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

Mr President, I seek leave to speak for up to 20 minutes.

Leave granted.

The month of October is a very significant and important month for the mental health sector, for people suffering with a mental illness, for their families, friends and carers, and for our community as a whole. The World Health Organization defines mental health as follows:

… a broad array of activities directly or indirectly related to the mental well-being component included in the WHO's definition of health: "A state of complete physical, mental and social well-being, and not merely the absence of disease". It is related to the promotion of well-being, the prevention of mental disorders, and the treatment and rehabilitation of people affected by mental disorders.

Let me begin by once again putting on the record just a few of the stark mental health statistics in Australia, and let us not forget that we do so, as I said, in the month of October, bearing in mind that tomorrow is World Mental Health Day. In recent weeks we have seen this Senate mark R U OK? Day, World Suicide Prevention Day and a range of other important days when mental health, mental illness and those suffering have been at the forefront of our thoughts.

I turn to some very important statistics. In 2007, almost half—45 per cent, or 7.3 million—of Australians aged from 16 to 85 years reported that they would have met the criteria for a diagnosis of a mental disorder at some point in their life. One in five Australians will experience a mental illness this year. In 2007 anxiety disorders, affecting 14 per cent of all people aged from 16 to 85 years, were the most common mental disorders reported in the 12 months prior to interview. The most common anxiety disorder for both men and women was post-traumatic stress disorder, but women were almost twice as likely as men to experience this disorder. Females were more likely than males to have experienced anxiety disorders both in the 12 months prior to interview—18 per cent and 11 per cent respectively—and in their lifetime—32 per cent compared to 20 per cent for men.

Affective disorders, also known as mood disorders, such as depression and bipolar affective disorder, affected six per cent of people aged 65 to 85 years in the 12 months prior to interview. A higher proportion of females recorded affective disorders than males, both in the 12 months prior to interview—seven per cent compared to five per cent—and in their lifetime—18 per cent compared to 12 per cent.

The harmful use of alcohol and other drugs is an issue that has many negative effects for individuals, their families and friends and the wider community. Substance use disorders involving the harmful use of or dependency on alcohol or other drugs were less prevalent than other types of mental disorders, affecting five per cent of people aged 16 to 85 years in the 12 months prior to interview. Males were more than twice as likely as females to have had a substance use disorder both in the 12 months prior to interview—that is, seven per cent of males and three per cent of females—and over their lifetime—35 per cent of males and 14 per cent of females.

Alarmingly, suicide is the 15th most common cause of death in Australia, although many academics and experts believe that suicide is significantly underreported and state that the actual figures are higher than those reported.

Mental health accounts for about 13 per cent of the total burden of disease in Australia, but only about six per cent of the health budget goes to mental healthcare services. People with a mental health disorder also may not be able to participate fully in the labour force. This has individual impacts in terms of the person's income, social participation and self-esteem, and also has wider economic impacts. The annual cost of mental illness in Australia has been estimated at $20 billion, which includes the cost of loss of productivity and labour force participation.

As I said, tomorrow, Wednesday 10 October, is the United Nations World Health Organization's World Mental Health Day, designed to raise public awareness about mental health issues. The day promotes open discussion of mental disorders and investments in prevention, promotion and treatment services. This year, the theme for the day is 'Depression: A Global Crisis'.

Depression affects more than 350 million people of all ages worldwide in all communities, and is a significant contributor to the global burden of disease. Locally, there are 160,000 young Australians between the ages of 16 and 24 who live with depression every day. Affective disorders such as depression and bipolar affect six per cent of the Australian population. The Mental Health Council of Australia's theme for 2012 is 'Whoever you are or wherever you live, you are not alone'. Furthermore, October is Mental Health Month in New South Wales and also when every state and territory holds their mental health weeks. The theme this year for the New South Wales Mental Health Month for those who suffer or have suffered a mental illness is Celebrate, Connect, Grow.

The month of October is a time not only to raise awareness of these issues but also to celebrate people's recovery. It is also a time when the sector and the lawmakers must look collectively to the immediate and long-term future to see how we can deal with and resource every facet of this complex challenge: from early intervention and prevention in our youth; from research to clinical trials; and from mental health nurses, social workers and occupational therapists to carers and community support groups. These are serious issues that require serious solutions. In mental health, the coalition has a demonstrable, reliable track record of delivery, listening to the sector and acting decisively to provide these real solutions.

