Wednesday, 30 October 2019

Matters of public importance

Mental health

The SPEAKER (14:01): I have accepted a statement from the member for Ringwood proposing the following matter of public importance for discussion:

That this house notes that nearly half of all Victorians will experience a mental illness in their lifetime and around one in five Victorians will experience mental illness this year alone and therefore:

(1) the Andrews Labor government has acknowledged how broken the mental health system is and has committed to a long-term vision to improve mental health services for Victorians, including the Royal Commission into Victoria’s Mental Health System and the commitment to implement all recommendations; and

(2) this house calls on all members to start conversations within their communities around mental health with a goal of ending the stigma and discrimination associated with mental ill health still experienced by so many Victorians.

Mr HALSE (Ringwood) (14:02): I am delighted to be speaking on this matter of public importance this afternoon. Can I start by thanking the Premier and the Minister for Mental Health for the opportunity to lead the discussion during this MPI. It demonstrates that the Andrews Labor government recognises not just that mental illness is a key issue in our society but that mental illness is the largest and most serious health challenge of our age. It is a fact borne out in some shocking statistics. Nearly 50 per cent of the population will experience a mental health illness at some stage during their life. Almost one in five Australians will experience a mental illness in any given year. At least one-third of young people have had an episode of mental illness by the time they are 25 years old. More than 600 people in Victoria died by suicide last year, more than double the state’s road toll. And the World Health Organization predicts that by 2030 depression will be the leading cause of disease around the world.

The numbers show that we all know someone living with or experiencing a mental illness. There is a reason that many of us do not think we do. It is because mental illness for so many of us still carries such a stigma. Stigma is something that we talk about a lot but it has a lesser known literal definition: it means ‘dishonour and disgrace’. But stigma is not unique to mental illness. We have seen it attached to other medical conditions throughout human history—to cancer, to tuberculosis, to leprosy and, in perhaps the most dramatic example in recent generations, to AIDS. Victorians have collectively waged a long battle to break the stigma that surrounds mental illness and bring the issue to this chamber. It is our responsibility as politicians to now elevate and normalise this discussion and do our part to bring mental illness out of the shadows of stigma.

Let us do a little exercise for a moment. Imagine you are invited to a friend’s birthday party and imagine you are selected to deliver a speech, but then imagine that on that day of the event you are unwell and need to cancel. You call up to cancel, but what reason would you prefer to give for letting your mate down? Do you say you have got a bad back, or that you are suffering from crippling anxiety? Do you say that you have the flu, or that you are suffering from depression and suicidal thoughts? If you would prefer the former to the latter, that is stigma. That is the feeling of dishonour and disgrace.

Now imagine that you are a 34-year-old politician from Ringwood and you need four days off work to seek mental health treatment. What do you tell your staff members and your constituents? That you have struggled to sleep for a month, or that you have got tonsillitis? Now imagine just days after that you are asked by one of your ministerial colleagues to speak on an MPI in this place, one that sits so close to home and evokes such tremendous personal anxiety. Would you politely accept, or would you decline and explain why? What would you say? What would you do? But here I am.

At 8 o’clock this morning an insightful colleague saw my name on today’s speaking list and sent me a text message saying, ‘You don’t have to be the lead speaker. Indeed, you don’t need to speak on the MPI at all. You have choices, and I am here to support you’. That was the member for Oakleigh. It was a simple gesture and one that I truly appreciated. I would also like to thank the Minister for Mental Health for his support of my leading this discussion. So imagine what could be achieved if we seriously committed to making ordinary actions like these the norm, to breaking that stigma and to creating not just a culture of supporting each other—of social responsibility—but a mental health system that works for all Victorians. What could we do? What could be achieved if we broke that stigma?

Let us first look at where our mental health system is at right now. In April 2019 Per Capita, alongside the Health and Community Services Union (HACSU), conducted a survey of frontline mental health professionals in Victoria. They asked the workers—the people best placed to inform us, the people we should listen to because they live in the system day in and day out. I will not list all of what the survey found, but it painted a picture of a broken system, a picture of a system that our government and the minister have had the courage to admit so many times in this place is broken.

