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Legislative Council - Fifty-Fifth Parliament, First Session (55-1)
2023-02-08 Daily Xml
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Transcranial Magnetic Stimulation

The Hon. T.A. FRANKS (16:32): I move:

That this council—

1. Notes that—

(a) transcranial magnetic stimulation (TMS) is an effective treatment option for some people with major depression;

(b) in 2018, the Royal Australian and New Zealand College of Psychiatrists recommended that 'TMS should be accessible in private and public mental health services and made available in addition to the current spectrum of treatment options';

(c) in 2022, the Prescribed Psychiatric Treatment Panel, a part of the Office of the Chief Psychiatrist of SA Health, recommended that TMS be introduced into public mental health services as a first-line treatment ahead of the significantly more disruptive electroconvulsive therapy;

(d) the inclusion of TMS in the range of options available under the public health system would ensure that people have access to suitable treatments that allow them to continue living their lives.

2. Calls on the health minister to ensure that TMS is made available to South Australians by including it in our public health system.

I rise to speak on the issue of the availability in this state of repetitive transcranial magnetic stimulation in our public health system. Repetitive transcranial magnetic stimulation (TMS) is a treatment for people suffering from a large range of mental health issues, but predominantly it is used in the treatment of major depression.

TMS is an option for people who have found that other treatments have not been effective. It is an option that does not require people to be admitted into hospital. It is a treatment that allows people to keep functioning in their everyday lives.

TMS is a form of neurostimulation, which unlike other forms does not require that person undergoing treatment to be put under general anaesthesia or to be an inpatient throughout their treatment. TMS can be done with minimal disruptions to the patient, yet for many suffering major depression it can be effective.

Someone undergoing TMS would visit a treatment facility, be awake and sitting in a chair for around 40 minutes while they receive that treatment. That person would then be able to get up and leave and continue with their day, whether it is work, uni, family commitments or whatever, but currently TMS is not offered in the public health system in South Australia. For people with private health insurance who are able to afford the out-of-pocket costs, the treatment is available, yet for those who cannot afford this option that lack of availability is a real challenge.

Within our public health system people have the option of the significantly more disruptive electroconvulsive therapy, or ECT. This is more intensive neurostimulation and requires the patient or the consumer to be in a hospital and to go under general anaesthetic. Indeed, it is disruptive, it is distressing and it is invasive. It is a choice of suspending their life while they have the life-saving option presented to them. While TMS offers a less disruptive, less distressing and less invasive option—and indeed the studies have shown that it helps around 50 per cent of patients who experience treatment resistant depression—it is not accessible, even if you can afford it.

What is quite concerning is that, as of November 2021, TMS therapy was listed on the Medicare Benefits Schedule and there are industry calls to introduce it into our public health system as an alternative non-invasive low-risk option for those experiencing major depression, but these have yet to be acted on. Back as long ago as 2018, the Royal Australian and New Zealand College of Psychiatrists recommended that TMS:

…should be accessible in public and private mental health services and made available in addition to the current spectrum of treatment options. It should be affordable and, where appropriate, offered as a therapeutic option for the treatment of major depression.

Last year in South Australia, the Prescribed Psychiatric Treatment Panel, in conjunction with the Office of the Chief Psychiatrist of our state within SA Health, also recommended that TMS be introduced into our public health system, into our services as a first-line treatment ahead of the significantly more disruptive ECT option.

Accessible, affordable treatments for mental health are vital. They save lives. They help people live lives better. TMS presents an opportunity to help people who otherwise may enter the hospital system and undergo a more disruptive and invasive treatment when TMS would have helped them and potentially prevented them from needing further treatment. We must provide a spectrum of treatment options which allow people to get the mental health treatment they find most effective for them—that works the best for them and allows them to live their lives.

I was not familiar with this treatment, and certainly I think most of this place would be unfamiliar with ECT. I thank in particular an advocate who came and met with me, Mr Sam Diprose, for raising this issue with me. He has benefited from being able to access this treatment. He is able to live a good life because of this treatment, and he has now made it his life's mission to see South Australia ensure that others' lives are saved in the same way that he believes his has been.

I have written to the member for Elder in her role as Premier's Advocate for Suicide Prevention, and I have also written to the Minister for Health, but I raise this motion here with all members of this parliament in time for budget discussions. This is a life-saving measure. It is a measure that a person living interstate would be more readily able to access. While I was on holiday in New South Wales I googled 'TMS near me', and I was able to find a range of options that simply are not present currently in South Australia.

During the past election, the Premier made health a major election issue. That was because the people of South Australia demanded that health be a major election issue. The Premier was fond of saying—and I note that I put it on the Hansard first—that if COVID was the earthquake, mental health is the tsunami. Well, the tsunami is coming, and we do need accessible, available TMS to ensure we are preparing South Australians and supporting South Australians to build back better, to recover and to live their lives well beyond COVID or beyond what other traumas or other issues they have that have given them the unfortunate experience of either major depression or other associated conditions.

This is a very simple motion. It takes the experts' words and calls and it puts them before this council. I hope that it will put pressure on the Malinauskas government to act and to ensure that we have these options for South Australians announced in the coming budget.

Debate adjourned on motion of Hon. I.K. Hunter.

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