I would just like to take a few moments to highlight some of these significant achievements. In 2006 the coalition made a $1.9 billion investment over five years in mental health. It was the single biggest commitment to mental health by any government in Australia's history at that time. Many, including me, would argue that it is still the biggest ever real investment in mental health in Australia—a point I will come to in a moment.

In 2010 the coalition's election policy for mental health was $1.5 billion and comprised the establishment of 20 early psychosis prevention intervention centres in major metropolitan and regional areas, providing health care aimed at recovery and prevention of relapse; provision of 800 beds for acute and subacute care, specifically to support the early psychosis prevention intervention centres; and funding of an additional 60 headspace sites, providing one-stop shops for young people, with information and services relating to general health and wellbeing, mental health and alcohol and drug services.

Leading mental health practitioners, including former Australian of the Year Professor Patrick McGorry, and Professor John Mendoza, publicly endorsed this policy. In fact, on 1 July the Australian quoted Professor Mendoza as describing the coalition's policy as:

… the most significant announcement by any political party in relation to a targeted, evidence-based investment in mental health.

In an extraordinary set of circumstances following the 2010 federal election, both the Senate and the House of Representatives passed motions calling on the government to implement this policy in October and November 2010 respectively. However, both Labor and the Greens voted against these motions in both the Senate and the House of Representatives. They therefore not only ignored the will of both houses but they stifled much-needed real action in the mental health sector.

We then had the 2011 federal budget—the so-called 'mental health budget'—in the 'year of decision and delivery'. To begin with, the government had to be shamed into making any substantive announcement in mental health after sustained pressure from the coalition and the mental health sector, which was crying out for help. The budget announcement, with much fanfare, included the headline figure of $2.2 billion. The spin from Labor was that it was impressive; but like most things that this government does, the devil was in the detail.

What we soon uncovered was that there was only $583 million of net spend over the forward estimates. The bulk of new money in this headline figure fell outside the forward estimates in the fifth year or, as most people in the sector suspect, in the never-never. It was certainly a deceptive figure.

In fact, in the 2011-12 financial year there was only $47 million allocated—yes, that is right, $47 million from this so-called $2.2 billion figure. This Labor government actually cut mental health spending by ripping $580 million from GP mental health services and the allied health treatment sessions from the Better Access program. Dr Lesley Russell, former policy adviser to Julia Gillard in her then role as federal shadow minister for health, who prior to this had been part of the policy unit in the office of the Hon. Simon Crean when he was Leader of the Opposition with responsibilities for health and ageing, stated in the Canberra Times on 22 February 2011:

The funding response to date from the Government has been a paltry $112 million for four years, which hardly makes up for the $354 million cut from mental health services since Labor came to federal power.

Dr Lesley Russell, this highly regarded stakeholder who has worked in the inner sanctum of the Labor Party's health policy department, has clearly belled the cat and confirmed what the coalition and mental health experts have been saying.

So how much of the so-called 'big spend' on mental health has actually been rolled out? Take, for example, the suicide prevention money. Remember the 2010 election promise of $277 million for Taking Action to Tackle Suicide? In the first year the government was supposed to spend $9 5 million to roll out important programs. How much was actually spent? I understand that only $7.3 million was spent. It has taken Labor almost two years to spend some money to start addressing suicide issues in the Kimberley. This was after a long and laborious process of committees and consideration. Meanwhile, on the ground in the Kimberley the problems continue.

The coalition has also been taking the fight for a better deal for the mental health sector to the government on another front. We were successful in initiating a wide-ranging Senate inquiry into the funding and administration of mental health services in Australia. The inquiry was conducted by the Senate Community Affairs References Committee and follows from the 2011-12 budget changes relating to mental health. The committee received a record 1,500 submissions with many of these addressing the adverse effects of the changes—or, should I say, the cuts—to Better Access. These changes caused a lot of stress to patients, their families and those practitioners treating them. It is typical of a government that cannot get anything right. The government was once again shamed into a backflip to reinstate, albeit temporarily, some of the sessions that had been cut in order to find some savings. This debacle was created as a direct consequence of not consulting with the sector, as we did when we were in government. These cuts to Better Access were made with scant consultation with key stakeholders and practitioners, the very people in a position to know what these cuts would mean to the community.