Let us tell it how it is. The system does not have enough staff. It does not have enough resources, and the models of care are increasingly outdated—not just of late but for decades. And as demand grows, we know that we need to do more. We know that the system needs reform. The under-resourcing means that too many Victorians miss out on the treatment they need due to factors outside of their control. These factors are numerous and could be a lack of physical access, homelessness or cultural barriers. There might be social stigmas attached or it might be not having the time to seek treatment—or even trauma or abuse. Research indicates that up to 54 per cent of people with diagnosable mental health illnesses do not access any treatment. That is half of all people with mental health issues who do not access treatment. Compounding the problem is the delaying of treatment due to serious problems in detection and accuracy of diagnosis.

So what is to be done? The conversation around mental health can often be limited to gestures—to encouraging people to look after themselves or to do what they love or whatever—or to putting responsibility for mental health only on the individual. There is a place for gestures and awareness raising, and to an extent that is important. But it must, in the end, be backed by actions to make a difference to people’s lives. Actions that look at social and health determinants: people’s environment, their welfare at work, the pressures on their families and relationships. The storylines must become budget lines, and it is in our power in this place to do something about those. That is why this Labor Andrews government took the historic step of announcing the Royal Commission into Victoria’s Mental Health System. Guesswork and gestures were never going to be enough, and this Labor government understood that the mental health crisis needs fixing.

So having said that, here are some dollar figures—some budget lines, if you will—from Labor’s recent 2019–20 budget. Dollar figures show what we have done ahead of the royal commission handing down its interim report: nearly $29 million over two years for more than 7000 extra people to access early care and support through additional clinical health services in the community; $23.3 million for additional beds; $6.6 million to increase clinical supports at three prevention and recovery care units to support Victorians in the early phases of recovery; $9 million to support our mental health workforce; $8.5 million to continue supports for Aboriginal Victorians with severe mental illness; $19 million to support mental health clinicians at the Victorian Fixated Threat Assessment Centre and deliver specialised mental health services to meet the needs of people referred by the centre; $5.7 million for the Mental Health Complaints Commissioner to ensure they continue their critical role safeguarding the rights of those who access the mental health system; and $3 million for asylum seekers to provide support for our newest Victorians—people with experiences of trauma, of torture and of family loss and separation. In fact it is a $173 million boost to mental health and alcohol and other drug initiatives to support more Victorians while the royal commission undertakes its important work. But there is so much more to be done, and we are just getting started. Indeed the implementation of the recommendations of this royal commission will be a reform on par with universal education, Medicare and other reforms that—as a cursory glance at history shows—only Labor governments get done.

I want to acknowledge the workers in the mental health sector: the nurses, the community and allied health staff, the doctors and every single mental health worker. They do some of the most worthy work in our community in the most trying of circumstances. I also want to thank the Health and Community Services Union for their work in organising and pushing for these reforms. I never forget that I am one member of a parliamentary wing of a political party of a wider movement, a movement made up of workers, extraordinary workers, who join unions like HACSU, the Australian Nursing & Midwifery Federation and the Health Workers Union. These reforms will be the reforms that workers in the movement, alongside advocates of all kinds, have fought and worked for for so many years. It has been hard work over a long period from a lot of dedicated people, but there will be results.

I conclude with a message of hope to anyone affected by poor mental health in our community. Some of the strongest people in our community are those who win battles that we do not see, that we know nothing about. It can be a lonely experience. It can seem like there is no-one out there to help, and accessing that help can be a huge step to take. There are days when you just do not feel like getting up, like you cannot go on. But that is when you put one foot in front of the other and you continue to walk. My message is simple to all those within our community, to the hundreds of thousands of Victorians who struggle with, who live with, who manage and who walk every day with their own experience of a mental health illness: you are not alone, we are listening—this government is listening—and we will treat the recommendations of the royal commission with the seriousness they deserve. If we do this, if we commit to this, we know that things in this state will change for the better.

