Deborah O'Neill (NSW, Australian Labor Party, Shadow Assistant Minister for Innovation) Share this | Hansard source

I do concur with the remarks that Senator Siewert has already put on the record. I'm delighted to let the Senate know that the Community Affairs References Committee has landed a unanimous report on mental health services in rural and remote Australia after 16 amazing hearings, which took us travelling to nearly every state and territory, from Derby in WA to Mount Isa in Queensland, to hear firsthand of the service gaps that are, in some cases, cavernous and gaping.

We spoke to locals from very diverse backgrounds, including mental health consumers, farmers, miners, Aboriginal and Torres Strait Islander peoples, local councils, teachers, nurses, doctors, academics and committed volunteers at the frontline of suicide prevention. I want to thank each and every one of you for your critical evidence and for the courage to come forward and share with us what were often very personal and at times traumatic experiences.

Whilst the prevalence of mental illness is similar across urban, rural and remote Australia, there is a much higher level of need in rural and remote locations, complicated by lower rates of access to mental health services in those contexts. Sadly, as remoteness increases, so does the rate of suicide. Between 2010 and 2017, the rate of suicide in remote areas was almost double that of major cities, while the rate in very remote regions was almost 2.5 times that of major cities. One of the things that struck me in this inquiry is that we kept hearing about people who were more afraid of living than they were of dying.

The barriers that exist range from the obvious, such as the actual presence or availability of services and health professionals in an area, to the more subtle, such as the attitudes towards mental health within the community or the effects of social determinants of health, such as socioeconomic status or employment. I'm strongly of the belief that one's location should not affect the capacity to access quality services, especially in these days when digital capacity, if the technology is stable and affordable enough, can facilitate ongoing, stable therapeutic relationships with a health practitioner of a person's choice in another state or context. The other thing is that access through digital means, supported by great local physical support, allows people to get around the perceived stigma that still remains with regard to mental health in our public health conversations these days.

The committee made a swathe of recommendations to improve the quality and accessibility of mental health services in rural and remote communities. For confidence in certainty and continuity of care, we've recommended that governments at all levels should develop longer minimum contract length terms. In rural and remote areas, this is absolutely essential to attracting and retaining a suitable workforce who can build over time the quality of therapeutic relationships necessary to deliver effective outcomes from treatment. Some contracts we heard of, and increasingly in the course of this government, were for just 12 months at a time. The impact of such a choice by the government is devastating because services are simply being removed from community.

We've also recommended, very importantly, that all primary health networks have a First Nations member on the board. This representative is crucial for fostering greater trust, connectivity and culturally appropriate care. It was horrifying to hear that translation services were simply denied. The assumption was that somebody who was expressing mental ill health and who was finally able to connect with a service provider had to bring their own family member to talk about matters that were deeply personal, because the funding and the staffing of interpreter services simply didn't exist. We know, sadly, that suicide continues to disproportionately impact Indigenous communities, with Aboriginal and Torres Strait Islander people twice as likely to die by suicide.

I'd like to close with a few necessary and sincere acknowledgments. I'd like to thank the chair, Senator Siewert. We enjoyed a great period of conversation with many people after the hearings; there just wasn't enough time to hear everything they really wanted to put on the record. I'd particularly like to thank my Labor colleagues on the team with me who participated in the various hearings, including: Senator Pratt in Western Australia; Senator Watt, that man of action, in the Queensland area; and Senator Polley and Senator Brown for their presence at hearings in Tasmania. Together, we've worked towards a really great outcome. If these recommendations are adopted in their entirety, they will provide a vital change that's required in our rural and remote communities.

I also want to thank the secretariat for bringing this report together and for travelling with us across the breadth of this great country. Their hard work, assistance and dedication throughout have been fundamental in this report being a record of the great state of need in our community, at this time, and delivered here today. I'd also like to thank the state government bodies, the mental health service providers, academics, peak representative organisations, local PHNs and community members who provided evidence to the committee, for without their submissions and firsthand accounts, we would not have the full breadth of information about the quality and accessibility of mental health services. Thank you to those who shared their lived experiences with us, and I am hopeful that our report can play a vital part in ensuring the change necessary to deliver access to services, for people, where they live. I seek leave to continue my remarks.

Leave granted. Debate adjourned.