Lyn Allison (Victoria, Australian Democrats) Share this | Hansard source

First of all, my sincere thanks to Senator Moore, Chair of the Senate Standing Committee on Community Affairs, and to the rest of the committee for agreeing to deliver an interim report on this important inquiry. I recognise that it has been done for my benefit, since I will not be around on 25 September for the final report. That disappoints me somewhat. However, when I saw the interim report, as drafted by the chair, I felt very confident that that inquiry and its report are in extremely good hands. Again, I thank the committee for taking on the first inquiry into mental health services in this country, and to you, Senator Humphries, as chair at the time, I say thank you for your efforts.

It is my view that the community affairs committee is one of the best in the Senate. We work collaboratively, we work cooperatively and we deliver excellent reports, and that is because we pick up on issues which are very important to the community. Almost all of our inquiries receive an enormous number of submissions, even from state governments now and again, so we have that cooperation in inquiring into these very difficult and complex areas of service delivery where there is a crossover of jurisdiction and responsibility between state and federal governments. Mental health is probably one of the most complex areas in respect of crossing over jurisdictions.

As I said, I was enormously pleased with the interim report. It succinctly covered the issues. I thought our first report was very comprehensive. The recommendations we made were sound, so we felt it was important that we followed up with a second report to look at the COAG process. An enormous amount had changed since the previous report. Not only did we liberate $6 billion worth of new mental health services from the Commonwealth, state and territory governments but it seems that our work in this place has generated a lot of thinking about mental health and, if I can be so bold, has even encouraged state and Commonwealth agencies to work much more closely together for a common aim, instead of engaging in the usual buck-passing and cost shifting that we have seen in the past. I count that as one of my most important actions on behalf of the committee since I have been here and that, I think, says something. When you understand the effect of mental illness on the lives of people and their families who are directly impacted you begin to understand the scope of the problem. I think it is fair to say that in the past in this country we have, as have many countries, tended to bury this issue and not tackle it directly head-on. We discovered in the first inquiry and in this one that, whilst there was adequate care—although even that was under pressure at the acute end of the mental illness spectrum—people whose illness could be interrupted, intervened upon, even prevented were being ignored in the whole process.

This penultimate report is the sum of an enormous amount of work which is being done not just by our committee but also by agencies who have put in the time and effort to make submissions, who have appeared before our committee right round the country. It is a collaborative, collective effort of many people, and I want to acknowledge that. I want to thank the secretariat for their work. This report was done in record time and, as I said, it is very rare for me to look at a report prepared by the secretariat and have absolutely no corrections I want to make or additions I want to put to it. I just read it and I thought, ‘Yes.’ Congratulations to the committee for delivering that report. It was a great pleasure to read and it certainly reflected all of the key issues. I know the next report will come out with much more detail. It will have what people actually said to us in submissions and in evidence given before the committee and it may have some recommendations—I do not know what they will be—but I am very confident in the ability of the chair, Senator Moore, to deliver an important report again. In all, I am enormously pleased to have been part of this process. I know that it makes a difference to people’s lives in a way that probably not much else in this chamber that we do does.

Mental illness touches one in every five families at least. We know the prevalence of mental illness. We know the shortcomings of our system. We know the number of people who are homeless, who are unemployed, who fail to get services, and this committee has been able to do something about that. It was a record response by the Howard government to this. I think we had the cheque for $1.9 billion on the table within days of tabling our last report. That must be a record in this place. The department and the government showed a keen interest in the whole of our inquiry. I understand we had departmental people who were monitoring the whole process, so they were benefiting, if I can put it that way, from the evidence that we heard very directly and very immediately.

All in all, it was a very pleasing response. But it did tell us, as I said, that the $4 billion was not enough, that the level of spending on mental health services still did not match what is called the DALYs, the disease burden on the community, and that mental health has always been the poor cousin of other areas of health in terms of a unmet need and attention to this difficult area. And the committee found that there were some aspects of the COAG proposals which we thought could have been done better. In fact, we would just rather that all state and territory governments had picked up on all our recommendations.

However, there are other points of view and clearly some of those recommendations were taken up and some were not. One of the central questions here was whether or not we were getting good return on the investment. An extra $4 billion is a lot of money to be spending on mental health, so central to this second inquiry was the question, in relation to our evaluation and our collection of data, of whether even at a later stage—it is early in the process—we would be able to look at the data and say, ‘Yes, this works.’ I think central to what we found was that it is possibly not the case and that we need to be much better at evaluating the programs that are in place and seriously questioning whether they are best practice.

Unfortunately, in mental health as in so much else we inherit an existing system which is a mix of public and private, a mix of providers, and if you just tweak around the edges you probably do not get as far as might be possible if you had a clean slate. So we have to work with the systems that we have, and that is certainly what the government has done. But I think we need to look carefully at how effective that is.

Our second inquiry provided us with important mechanisms for identifying the problems with the new initiatives and to highlight the service gaps and shortfalls which still remain, as well as showing us that progress had been made and it was substantial. A long overdue injection of funding has allowed the provision of more community based services along with much greater access to clinical services provided by psychologists and other allied health workers. That is perhaps one of the most important initiatives that was taken up by the previous government and continued with this government—the ability of general practitioners to be able to refer patients to, particularly, clinical psychologists. They were the ones who did most of the consults for people to get what we call the talking treatment, to not just be put on medication and pharmaceutical products but be able to have their needs met by other professionals, who, to be honest, will have much more training in mental health than many GPs, who may go through their undergraduate medical courses without having done any training in this area. It is not that they are not doing a good job; the question is, is it good enough?

Some of our responses—at least mine—to the COAG proposals were negative, and I have to say that the Personal Helpers and Mentors Program was one of those. Again, an enormous amount of money was to be spent on this, and some of us were sceptical about whether this would work. It did not seem to have been integrated into services and that was a central theme of our first inquiry. But it turned out that this had been—