Ms KEALY (Lowan) (14:16): It is an enormous privilege to be able to speak on today’s matter of public importance submitted by the member for Ringwood. I do give credit to the member for his contribution today. It is an extraordinarily courageous and bold move to be able to open up and speak of your challenges around your own mental illness. However, when you are elected to this place it is often your own stories which are most compelling to people within your own electorate. That is why we must tell our stories and do so free from any persecution and free from any side commentary. So as I said, I do commend the member for Ringwood for sharing his story.

I do want to acknowledge from the start all the people living in Victoria with mental illness and mental ill health. My office receives many contacts from people—from family members, from people who work within the sector—who are often in extreme distress, who often cannot get the support that they need and who are often facing extremely stressful conditions and do not know where else to turn but to come to my office. The number of people who are suffering from acute mental health crises who feel like they cannot go anywhere else and who come to my electorate office in Horsham really is quite amazing. We certainly are a triage desk for many of those people within our community. My staff handles this very well; they do so exceptionally well.

So for those people who are dealing with depression and anxiety, suicidal ideation, eating disorders, postnatal depression, diagnosable mental illnesses and the entire spectrum of mental illness and mental ill health, we are working towards making a difference for you and making your journey through life much more tolerable, to give you hope and most importantly to do it with compassion. We must always put that first. We must always, when we are talking about models of mental health, look beyond the clinical aspect. It is important that we always treat people with mental illness as people first and foremost. We must always act with compassion, support and awareness—awareness of each other, compassion for our friends, families and constituents and support for all Victorians.

Certainly the Liberal-Nationals are fully supportive of the Royal Commission into Victoria’s Mental Health System. It has been an amazing journey, I think, over the past year to see so many submissions from the wider community and people being able to express their experience with Victoria’s mental health system. So frequently this has involved sharing extraordinarily challenging stories of loss and of not being able to access the services needed. We heard from parents who have had children who have been admitted to an acute hospital bed—a psychiatric bed—have self-discharged and then self-harmed and taken their own lives. We have a responsibility to make sure that that is not the type of mental health support we are offering for people in Victoria. But when it does happen, we must listen to those family members who want to make change to people who do not want that experience to happen to other family members and to other people who are challenged with mental health. We must listen to the people who have provided evidence to the mental health royal commission, including the fabulous mental health workers, who know that there is a pathway to do this differently in Victoria. We must listen, we must act and we must provide the mental health support and services that every single Victorian deserves.

The problem that I see in the state of Victoria at the moment is that we constantly hear from the government these glowing reports that, ‘It will be great when we implement the recommendations from the royal commission’. The problem is that there are people who cannot access the mental health support that they deserve today. I think it is an absolute contradiction when we hear commentary from the Labor government that mental health is such a priority when at the same time we are seeing devastating cuts to the community mental health budget. It is appalling.

Yesterday I heard yet another story of the cuts that are being made to mental health in the state of Victoria at the moment. Yesterday I met with Cohealth. Cohealth have had a cut of $11 million over the past two years under the Andrews Labor government, which has meant that they have had to cut their entire community mental health service. They now have 300 fewer mental health workers providing support services to the people who need it most, who are at most risk of homelessness, of disadvantage and of drug and alcohol addiction, and who would not ordinarily enter the normal public health service. The Andrews Labor government has cut those workers.

As a result, we are seeing huge flow-on effects to other critical areas in Victoria. Our prison system is overflowing, our emergency departments are overflowing and we are seeing ramping happening. It is appalling to look at some of the statistics around our emergency departments. People with mental illness are waiting an enormous amount of time sitting in emergency departments waiting for mental health beds. If we look at that, the rate is now 53 per cent of people who are presenting are not able to get admitted into beds within the 8-hour time frame.

