Penny Wright (SA, Australian Greens) Share this | Hansard source

As the Australian Greens spokesperson for mental health I am pleased to participate in this debate on the matter of public importance. It is an opportunity to highlight the extremely important issue that is the reform of mental health in Australia. We know now that one in five Australians will experience mental ill health in any given year and, against a backdrop of what is acknowledged to have been decades of neglect of mental health funding and the mental health sector, there is clearly an important need for reforms to be undertaken by all governments in Australia—federal, state and local governments.

What could we achieve if we had genuine commitment to this? I am interested in seeing this issue transcends politics because I think it is far bigger than that. Most Australians would understand that with mental health touching on the lives of so many Australians, if not them individually or their families, carers and friends, it affects our productivity, the workforce and our general sense of wellbeing in the 21st century. With all of that being so pervasive in Australian society most Australians would expect that their elected representatives would be able to transcend politics and work together to find common ground to advance promotion of mental health in Australia, and to actively work to mitigate the worst effects of mental ill health.

Today marks the 20th anniversary of World Mental Health Day. It was first initiated by the World Federation for Mental Health in 1992 by Richard Hunter. Mr Hunter saw World Mental Health Day as a focal point around which global mental health advocacy could gain maximum public attention. It is a good opportunity to give consideration to the current state of mental health globally and, importantly, in Australia, and to the way we can improve the situation.

World Mental Health Day provides an opportunity for us all to work together to raise public awareness and to encourage education about mental health issues worldwide. There has indeed been a lot of positive change over the past 20 years. Just this morning, the Executive Director of the Mental Illness Fellowship of Australia, David Meldrum, was speaking on Radio National. He gave his view that there has been a generation of work around breaking down the stigma surrounding mental illness. Fortunately, in his view, the public debate around mental illness has become a lot more open. That is certainly an experience I would agree with, and I think many people in Australia would understand that there is now a lot more literacy and willingness to speak about these issues.

This open discussion is important because mental illness touches us all in one way or another. It is well understood that one in five Australians will experience mental ill health this year alone, and approximately 45 per cent of all Australians between 16 and 85 will have a mental health condition at some stage during their lifetime. Significantly, mental ill health is the third major morbidity and disease burden in Australia behind cancer and cardiovascular disease. That is a statistic that will surprise many; certainly, cancer and cardiovascular disease are acknowledged to be severely debilitating for many Australians, for the Australian economy and for our sense of wellbeing, but I think it will still surprise people to know that, sadly, mental ill health comes in third place to those.

These numbers mean that mental health policy goes to the heart of our nation's wellbeing. When it comes to numbers there can be no pussyfooting around: we have to look at the numbers of dollars available to address these statistics as well. Goodwill and fine intentions are not enough; we actually have to look seriously at what money as a community we are prepared to devote to ameliorating the mental health burden in our health system.

The total health burden of mental health in Australia is now 13 per cent, but as yet dedicated mental health funding is still hovering around six to seven per cent, so it is actually half of what we would require if we were going to fund mental health services proportionately to the mental health burden. If we are to genuinely tackle the serious challenges posed by poor mental health in Australia then we must be aiming to ensure that the amount of funding provided for mental health services, programs and policies accurately reflects this burden so that the funding is commensurate with the need. To achieve this we must have a commitment by government to increase mental health funding year by year until the proportion of mental health funding from the health budget reflects the true cost of mental ill health to the Australian community. To do otherwise is a false economy, because there is a clear established link between mental ill health and physical ill health—physical conditions like diabetes, cardiovascular disease and so on are clearly linked and that is why there is a greatly concerning gap in life expectancy between particularly those people who have persistent and severe illnesses and the average Australian population.

The Australian Greens acknowledge that there was a solid commitment made to mental health by the government in the 2011-12 budget with about $1.5 billion allocated in the five-year package for new initiatives or the expansion of existing initiatives. Unfortunately progress on the implementation of programs has flagged as part of this investment has been slower than we might have liked. Concern by some stakeholders has been raised with the Australian Greens that this funding might not ultimately be the health budget centrepiece that it was originally regarded as, given the context of chronic underfunding of mental health services over previous years.

One area where we have been consistently seeing difficulties in accessing mental health services and the quality and range of those services is in rural, regional and remote areas of Australia. While people living in country Australia generally experience mental ill health at levels equivalent to people living in urban areas, they encounter higher risk factors for mental ill health including unemployment, lower socioeconomic status, poorer levels of education and reduced access to mental health services. People living in country Australia receive less than half the total number of mental health services of people living in metropolitan areas. Male farmer suicides are reportedly as high as one a week and it is likely that official statistics do not reflect the true number of these incidents. There are other factors arising from the loss of identity or income, including in changing employment patterns and industries, that reflect environmental and economic pressures that we will be continuing to face in Australia in the 21st century. The lack of available services and difficulty accessing existing services exacerbates the situation and ultimately means that the burden of mental illness is proportionately higher in country Australia.

Over the past few months I have been touring Australia and I have met with mental health service providers, consumers and carers who I call the experts in mental health care. I have heard about many of the gaps in service delivery, problems with accessing mental health services and the good initiatives that are working really well but are stretched due to lack of funds and resources. One of the things I have consistently heard about is the importance of outreach services. This is particularly relevant in situations where there is great geographical isolation. Also many people who experience persistent and severe mental illness do not have access to their own independent transport so they become increasingly isolated and unable to access what services are available. I recently came across an outreach service called Rural Alive and Well in Tasmania which decided not to sit back and wait for people to approach them but to do advocacy, counselling and referral to further support in a bid to reduce suicide in the Midlands of Tasmania. At a time when many are doing it tough support like that is invaluable.

It is absolutely non-negotiable—and few people would argue that it was—that adequate funding be given to mental health in Australia and that equal need should mean equal access no matter where people live. Given the recent sizeable investment in mental health in Australia it is time to evaluate whether the funding is improving the delivery of mental health services in Australia. So it is imperative that we identify current unmet needs and gaps to service delivery and work to improve these. That is what the Australian Greens are in the process of doing, particularly at the moment in relation to rural, regional and remote areas. The Australian Greens will keep working collaboratively in a non-partisan way towards increasing awareness of mental ill health in Australia in the interests of reducing stigma and promoting wellbeing which will be of benefit to all of us.