Senate debates

Tuesday, 11 September 2012

Adjournment

World Suicide Prevention Day

8:37 pm

Photo of Concetta Fierravanti-WellsConcetta Fierravanti-Wells (NSW, Liberal Party, Shadow Minister for Ageing) Share this | Hansard source

I seek leave to speak for 20 minutes.

Leave granted.

I rise to speak on World Suicide Prevention Day, which was yesterday. World Suicide Prevention Day has become a very important day in our calendar. It is now held every year on 10 September around the world. After its successful launch in 2003, this day has seen numerous events, conferences and a whole range of other activities undertaken to call to public attention one of the world's largest causes of premature and unnecessary death. The International Association for Suicide Prevention, in collaboration with the World Health Organization, calls on governments, agencies, NGOs and a whole range of other organisations to be involved in organising activities. On World Suicide Prevention Day, the coalition encouraged everyone in the community to light a candle near a window at 8 pm in support of World Suicide Prevention Day. It is said that the lighting of a candle is a token to remember a loved one who may have taken their own life and also to generally show support for suicide prevention.

The latest figures from the World Health Organization indicate that on average one million people across the globe end their own lives—in other words, one person ends their life every 40 seconds. Whilst it is one of the leading causes of death worldwide, in Australia it is ranked 15th in the overall causes of death. So World Suicide Prevention Day is about increasing awareness of the problem of suicide, and this year's theme was 'Suicide prevention across the globe: strengthening protective factors and instilling hope.' Sharing ideas, talking and listening can do a great deal in reducing suicide rates and suicidal behaviour.

Let us look a little more closely at some of the statistics for Australia. Many things lead to a person having suicidal thoughts and then going on to commit suicide. It can be relationship problems, money worries, drug abuse, bullying, self-esteem, gambling, childhood abuse, alcohol abuse, genetic factors or worrying excessively. All together these things form a spiral to despair. In the 2007 National Survey of Mental Health and Wellbeing there were some absolutely staggering figures. Over a lifetime, 13.3 per cent of our population have ideas of suicide—that is 483,000 people. Four per cent develop suicidal plans, and another 3.2 per cent actually attempt suicide. This means that 126,000 people develop suicidal plans, 84,000 attempt suicide, yet we have completed suicides of 2,200.

We know that suicide is the leading cause of death for 15- to 24-year-olds. Indeed, yesterday, on World Suicide Prevention Day, headspace put out a very interesting publication in which it put suicide at 23.3 per cent, above car accidents at 14 per cent, drugs and poisoning at 4.2 per cent, motorcycle accidents at 4.2 per cent, pedestrian accidents at 2.9 per cent and cancer at 2.4 per cent. Yesterday we also saw some very interesting articles not only in the press but also on Four Corners. Professor McGorry, writing in the Melbourne Age yesterday, talked about the culture of shame and secrecy surrounding suicide which is preventing more young lives from being saved. The article is headed 'A deadly silence that has to end'. He states:

It's a daily procession of preventable deaths, often with local surges called ''clusters'' or mini-epidemics, swollen by suicides in older adults.

While Professor McGorry has particularly focused on youth suicide, his article also talks about adults. Yesterday we had another interesting article written by Mr Kemp in the Adelaide Advertiser entitled 'Time to lift the veil of silence'. It called for the media to report suicides. Of course, this is always a very, very difficult issue. The point being made in the article is that the media have a responsibility to make people aware of suicides and not to contribute to underreporting of the problem. This is according to the view of Michael O’Connell, Commissioner for Victims’ Rights. As we can see, there is a great difference between the number of people who think about suicide and actual suicides. In 2007 we had only 2,200 suicides, and yesterday this Senate passed a motion citing ABS figures of 2,500 suicides. But the reality is that those figures do not take into account that young man who may wrap his car around a tree at midnight on a country road, which is then termed an accidental death, or perhaps the little old lady who is found dead in her home alone and whose death is again termed as accidental. There are issues associated with that, and they were canvassed in the Senate's major report on suicide. It is a catch-22 situation, because if we do not know the actual number of suicides then how can we better help those people and target the assistance in those areas? That was the gist of the motion that Senator Wright and I put yesterday to this Senate. Yesterday evening Four Corners had a very confronting episode in relation to youth suicide, about remaining silent and the shocking dilemma of youth suicide. So let us look at what has happened in recent years in relation to suicide prevention and efforts that have been made to tackle suicide. At the 2010 election we heard an announcement by Ms Gillard about 'Mental health: taking action to tackle suicide'. The Australian Labor Party site talks about suicide as a tragedy and it promises:

A re-elected Gillard Labor Government will redouble our national efforts to prevent the tragedy of suicide in order to reduce the tragic toll it imposes on individuals, families and communities.

There was a commitment of $277 million over four years to provide a series of initiatives. We saw very little spending, but we saw this announcement being made not once but quite a number of times—as if this was new money being passed off, but of course they were really talking about the same money. There were a number of media releases by Minister Butler in November 2010, but basically he was just talking about the same announcement.

