a story to share, whether it is firsthand, second-hand or it happened to people we know of who are struggling with their mental health in regional areas or, sadly, people who have succumbed to that and taken their own life. The close-knit nature of regional communities means that the support within those communities really needs to be robust, and I commend the people I have mentioned already, the organisations that do great work within my community and the many that I know do great work right across regional South Australia.

Mr WHETSTONE (Chaffey) (12:18): I, too, would like to make a contribution on World Mental Health Day and just reinforce some of the circumstances, situations and the challenges that everyday people face, particularly in the regions. As has been stated, those who live on the land, those who live off the land, particularly face strain and stressors that are exacerbated by the challenges of being a primary producer. Some of the challenges of living in a regional setting include the tyranny of distance, which does create a barrier, as does being somewhat isolated—isolated away from mainstream health support, whether it is mental health support or some of the suicide prevention initiatives that we have in society.

I think it has been very well documented that supporting one in five South Australians affected by mental health illness should be a priority of any government of any persuasion. This includes making sure that 45 per cent of South Australians who experience a diagnosable mental health illness throughout their life will better understand what it means to them and the needs that they would like to see addressed, particularly in a regional setting.

We know that suicide is the leading cause of death of South Australians between the ages of 15 and 44. As a local MP in a regional setting, I too have very proudly made initiatives not only as a local member, but a friend and I started up a men's shed. It was not the traditional men's shed that we all enjoy today, but it was a gathering of farmers, particularly men, who were going through a really rough period. That was back in the early 2000s, when we were going through drought and we were going through a downturn in commodity prices, not only in the wine industry but in a lot of the horticulture commodities.

That initiative has been running for over 30 years and it is still running today. We meet whenever I can, and when I am in the region I will get along on a Wednesday night to Bluey's. It is a men-only event and it gives an opportunity for men to have a conversation sitting around a roundtable. There is no music and we all take it in turns to cook, but we also show an initiative of starting that conversation. Many of these conversations are about exposing if someone is going through a tough time. It is about that conversation and it is about making sure that those visitors, whether they are new or ongoing, understand that they are not alone and that there are many who are in a similar situation.

As I have said, with these health issues—whether it is mental health, whether it is the conversation around suicide prevention—it has been well documented how much more magnified they are in the regions. Metropolitan Adelaide access to psychiatrists is comparable with the Scandinavian countries, but our regions are definitely at a disadvantage. I met with the Chief Psychiatrist only a couple of days ago, and the member for Elder graciously came up with her Suicide Prevention Council. I think it was a great initiative to come up to the Riverland and understand the challenges that that region is currently facing.

I also want to pay tribute to a couple of groups of women: Val and Judy, who gave an overview of what was happening in the Riverland. Val has been a long-time advocate of suicide prevention as well as the formation of the CORES Program. What we saw was that Val has had the initiative to come together and secure local government funding, and now the federal government has put some money towards trainers and community engagement officers. That has been a great initiative. I have been along to a number of community engagement meetings and it really does expose the vulnerability of people who are isolated in faraway places, living on a farm.

In some way, shape or form those people pull the blinds down and do not have an understanding of the support that is out there. Whether it is a medical professional or whether it is a neighbour or whether it is a good community citizen, those support mechanisms are there. I was very happy as a former primary industries minister to reinstate the FaB Scout mentoring program. That is about community people with some level of profile or understanding being able to knock on a door of the house knowing that that family member or that family is struggling, whether it is financially, whether it is their mental health, or whether it is social or marital issues that they are dealing with.

They sit down around the kitchen table and have that conversation and that understanding of just how severe the situation is and then comforting that person and saying that going to get help is okay and that having a conversation is okay. Many of these initiatives around that conversation really do help. We do not know just what some of those conversations have meant to a number of people. Has it saved a life? Has it saved an attempted suicide or a successful suicide? We know that men disproportionately lose their life through suicide because they just seem to be able to get it done, though that is not the right turn of phrase.

Sadly, I have been called to constituents' homes and I have been called to friends' homes where there are people who have attempted to take their life and who are not prepared to go and get medical help. I am a person without a uniform and without the baggage they deem would be intrusive, and I have sat down with people to get them talking and get them through that really tough phase.

I must mention the FaB Scout mentoring, particularly in the Riverland. Robin Caine, Brent Fletcher and John Chase are three outstanding community people who in many, many ways have had those conversations that will bring people out of an environment, where they are much more vulnerable, to gaining medical and professional help.