Further, these cuts were not based on any evidence based data but were simply, as I just mentioned, a cost-cutting exercise with the sole objective of meeting a political objective, to the detriment of the community. Having squandered billions of dollars on pink batts and Julia Gillard memorial halls, it is now the most vulnerable that will pay the price of Labor's irresponsible and wasteful mismanagement.

But backflips in mental health under this government are unfortunately not new. On 19 May 2010, the then health minister, Nicola Roxon, was forced to perform the first budget backflip of 2010, less than a week after it was delivered, to defer changes that would have prevented social workers and occupational therapists providing much-needed mental health services. This was another instance of Rudd-Gillard government incompetence—no consultation, no heeding of the expert advice, and little consideration for the impact on those suffering from serious mental conditions, their family, their friends or their carers—with essentially no consideration given to the welfare of the community which they were elected to protect.

The coalition senators' dissenting report also highlighted another concern with these ill-conceived cuts to the Better Access program. We believe the consequences of the shift from Better Access to ATAPS have not been fully considered. This is particularly worrying given the challenges facing ATAPS which are highlighted in the ANAO report. Fundamentally, there is a real question as to whether the ATAPS structure is sufficient to meet this new demand that has now been created through the Better Access cuts. This is especially concerning given the estimates provided at the hearing that there are potentially 87,000 people who were moving from Better Access to ATAPS. This is also complicated by the uncertainty of the move from the current system of Divisions of General Practice Network to Medicare Locals and how these changes will exacerbate already strained financial and structural issues and the provision of health services.

When Tony Abbott was minister for health, he announced the Mental Health Nurse Incentive Program would receive $191.6 million over five years. At the time of its introduction, this program was expected to provide services to 36,000 people annually at a cost of $72.7million by 2010-2011. However, the Department of Health and Ageing confirmed during Senate estimates that more than 40,000 patients had used the program at a cost of $28 million. This program appears to have been cost-efficient and beneficial and it is unclear why the government is capping it. There appears to be no clear basis for it and no evaluation of the program to justify the cap. One can only surmise that the sole objective is purely cost cutting.

There is also a question as to the additional moneys that the government did not spend in the earlier years of this program but which were allocated in the forward estimates. Unfortunately, this is another typical Labor tactic which we have previously witnessed in mental health, where programs are cut with no consultation and little consideration that the impact will have on those suffering from mental health conditions. Like many other changes, Labor has failed to adequately assess the impact on key stakeholders and, most importantly, on patients.

Which brings me to the government's so-called 10-year roadmap. Call it a blueprint, a white paper or however else you wish to describe it, for an issue as complex, for an issue as serious, for an issue that directly and adversely affects the day-to-day lives of millions of Australians, one would think it would be undertaken with the requisite professionalism and respect that such a noble enterprise demands. However, this was far from the case. The Gillard government released its draft 42-page Ten Year Roadmap for National Mental Health Reform and then only gave people two weeks over the last Christmas vacation period to consider it. Was this a real consultation period or merely a political gesture in order to make the claim that the sector was 'consulted'?

The roadmap appears to be nothing more than a wish list with very little detail. Therefore, it is not surprising that this so-called roadmap has been heavily criticised by a variety of mental health experts who have gone on the public record. They included eminent people such as Professor John Mendoza, Professor Alan Rosen and Dr Sebastian Rosenberg. Professor Rosen correctly stated that you do not put out a roadmap if you do not have a destination. Professor Mendoza has called it a 10-year roadmap to nowhere, stating that it achieves nothing and contains little of value worth publishing, and suggested it should be torn up. I would remind the Senate that Professor Mendoza, in a major embarrassment to the government, resigned on 21 June 2010 from his position as head of the government's National Advisory Council on Mental Health, stating that 'after two years ... it was pretty clear we were getting nowhere'.

Therefore, sadly for those suffering from mental illness, for their family, friends and carers, all we are seeing is another hallmark smoke-and-mirrors trick by this Labor government. The reality is that one in five Australians needs help now, not a 10-year timetable to nowhere. It is time for the Gillard Labor government to get serious about delivering real outcomes in mental health and to stop paying lip service to the sector. We are dealing with some of the most vulnerable people in our community.

I conclude by saying to those opposite: events in our lives are unpredictable and mental illness can strike anyone at any time. One day, it could be any one of us. Stop playing politics with mental health and get on with helping those one in five Australians who need help now.

Senate adjourned at 20:24