Rachel Siewert (WA, Australian Greens) Share this | Link to this | Hansard source

I rise this evening to speak on the proposed national mental health and suicide prevention agreement. In all the multitude of inquiries into the mental health system in Australia the problems caused by fragmentation have been consistently identified by consumers and carers as creating an ad hoc patchwork of services that are difficult to navigate and access. This pandemic has clearly exposed this major problem. This issue featured again in many submissions and the recommendations of the Productivity Commission inquiry into mental health when it released its findings in November 2020. The lack of clear roles and responsibilities between the Commonwealth and state and territory governments was identified as a major factor in this fragmentation.

As part of the Australian government's response to the Productivity Commission's findings, the Prime Minister announced the development of a national agreement on mental health and suicide prevention to be agreed with the states and territories by November 2021, providing 12 months in total for its development. Implementing such a national agreement is one of the key actions identified in Mental Health Australia's charter on mental health, which was signed by over 110 organisations in the mental health sector. The announcement of a national agreement is promising, but it has been more than eight months since the announcement and there is little publicly available material about its development, with no clear national consultation process.

The Prime Minister indicated that national cabinet had established a health reform committee and that this group would take accountability for delivering the national agreement. There's also a small strategic advisory group, but the membership of this has not been widely promoted. Its advice to date is not public, and it is not evident that this group has sought views from the sector on the development of the national agreement. The mechanism for seeking the views of Australians with lived experience with mental ill health is not known.

The peek body, Mental Health Australia, is not represented on the expert advisory committee overseeing the development of the national agreement nor have they been asked to undertake consultation with the sector in relation to its content. In the absence of alternatives, Mental Health Australia undertook its own consultation to inform the development of the national agreement. It's really quite astonishing that the peak mental health body of this country has not been invited to take part in the development of this national agreement. If we want this work—and, of course, it's absolutely critical that we have to do this work—the government needs to take advice from experts and we need transparency around the consultation process. Why is it always so cloak and dagger with this government?

It's also very concerning that consumers of mental health and people with lived experience are not being included either—or certainly it doesn't appear so. We cannot have a plan to address mental health and suicide prevention without genuine engagement with those with lived experience in mental ill health and inclusion of people with lived experience in the design, negotiation, implementation and ongoing monitoring of the national agreement. People with lived experience need to be partners with the government and to be part of the senior governance groups. The system must be genuinely consumer centred, with consumers' needs at the forefront.

The government, it appears, hasn't bothered to consult with the peak body on the national agreement, but Mental Health Australia have provided some comprehensive expert advice on how to make the agreement work and address fragmentation in the sector. They have taken the initiative. The advice to government is a comprehensive view from the health sector on the reform opportunities presented by the development and the potential of a national agreement. It contains structures, priorities and initiatives that can assist to improve outcomes for people with a lived experience of mental ill health and those who love and care for them.

They highlighted six key areas for a successful national agreement: firstly, the foundational principle that there must be involvement of people with lived experience of mental ill health in the development, implementation, oversight and evaluation of the agreement. Secondly, there is a need for clear accountability, coordination of activity and transparency of action and the need for first ministers to take responsibility for the outcomes of the agreement. Thirdly, there must be a commitment to long-term funding enhancements based on an objective reference point and investment should be incrementally added to the system against a set of transparent priorities and with transparent governance and oversight. Fourthly, governance and implementation mechanisms must include representation from the sector, drawing on its expertise, and recognise the foundational principle of the involvement of individuals with lived experience of mental ill health. Fifthly, there needs to be a focus beyond the health system that includes responses that address the social determinants and root causes of mental ill health and suicide, including poverty, trauma and incarceration. Sixthly, the evaluation and measurement of outcomes built into the agreement must include whole-of-government measures that deal with long-term improvements in mental health and wellbeing for the whole community.

We can't just have yet another government announcement that gets a headline and then nothing, as we all move on. This is more than a headline. It needs urgent action, and the community needs to be adequately and properly consulted. We have a fast-evolving mental health crisis in this country. We cannot miss this opportunity to implement a fit-for-purpose national mental health and suicide prevention agreement. This is simply too critically important to treat in the manner in which the government is apparently treating this very important agreement. Without the input of the sector and people with lived experience, the national agreement will miss a significant opportunity to make a real difference in people's lives. This agreement, if prepared properly, will make a real difference to people's lives. Unfortunately, we're perhaps going to get an agreement that features the ad hoc and fragmented approach that so strongly characterises the mental health system in this country. We, the community, expect better. People with lived experience urgently need to be consulted on this important agreement.

I urge the government to update the community, the sector, Mental Health Australia, representatives and consumers on where this agreement is up to. Include them, as a matter of urgency, in this process. Listen and pay very close regard to the six key points that Mental Health Australia are pointing out as needing to be undertaken urgently if we are going to have an agreement of which we can all be proud and, most importantly, which delivers the results that are so urgently needed.

Senate adjourned at 22:07