Some of the other initiatives I have attended over a long period of time include the Chew the Fat campaign. It has been a very, very successful gathering of farming men who come to a common shed in a district. They normally put on a few beers and have a pig on a spit, and they have motivational speakers there. I have listened to many motivational speakers. Derrick McManus is one many would be familiar with here in South Australia—a former police officer shot multiple times through a siege—and the story he tells is very touching. There are many more I could talk about, but I will not go into the detail because I know that I will forget names and the situations of some of them.

I must say that up in the Riverland we are currently going through some very uncertain times. We have the pressure on commodity prices, particularly in the wine industry, we have issues with some of the biosecurity challenges and we have the uncertainty with what the water reform packages will mean to regional communities. While I have the Deputy Premier here, I think it is pertinent that I do mention that a lot of governments make decisions in the city and do not have a clear understanding. I have lived it: I have been through water reform as an irrigator and I have seen what buybacks can do. I want to ensure that every available opportunity is dealt with, particularly in relation to people's mental health.

In closing, I want to make sure that any form of government of any persuasion does all it can to better support mental health and mental health support services and to acknowledge the great work our volunteers in regional settings do here in South Australia.

Mr PEDERICK (Hammond) (12:28): I rise to speak to this motion and the amended motion on World Mental Health Day. Mental health obviously affects everyone throughout the community to varying degrees. As has been indicated already today, there are many challenges, and there are many challenges at the moment right across the farming sectors of our state. We have had four or five pretty good years in agriculture. That does not mean there have not been challenging times with some of the seasons, but they have been pretty handy seasons generally—pretty handy incomes from sheep, cattle and cropping.

It has not been universal. There are certainly plenty of challenges in the irrigation sectors, with uncertainty about the future of water, with the flooding recently and the future of areas along the River Murray in South Australia, especially on the lower end, with what will be the management of those flood plain swamps into the future. It certainly can have, and does have, a debilitating impact on people.

I am hearing stories firsthand already, where we are seeing the sheep prices that are cascading because of what I believe are poor decisions about the banning, or the potential banning, of the live sheep trade out of Western Australia. It has a direct impact on stock prices not just here in South Australia but right across the Eastern States as well. Because of that, more and more stock is being trucked to South Australia, some to feedlots and some to abattoirs.

What people need to understand is that the live sheep price always put a floor in the market for those wethers that were heading, generally, to the Middle East. When you take a market completely out of an equation it kills the market, literally. It has had quite a debilitating effect. People getting sheep processed are getting charged now for getting rid of the skins, at about $2.50 a head. People do not think that is much, but it adds up to be a fair bit if you are sending, depending on the truck size, 400, 600 or 800 sheep on a load to be processed.

We have certainly seen that beef prices have come down as well. It is just the vagaries of the market. Some people have been caught—it was just the way the market fared—buying pregnancy tests at a higher price for in-calf heifers or young cows. The next thing, in a very short space of time, almost overnight, was that those prices had halved, and they have been left in a real situation where, instead of unloading that stock and trying to make some money, they have to find some feed, whether that is agistment or on another property.

There is also word getting through now that people have geared up—and that is fine. Machinery is very dear, very expensive, in farming. Harvesters now cost north of $1 million; a lot of tractors are knocking that $1 million mark; air seeders would be way up there, up around $600,000 or $700,000; and boom sprayers are around the same mark. I am probably a little bit off on the price, but it is an expensive game. It is an expensive game.

The issue is that, all of a sudden, there has been a serious drop in market prices for sheep and cattle, and that is having an effect. I am already hearing of properties that have been put on the market, family properties that have been held in families, sometimes for generations, because all of a sudden there is this major impact on the bottom line. It is tough, and we give our support to those farmers. They need all the support they can get.

Certainly, mental health is one of those things that affects people right across the board, including our youth. I acknowledge the work of Headspace in Murray Bridge and right across the state, helping our youth and giving them options to get together, whether it is just simple stuff like getting together and forming a band or just having somewhere to go and meet instead of sitting at home being on the infernal phone and getting trolled. Sadly, some kids, as we have seen in the past, have taken their lives because of what they have seen on social media. It is a terrible thing, some of the bullying that goes on. My heart goes out when you hear of those terrible circumstances and the terrible result, not just for the child, obviously, but for the families involved.

Right across my electorate—and the boundaries have changed many times in my five terms; I am in my fifth term now—suicide prevention networks right across the community are doing their best to get their message out to assist people so that they can make the right decisions moving forward. I know another group, Silent Ripples, in Murray Bridge every year has a memorial on the banks of the river, opposite the Bridgeport Hotel, remembering those who sadly have lost their lives to suicide and thinking about the families left behind.

