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Legislative Council - Fifty-First Parliament, Third Session (51-3)
2009-03-26 Daily Xml
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MENTAL HEALTH BILL

Second Reading

Adjourned debate on second reading.

(Continued from 24 March 2009. Page 1642.)

The Hon. CARMEL ZOLLO (12:02): I rise to make a short contribution on this bill. As the first minister for mental health and substance abuse in South Australia, albeit for a short time before the last election, I rise to congratulate the minister in another place on introducing this very important piece of legislation. When one considers that one in five, or 20 per cent, of Australian adults will be affected by mental illness at some time in their lives, one can see the importance of having a dedicated portfolio in this respect. The legislation before us concerns itself with the 3 per cent who are seriously affected by their mental illness.

Members would be aware that a thorough review of the act was undertaken and chaired by Mr Ian Bidmeade, a legal policy officer and solicitor. At the time I became minister for the portfolio in late 2005, the government had recently released the report of the review, 'Paving the way', of the mental health legislation in South Australia. The report was distributed to some 500 stakeholders and was well received. It proposed a number of changes to modernise the legislation and improve responses to people with mental illness. The majority of the changes recommended in the report were supported by the government and have been adopted in this legislation.

At the same time, the government has complemented this legislation with a number of other important provisions for the delivery of services for those mentally ill, ranging from significant infrastructure construction for both primary and step-down centres and funding for NGOs involved in service delivery to the release of the master plan for the Glenside site. The recommendations of the Social Inclusion Board are to be commended. The reform package announced by the government is in the order of $107.9 million. I also congratulate my colleague in this place, the then minister (Hon. Gail Gago), for her work in furthering this legislation and other initiatives during her time as the minister responsible for mental health and substance abuse.

The aim of this bill is to provide that contemporary framework for the provision of services to people with serious mental illness who are either unwilling or unable to consent to their own treatment. Because this bill is primarily about the use of powers to treat people with serious mental illness against their will, it does provide for the checks, balances and protections necessary for the transparent and accountable exercise of these powers.

The minister has already placed on record that the objects of the bill were refined following consultation and included to ensure that people with serious mental illness retained their freedom, rights, dignity and self-respect as far as is consistent with their protection and the proper delivery of mental health services designed to bring about recovery as far as is possible. It is also noted that the protection of the public is addressed in this legislation as well.

Like all members, I was pleased to receive a letter from Carers SA in support of the legislation. We all recognise that it has been a strong advocate for changes to this legislation for some years. We all agree that it is the carers who frequently take responsibility for the care of the consumer in the community, including medication, medical appointments, social and living arrangements, pre and post acute care in the community, and emergency assistance. When I was the minister responsible, Carers SA provided strong advocacy on behalf of carers.

The bill recognises the role of family carers as partners in the care by the provision of relevant information to them and includes them in the development of ongoing treatment plans and discharge planning. I have had brought to my attention, not only at ministerial level when minister but also at the constituency level on a number of occasions, the importance of including carers in the development of ongoing treatment plans and discharge planning. When they are not included it is they who are left to pick up the pieces and restart the merry-go-round of medical visits and assessments, ensuring medication is complied with, meeting accommodation requirements and ensuring that income support is in place. A recent constituent case comes to mind where, inadvertently, the family was not aware of the discharge plans and it was necessary to take urgent action to rectify the situation.

As has already been placed on the record, patients and their carers have welcomed the requirement for treatment and the care plans in this bill and their involvement in the development of the plans. Those who love and support the consumer also find themselves needing to make life-changing decisions, so it is timely that their role is recognised in this legislation.

I again concur with the minister's comment that it is important for families to have their role as informal, unpaid family carers, as partners with service providers in providing the care and treatment of their loved ones, to be recognised. The appropriateness of sharing of information with carers who care for a person with a mental illness, who is subject to an order, cannot be emphasised enough.

I also place on record the commitment of all advocacy mental health groups and NGOs in the provision of mental health services in our community. Yesterday morning, I am certain along with everybody else, I received a copy of the latest newsletter from the Mental Health Coalition of South Australia. I was pleased to see on the front page the following:

The state government has invested in mental health policy, strategic direction and infrastructure. The Social Inclusion Board's Stepping Up Report and the South Australian government's responses identify new models of care to drive change in the system to a more recovery-oriented focus. New models of care are being developed and implemented across the mental health system with more emphasis on community based support services. State government initiated amendments to the Equal Opportunity Act are proposed to include protection of people with mental illness from discrimination.

The concluding comments are that we are moving in the right direction but there is still more to be done. I would respond that the mental health area is one that this government has demonstrated its strong commitment to and, of course, I would always recognise and respect the role of the Mental Health Coalition in advocating for more. This legislation also deals with the monitoring and strengthening of ECT as well as the strengthening and protection of neurosurgery procedures, and updating the legislation as required.

As one would expect, and as outlined by the minister, the criteria for compulsory intervention for the purpose of mental health care and treatment are critical components of any mental health legislation as they determine when an individual's wishes can be overridden and assessment and treatment provided compulsorily. These are matters that have required close consideration by all the parties involved.