Let us look at how this money was rolled out—or may I say not rolled out. Professor Mendoza, in a piece entitled 'Mental health and suicide prevention are now red hot national political issues' on 2 March 2011, writes:

The much trumpeted suicide prevention funding announced during the Federal election campaign last year totaling $277m will see just $9.1m spent this year. Again this is symbolic of a Government that talks the talk but fails the test of real action.

Mental health and suicide prevention are now red hot national political issues. This is in part due to the continuing delays on any real reform or action by the Federal Government despite having more advice than any previous government on what actions are required.

Professor Mendoza goes on to say:

It has had dozens of program-specific advices from the National Advisory Council on Mental Health and overall system reform from NACMH and the National Health and Hospitals Reform Commission–almost all of which it has ignored.

It knows what the priorities for investment are–prevention, early intervention, community support services including supportive accommodation, research and new governance and accountability.

As we know, Professor John Mendoza was the original chair of the National Advisory Council on Mental Health. He was appointed in June 2010 and he resigned, criticising the Rudd government for its lack of action on mental health. In his interview on 21 June 2010 he said:

JOHN MENDOZA: Well it’s a frustration rather than anger.

He then went on about the lack of action. Basically he made this important comment:

They had commented on many aspects of the Howard government’s response in this area as being inadequate and wanting to do a lot better and, in fact, the formation of the council was specifically in response to, I guess, the lack of progress from the reform policy agenda that had been in place for some time.

So after two years, however, it was pretty clear we were getting nowhere.

Then we had the so-called National Mental Health Reform package. As is usual with this government, there was the grand announcement and finally, after motions both in this chamber and in the other place sponsored by the coalition urging the government to take action—and indeed motions passing what was the coalition's policy at the last federal election—the government was shamed into doing something on mental health in its budget. There was the big announcement of the $2.2 billion package, GetUp!, the candles and the full bit. But, of course, despite the money, the net spend over the forward estimates was only $583 million and most of that package was money taken out of the Better Access program.

I will not reiterate to the Senate the findings of the Senate Community Affairs References Committee inquiry into the funding of mental health in Australia. Suffice to say that the government's changes in relation to Better Access were undertaken with absolutely no consultation with the sector and absolutely no consideration as to what the impact of those changes would be—most importantly, on patients who were accessing those programs.

In 2011-12 there was only $47 million spent and $62 million in cuts from existing programs. Throughout this process the minister failed to say how many of the 'new initiatives' were actually new money or simply recycled money and re-announcements. Of course, the package, as with most things with those opposite, was tainted with the never-never brush of so many of the Gillard government programs. The draft Ten year roadmap for national mental health reform has been roundly criticised by Dr Rosenberg, Professor Mendoza and also by Dr Lesley Russell, former adviser to then shadow minister for health, Julia Gillard. The evidence-based spending 'effectively delivered and transparently monitored' is not a feature of that 10-year plan. The point is that one in five Australians needs help now. They do not need a 10-year timetable with no onus whatsoever on the government to deliver. Sadly, for those with mental illness, we have seen another smoke-and-mirrors trick. This 10-year map was described as a road map to nowhere, and Professor Mendoza and others have suggested that it should be torn up because it achieves nothing and contains little of value worth pursuing. As Professor Alan Rosen, from the Brain and Mind Institute, said, 'You don't put out a road map if you don't have a destination.'

When you do look at the money side of that, you can see that it was previous money. The suicide money was put in, money that had not been spent, and it became very clear that the rate of spending had been so slow in this very important area. It is very difficult to track spending on programs in mental health simply because they are not reported or are disaggregated by program. When you look at the moneys actually spent in 2010-11, just from answers to questions on notice, it was not even the $9.5 million that Professor Mendoza was talking about of the moneys allocated; indeed, barely $7 million was spent in 2010-11.

In relation to moneys that have been allocated it is very clear that, despite the statistics and despite the importance of this area, the government is very tardy in relation to rolling out important programs. We are seeing criticism from people like Professor McGorry, Professor Mendoza and Professor Hickie, who, in an article in Hospital and AgedCare of March 2012 roundly criticised the government. He said:

As a result of the mess left at the end of the Rudd era, key structural issues in mental health services remain unresolved. There is no commonly agreed service model, particularly for out of hospital and ongoing community care.

Then we saw not only the spectacular cuts that were made by then health minister Roxon in relation to occupational therapists and social workers but also the usual backflips from Minister Roxon. Most recently, we have the decision in the last budget to freeze the funding for the Mental Health Nurses Incentive Program at the 2011-12 level. I want to quote from some correspondence I have received in relation to this. It says:

The program has been in operation for five years and in that time it has treated tens of thousands of patients with severe and complex mental illnesses. The funding freeze has been made in such a way that many thousands of patients' lives are at risk as they will be unable to access the program.

My correspondent goes on to tell me it provides one-on-one clinical nursing support in case management to people who have been put in the too-hard basket by the system, often people who are suicidal, homeless, young people who have been withdrawn from school and families and many others. What really concerns me is that this is not just a cap on the number of nurses in the program. I have been advised of cuts in actual services around the program and in different other parts. So what do we have from Minister Butler? Despite the fact that there is a program, he continues to make announcements about how things are going to be rolled out. That is all very well but what he is not doing is actually rolling out, so I would like to understand where the money has gone and why it has not been spent on very important areas.

Senate adjourned at 20:57

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