I have also been pleased to be involved in Ski for Life. I do not think they have had an event for a little while now, but seven or eight times at least, probably more, I have been at the launch of that in Murray Bridge early in the morning. It is quite a few hundred kilometres to do the loop right through to Renmark. Some people ski the whole way, but usually it is teams skiing up the river. That is all about promoting suicide prevention and good mental health. They get quite a few teams there with the speedboats and support crews. It is a great way to get people together to get that message across.

Another thing I want to bring up today as the shadow minister for veterans affairs is veteran suicide. This happens far, far too often for the men and women who have served our country and, for a range of reasons, cannot get the answers they want. I note that the federal inquiry into veteran suicide is ongoing and has recently been in Adelaide. We need to do all we can for those men and women who signed up as recruits, sometimes at a fairly young age, to serve their country and were prepared from that moment to lay down their lives. No greater thing can someone give to their country. The fact is that they are prepared to do that.

Sadly, some have lost their lives in battle, but then so many more lose their lives when they come home. We see people coming home from the challenges of places like, in more recent times, Rwanda and Afghanistan and from the wars in Iraq. There are also people who have served in Timor and other places. This came after we saw the troops coming home from Vietnam, who were not welcomed home. A lot of them still struggle today. The more support we can give to people who have given their all and are prepared to give everything to those of us who are not serving in the military, the better. Whether it is home or overseas, it does not matter—it is vital service to our country wherever it is. I salute them all.

We need to make sure we keep getting the supports throughout the community. In the last little bit of time I have left, I want to acknowledge MATES in Construction as well, because the construction industry is another area where too many suicides take place. I acknowledge the work of MATES in Construction, where they have their toolbox meetings and those kinds of things to talk to tradies to just help them along and give them that good advice.

I would have missed a whole range of organisations, but I want to acknowledge everyone in their work to get the right outcome on World Mental Health Day. I thank everyone involved. I urge people, if they are in trouble, just to talk to someone. There are plenty of people prepared to listen. I support the amended motion.

The Hon. D.G. PISONI (Unley) (12:38): I rise to support the amended motion, because this really is beyond politics. I think we need to send a very strong message collectively in this place that finally those who make decisions recognise the importance of working together in this matter. Having a brother who has been a prominent player in the union movement and in the Labor Party for as long as I have been in the Liberal Party, we both want the same thing: we both want the best outcomes in our education system, the best outcomes in our health system and the best job opportunities. The politics is how you achieve that—that is the politics. That is why you hear different policies from different sides of politics. The Liberal Party will have a different suite of policies to achieve that aim of the best schools, for example, and the Labor Party will have a different set of policies. Most of those are ideologically driven.

When it comes to mental health, support and care I think there is probably very little difference in the way we think we can achieve that. We know how important it is for people to be resilient. We have never been in such a changing world. There is the impact of social media on young people. If you were having a difficult period at school as a teenager, at least you had your weekends and after school free from that extra stress. Now, of course, with social media it can be 24/7. It does not matter if you ban mobile phones in school because most of the activity happens outside school hours.

Never before have we seen such an intense period of stress on our young people. We must ensure they have the resilience and the determination to see through another day. As my kids were growing up, I would say to them, 'Today might be a pretty shitty day for you, but just remember, tomorrow will be better.' 'Tomorrow will be better' is a very strong message for people who are feeling down. It is only a temporary feeling and obviously it is important to work with that person so they can understand that there is a way out for them that will see them back enjoying life and enjoying their time.

Dealing with depression is a very difficult period for any family and it is easy to dismiss somebody who is suffering from depression as just being a grumpy person or someone who is not pragmatic enough or somebody who is too lazy. It is important that we understand that non-social behaviour by someone close to us could have a much deeper root.

It is so pleasing that we are seeing major sporting codes, particularly some that are considered to be very masculine, now openly talking about someone who might be taking time off to manage their mental health, because we simply cannot have a situation where it is not spoken about, where people are discounted on their worth because they might be suffering from mental health or suffering from depression or suffering from stress.

There is a saying we tend to hear when in a job like ours or in business or some other jobs such as health care, where you might be continually drawn to matters of concern and matters that you worry about, and that is, 'Don't worry about it because if you can do something about it, fix it. If you can't do anything about it, there is no point in worrying about it because you are simply not going to be able to change it.' If you have analysed it, you can see you are not going to be able to change it, so do not worry about it because there is nothing you can do. It is just a waste of your energy. Put your energy towards fixing the problem that you are worried about. Then, of course, if you are doing that, there is no need to worry about it because you are taking the action that is required in order to do that.

