Mental Health

05 Jun 2006 questionsarchive

I seek leave to make a brief explanation before directing a question to the Minister for Mental Health and Substance Abuse, on the subject of mental health.

The Hon. J.M.A. LENSINK: The Australian Nursing Federation is an instructive web site for people interested in the topic of mental health. Indeed, an article which has been published in the Australian Nursing Journal in June of this year—very recent—is entitled ‘Mental health—It’s time for action’. The author is Melissa Sweet, who also happens to be the author of the recently released book Inside Madness which provides an account of the life and work of murdered psychiatrist Dr Margaret Tobin.

In the article there are a number of references of note and I would like to quote a couple of those. Under the subsection ‘Quality care’, Professor Hickie—that is, Professor Ian Hickie of the Brain and Mind Institute at the University of Sydney—warns of the following:

Some small sections of the mental health nursing work force, like other mental health professionals, need to move beyond their historic focus on custodial care. ‘No matter where we work in mental health, there is a danger of taking a custodial and disempowering and patronising attitude.’

In a box below that, a section headed ‘The national picture: a mixed report card’ states:

States and territories have achieved varying progress in implementing the national mental health strategy since 1993. Victoria is generally agreed to have made most headway in moving towards community-based care, while SA and New SouthWales are lagging behind.

Professor Hickie is quoted further down as saying he has been closely involved in efforts to put mental health on the political and public agenda. He said that, while the PM’s involvement is extremely encouraging, he is disappointed that most state leaders still have not grasped the issue. Professor Hickie stated:

Mental health reform requires a degree of tough leadership. You run into vested interests. It’s a long term, not a short-term investment.

Morris Iemma in New SouthWales is the only premier I have spoken to who seriously understands the issue and is seriously looking at solutions.

Another reference on the web site relates to a campaign which is about to be launched by the Australian Nursing Federation here in South Australia dealing with mental health in the public sector. The title of the campaign is ‘Time’s up, Mike; it’s time for action’. My questions for the minister are:

has she met with the Australian Nursing Federation and, if so, what specific issues has the federation raised with her in relation to areas of reform, and would one of those issues involve reforming the culture of our mental health system?

The Hon. G.E. GAGO(Minister for Mental Health and Substance Abuse): I thank the honourable member for her question and long explanation.

The Hon. J.M.A. Lensink interjecting:


The Hon. G.E. GAGO: I will start first with the honourable member’s last question. I have met with a delegation from the Australian Nursing Federation, and I acknowledge the important work that the federation contributes, both as an industrial organisation and as a union and, of course, as a professional body for nurses as well. I have indicated to the federation that I am prepared to meet regularly with it, and I look forward to the federation’s contribution.

A number of issues were raised at the meeting. I cannot recall all the matters discussed—it was a lengthy meeting— but, if I recall correctly, most of the conversation was around the proposed changes to the Glenside campus and the master plan, as well as discussions around work being done by the Social Inclusion Board in relation to mental health matters;

that is what most of the delegations have dealt with. However, in relation to the general comments made by the honourable member opposite, implying that South Australia is in some way lagging behind, I take this opportunity to remind the chamber of the important commitment the Rann government has made to mental health. In fact, this government is contributing $35 million more to mental health services than did the previous Liberal government.

The Premier has also designated a mental health minister to concentrate efforts and energies on the mental health issues, and the former minister, my colleague the Hon.

Carmel Zollo, and I have been the only mental health ministers in Australia, which I think shows the Rann Labor government’s very important commitment to mental health, together, of course, with the focus of the Social Inclusion Board in this regard.

I remind members also of the important work we have done in relation to deinstitutionalisation and the placing of community services: 18 per cent of the wider population will experience mental health issues some time over the next 12 months, during which period the chances are that family members or someone we know will in some way experience a mental illness. That is why we have worked very hard to provide a range of mental health services, rather than adopting a ‘one size fits all’ approach. Our approach is about balance; we have worked to create a mental health system that is tailored to individual needs, and that also includes deinstitutionalised or community-based care.

We have spent a lot of money—and we are continuing to designate money—towards moving mental health beds out into mainstream hospitals so that services can be provided closer to people’s homes and local communities and networks.

Also we are about to open the Margaret Tobin Centre, and there are new beds and capital investment at the Repat.

So, we have made a huge commitment to shift beds out to community placements.

I also need to mention the Returning Home project, which is helping people to get better, and I have talked at length about our recovery-based model of mental health care. We look at services such as the mobile assertive care teams (another community-based program) which provide intensive support, treatment and rehabilitation for people in their own environment and which are especially tailored for those who would not otherwise be actively engaged in mental health services. Acute crisis intervention service teams are also on call 24 hours a day for people with mental illness who are in crisis in the community.

There are also other important community-based initiatives which we announced at election time, and our GP shared care program. Of course, our GP services are frontline, and we have committed to fund 30 allied health workers such as psychologists, occupational therapists, nurse practitioners and social workers to work in private GP clinics across the state to assist people with mental illness and to provide much needed support for our GPs. These allied health workers will provide information and referral services to GPs, which will assist people with mental illness.

The Hon. J.M.A. Lensink interjecting:

The Hon. G.E. GAGO: The honourable member opposite needs to wake up and listen. I answered the part of her question about the delegation with the ANF and then I stated quite clearly that I was going on to comment, in relation to her questions, about institutionalisation and about her allegations of South Australia lagging behind in terms of community-based services. In effect, because the honourable member has finally woken up again, I am going through some of our important developments and commitments to provide community-based services for mental health clients.

Given that I was cut off in midstream, the other important initiative relating to community-based services is, of course, our Healthy Young Minds program. These services were an important election commitment of $10.5 million, and they are based at early intervention and prevention for young people with illness, amongst other things. There are many more initiatives and achievements that I could go on and discuss, but for the time being I will leave it there.

The Hon. J.M.A. LENSINK: I have a supplementary question. Was one of the issues raised by the ANF the ambiguous reporting structure within mental health?

The Hon. G.E. GAGO: Not to my recollection.