The bill sets out the new criteria for a community treatment order or detention and treatment order. We see a changed threshold for intervention orders to better manage risk for the affected person and the community, with the intention of facilitating early access to care and treatment if appropriate. It is hoped that enabling people to obtain early assessment and treatment, if required, will assist to reduce the risk of both suicide and homicide arising from illness that is untreated. The Guardianship Board will continue its important role in that in most cases community treatment orders will result from applications made to the Guardianship Board.

Another area that is to be improved is that of responsibility for the transport of those who suffer with a mental illness. It also deals with changes as to who can transport those who appear to be suffering a crisis with their mental illness by defining which officers can provide that transport when the use of police is not required. A memorandum of understanding has also been further strengthened between parties involved in the transport of people with mental illness. The partnership between health professionals and the SA Ambulance Service is particularly recognised when early access to care and treatment is required by the setting up of the new Mental Health Triage Service.

Whether it is this government's capital works program that is replacing old facilities, the furthering of important partnerships, the support for the delivery of high-quality services in the community or this important piece of legislation before us which provides a strengthened framework for those who are seriously mentally ill and need intervention, this government has demonstrated its strong commitment to those who suffer from mental illness.

Obviously, I am very pleased to support this legislation and have this opportunity to make a brief contribution. In particular, I would like to acknowledge the work and interest of all those who have had an input into this very important bill.

The Hon. R.D. LAWSON (12:13): I take up the last comment made by the former minister; namely, as she said, 'This government has demonstrated its commitment to people with mental illness.' The Attorney-General exposed the hypocrisy of that claim last week when he publicly admitted that mental health is not a priority of this government. He said he receives 50 submissions every day and that this is certainly not a priority of the government.

It is clear that, from the whole of the record of this government, it is not committed to providing adequate assistance to people with mental health issues in our community. One only has to see its appalling record in relation to the suggested redevelopment of Glenside Hospital; one only has to see the fact that James Nash House has been under-resourced; and one only has to read the comments of the Chair of the Parole Board (Frances Nelson QC) when she says that she has been batting her head against a brick wall in relation to the inadequate facilities for the supervision and care of those who are under licence, having been found not guilty by reason of mental incompetence. One only has to note that the Bidmeade report was delivered to this government in April 2005, and yet here we are in 2009, finally considering legislation.

I think it ought to be exposed right at the very beginning that this government does not have a proud record in relation to mental health issues; it has an appalling record. It has been more interested in headline chasing, in scapegoating criminal groups and the like and chasing votes rather than improving services.

The objects of the Mental Health Act, when this bill comes into operation, will be as follows: to ensure that persons with serious mental illness receive a comprehensive range of services of the highest standard for their treatment, care and rehabilitation with the goal of bringing about their recovery as far as possible.

That is the first object of this act: a noble sentiment, with which no one would disagree. However, the fact is that simply passing laws of this kind, without supporting them with appropriate resources and effective administration, is just idle hyperbole. This is a motherhood statement of no real significance, especially when you have a government that is not seriously committed to addressing those aims.

The second object of the act is to ensure that persons with serious mental illness retain their freedom and legal rights and can enjoy the ordinary patterns of life as far as is consistent with the proper delivery of services and the protection of the public.

Once again, a noble objective with which we would agree; in fact, nobody would disagree with a proposition of that kind. However, once again, if people with serious mental illness are to enjoy ordinary patterns of life whilst at the same time the public is being protected, there is a requirement for appropriate supervision and resources to ensure that that objective is met.

Whilst I support the principles of this bill and many of the changes that are made, I think it is important to place on record this government's abysmal record. The only other matter that I would raise in my second reading contribution—others will be raised during the committee stage—is the question of the community visitor scheme. I remember a university intern, Judy Clisby, writing a paper suggesting—and I think her paper was the first in South Australia in a formal sense to suggest it—that we adopt a community visitor scheme, and I made some mention of Judy's report at the time in parliament.

Bidmeade suggested, once again, as I remind the council, in April 2005 that all states apart from South Australia do have community visitor schemes to provide external monitoring of mental health and disability services. Bidmeade drew attention to the Victorian Mental Health Act, which empowers community visitors to inquire into the adequacy of services for assessment and treatment, for facilities, opportunities for recreation and training, etc., for the best possible care with the least possible restrictive environment, and to inquire into complaints made by consumers to the community visitor scheme.

In that state, the scheme is administered by the Public Advocate. Bidmeade noted that a similar scheme applied in New South Wales, where it was administered by the New South Wales community services division ombudsman. Bidmeade recommended the introduction of a community visitor scheme in this state. I believe that it is important that we do have this form of external scrutiny. For a government that claims to be open and accountable, it is amazing how often it objects to any proposed reform that will bring openness and will bring mechanisms for accountability. It has been vehement in its opposition to the establishment of an independent commission against corruption. It maintains its opposition at every opportunity.

The Attorney-General berates those who are propounding the establishment of such a commission. Likewise, in relation to our mental health system, where a simple mechanism that has been adopted elsewhere for encouraging openness and accountability is proposed, it is rejected. I am delighted that the Liberal Party will be supporting an amendment to this bill that will introduce a community visitor scheme in this state, and I look forward to the debate on that. I think that is one important measure that ought to have been included, but this government has not done so. One can only again ask why it has not. What does it have to hide? Why does it not want the probing eyes of community visitors in our mental health system? I look forward to the committee stage of the bill.

Debate adjourned on motion of Hon. J.M. Gazzola.

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