Staff taking phone calls in our electoral offices witness mental health issues and come into contact with people with mental health issues on a regular basis. I do think that additional training for electoral staff in dealing with such matters would be of value. It does not necessarily need to be an accredited training course. I think it needs to be the sharing of experience on how you deal with such a matter. We do know that sometimes people can start quite young in their working careers working for a member of parliament, whether it be in the Legislative Council or the House of Assembly or whether it be in a regional electorate or in a metropolitan electorate, and those matters come through the electorate office.

I can remember that probably close on 10 years ago I had a gentleman from public housing in Parkside who came to see me because he had aliens contacting him and he wanted me to stop it. Of course, I was very sympathetic and understanding. I made some inquiries about what advice I could be giving to this person. He was known to the authorities.

Unfortunately, although he was known to the authorities, a few months later there was a report of a house fire in Parkside. This particular gentleman, who was well into his seventies, had resorted to removing the aliens by blowing up himself and his house in Parkside. As someone who was involved in that process, it was quite shocking to experience it and to see the full impact of somebody with mental health issues who was not able to be dealt with. It is very difficult to know where to start without any training on how you deal with such a matter.

Recently, somebody who was driving a taxi for a living made a similar claim that their conversations were being interrupted by somebody in the Department for Transport. He was not able to tell me how they were being interrupted, but when he was in the taxi he kept hearing the voice of this person from the Department for Transport. I made some inquiries and was pleased to know that people were aware of his situation. He was no longer driving a taxi for safety reasons for passengers, I believe, but again it is another situation where shared experiences or direct experiences may very well help people to be of assistance to people in those sorts of positions, whether they be neighbours, family, members of parliament or staff members of members of parliament.

We tend to be the first point of call when people do not know what else to do and often it is a call of stress or a call of lack of empowerment to deal with the situation that they are in. We do know how difficult it is to refer that person to help. Firstly, there is finding that help—finding someone available who might have an appointment open—and, secondly, there is whether they have the money to seek the help or whether they have the time to wait for the public health system to help them with their issue.

I support the amended motion because it is a very strong message to the people of South Australia that this parliament is united in supporting them in their times of challenge. I urge the house to support the amended motion.

Mr HUGHES (Giles) (12:48): I have a few words of support for the original motion, and it is an important motion. A number of people from regional South Australia, a number of members, have indicated sometimes the paucity of services in regional communities. It is a real challenge at times getting health professionals to sometimes visit regional communities, never mind being resident in a regional community. I am not sure if there is one psychiatrist at the moment that is a resident of a regional community. Over the years, there have been very few in number. It is very hard to get them outside of the metropolitan area.

I remember a time in Whyalla before we had a mental health unit at the hospital. Lyn Breuer was the member and it was the Rann government, but before that, I remember the tragic images—and it was usually the police going out to a house—of someone with a mental health condition being put in the back of a paddy wagon, being driven either all the way to Adelaide or part way to Adelaide and then being transferred into another paddy wagon. It is an appalling thing to happen.

The police are often on the frontline of very challenging situations, and sometimes that does involve people with various mental illnesses. But, in saying that, we know that people with mental illnesses are less likely to offend than the general population, so I am not here to stigmatise. I am just here to say that, historically, some of this used to happen in what was, at the time, the largest regional community.

As I said, there was then a dedicated mental health facility. It is in the new part of the hospital in Whyalla, with six beds. It is not a secure facility but it does make a difference to what can be done in a regional community. But there is no resident psychiatrist there—there was one, but there is not at the moment. That is a real issue when it comes to regional communities' access to those services.

There are a range of organisations in our communities that do incredibly good work. In Whyalla, there is the Whyalla Suicide Prevention Network, a network that had a tragic loss of their chair, Kimberley Pursche, in a car crash just outside of Whyalla. She was a real driving force behind that organisation in Whyalla, and they did a lot of good work. In my broader electorate, I have the APY lands. When you look at the youth suicide rate for Aboriginal kids, it is through the roof and something that we need to seriously address and address all the complexity around it. It is tragic to see any young person take their life at a young age.

Some of the members have referred to the veterans and some of the challenges that they face. It always staggers me when it comes to priorities. Different governments have different priorities, but when I saw half a billion being spent federally on expanding the War Memorial when there was a desperate need for more effective services, more efficient services, more timely services for our veterans, I thought, 'What on earth is going on here with the priorities that we have?' I would rather see the investment going into people who need it than buildings and what looked like to me a bit of a vanity project at the time. That was a serious misallocation of resources.

It is welcome that there are going to be 120 extra mental health beds rolled out in our public hospital system because they are really needed. The fact that there has been that absence of beds and the professionals to go with them is one of the contributing factors to ramping in this state. But we should never lose sight of the fact that, here in South Australia, we need to be doing more in regional communities where there are massive gaps in the services available.

I have a daughter who works in this area. Sinead is a psychologist and at the moment she still lives in Whyalla—how long that is going to continue, I do not know—and works for Headspace. It was one of those things where you look at the sorts of incentives that are available for professionals to live in communities. Headspace funded her to become a registered psychologist after she graduated on the basis that she would commit to working for Headspace for some years after that. We need to be providing incentives to get people into regional communities, but it does go broader than that because it is often not just money; there are perceptions around lifestyle, there are people with partners and a whole raft of other factors that come into play.

We should not forget GPs in this argument because as primary health providers they are often the ones who see people initially in the city and in regional communities. We know that in country areas, and in some areas in the city, we are really struggling when it comes to GP services. There are long waiting lists and sometimes it is not even possible to get in to see a GP in country areas. That is primarily a federal issue but there is a whole raft of other complicating factors around GP services, so it was good to see the current federal government inject $3.5 billion into addressing the collapse in bulk-billing.

I think any of us who live in a country community servicing a regional community know that we have to do far more when it comes to mental health services in the country. Some of these communities have incredibly strong needs. The member for Unley mentioned public housing and some of the issues there. I know in my community, and in some metropolitan communities as well, a place like Whyalla, because of the history of industrial policy, probably has on a per capita basis more old Housing Trust houses still in public hands than in other places.

What that tends to do then, because it is now all category 1, is concentrate issues in communities without the services to meet the needs of people with mental health needs and, indeed, other needs. So there needs to be a real rethink on what we do in that area, given in some ways there will be unintended consequences because of housing done for industrial policy reasons having this long-run legacy when it came to a shift in policy, concentrating people who are designated as category 1. Disproportionately some of those people have complex needs, so it is not good to concentrate people like that in regional communities with a deficit when it comes to services. I might conclude there so Ms Clancy can talk quickly.

The ACTING SPEAKER (Mr Brown): Thank you for that brief contribution, member for Giles. If the member for Elder speaks—although not the original mover, it was moved in her place—she closes the debate.

Ms CLANCY (Elder) (12:58): I want to thank my wonderful adviser for helping to prepare a fantastic speech that, unfortunately, none of you will get to hear. The reason why none of you will get to hear it is that so many people in this chamber are passionate about mental health, so that is a really good thing. I really appreciate everyone's contributions, and I am also very grateful that you all have such great connections with your local suicide prevention network and with the work that is happening on the ground.

On Sunday and Monday this week, I was in the Riverland for my second visit as the Premier's Advocate for Suicide Prevention. I was there on our inaugural Suicide Prevention Council regional trip. All our other meetings have been held in the city and we thought it was really important for us to go out and have a chat with people in our regions, who we know are often more greatly affected by mental challenges and suicide.

I was really pleased to bring the council there and for them to be able to hear from all these incredible people doing such great work. There is this guy called John Gladigau—and I know the member for Chaffey is well aware of him—who is a grain producer, a grain farmer. He wrote and starred in a play, a musical, that is all about country people and mental health and puts it into language that people in regional communities can really relate to. It was really great for everyone else on the Suicide Prevention Council to hear from him as well. I feel like the Acting Speaker is about to tell me to stop.

The ACTING SPEAKER (Mr Brown): You may seek leave if you wish.

Ms CLANCY: That's okay. I just want to thank everyone very much for their contributions, and thank you to all the people doing great work in this space, especially our Suicide Prevention Networks.

The house divided on the amendment:

Ayes 12

Noes 22

Majority 10

AYES

Basham, D.K.B. Batty, J.A. Cowdrey, M.J.
Hurn, A.M. McBride, P.N. Pederick, A.S.
Pisoni, D.G. (teller) Pratt, P.K. Tarzia, V.A.
Teague, J.B. Telfer, S.J. Whetstone, T.J.

NOES

Andrews, S.E. Bettison, Z.L. Bignell, L.W.K.
Champion, N.D. Clancy, N.P. Close, S.E.
Cook, N.F. Fulbrook, J.P. Hood, L.P.
Hughes, E.J. Hutchesson, C.L. Koutsantonis, A.
Michaels, A. Mullighan, S.C. Odenwalder, L.K. (teller)
Pearce, R.K. Picton, C.J. Savvas, O.M.
Stinson, J.M. Szakacs, J.K. Thompson, E.L.
Wortley, D.J.

PAIRS

Speirs, D.J. Hildyard, K.A. Gardner, J.A.W.
Malinauskas, P.B. Patterson, S.J.R. Boyer, B.I.
Marshall, S.S. Piccolo, A.

Amendment negatived; motion carried.

Sitting suspended from 13:06 to 14:00.