Why is it appropriate and why are we celebrating around the royal commission when we know today what some of the problems are? If you cut community health funding, you cannot keep people well in the community. It is more likely they will be disengaged from their friends and family, they will lose their jobs, they are at risk of homelessness and, most importantly, they are at risk of even further mental health damage. It is causing lifelong damage to these individuals, and we need to see changes now.

I refer back to an Auditor-General’s report which was tabled earlier this year. It is titled Access to Mental Health Services and was released in March 2019. It emphasises how important it is—and that we simply cannot wait for the royal commission to act—to make some key changes to mental health services in Victoria. I quote:

The Royal Commission into Mental Health will undoubtedly highlight many areas for improvement across the system. However, the need for planning and investment to meet demand is already known and as such work to address this should not await the Commission’s recommendations. Further delay will only amplify the problems the Commission seeks to address.

This is coming from the Auditor-General’s office. There was another report tabled earlier in the year, Child and Youth Mental Health, which echoed similar sentiments.

While we keep on celebrating, we keep on hearing from the government, ‘We’re looking forward to these recommendations from the royal commission because then we’ll make changes’. It is simply not good enough. We are losing Victorian lives as we speak. People are becoming critically unwell, and it is having a huge impact on homelessness in our communities including, as I said, in our prison system. Forensicare’s annual report was enlightening: people are waiting an average of 406 days to get the custodial supervision orders that were ordered by the court so that they can get the mental health support they need. People are waiting in prison for well over a year to get the mental health support they need.

If you look at any KPI across the mental health system, you see that things have been getting critically worse since the Andrews Labor government was elected. We simply cannot keep on accepting this government saying, ‘We believe in mental health support because we are having a royal commission’. You have got options to make a difference, to act today and change Victorians’ lives today. The fact is that your cuts to community mental health in particular have been so significant and so drastic, and they are affecting so many issues. Ambulances are at the bottom of the cliff, essentially. That is what I hear from the mental health sector. It is not good enough. If you look at some of the key KPIs around community mental health support services, we have seen a 20 per cent cut by Labor in community mental health since they were elected. This has resulted in a reduction of 15 per cent in the number of bed days available to community mental health clients, so we have dropped from about 74 000 to around 62 000 a year. On the client support units, we have gone from 661 000 in 2014–15 to a cut of almost 50 per cent by Labor, to 338 835 in the 2018–19 year. On the clients receiving mental health support, since the Andrews government was elected in 2014 the number has dropped from nearly 12 000 to less than 6000. More than 50 per cent of people who were getting support five years ago cannot access those same supports today. That is absolutely diabolical.

You are not talking about just numbers, about the number of people who can access a mental health bed, about the number of people who can access community mental health support; these are people who are struggling with mental illness. While we may have the words to be able to say, ‘We feel very, very sorry for you’, let us actually make a difference. I do pick up one of the lines which I thought was compelling from the member for Ringwood: the storylines must become budget lines. We need to make sure that they are positive budget lines because what we have seen from Labor so far are just enormous cuts, particularly in the community mental health sector.

We are also seeing disastrous results when it comes to how people manage their own mental illness. Of course that comes through in how people self-medicate and the numbers of people who are using drugs and alcohol to deal with their mental health issues. We always need to make sure that we focus on early diagnosis, followed by early treatment and providing ongoing support, for people with mental illness to give them the best possible outcomes for successful and amazing lives where people reach their full potential. We are not seeing that if we do not have those supports available, if we are not able to provide early treatment and early diagnosis and if people are not able to get the support they need in their local community. In my electorate of Lowan, it is 2 hours to the nearest psychiatric bed. It is simply unacceptable to see the rates of occupancy in those beds. So often people cannot even get into a bed. But we are not looking at changing this at the moment. We are still waiting for these royal commission findings. As the Auditor-General has said, we simply cannot wait:

Further delay will only amplify the problems the Commission seeks to address.

So I do urge the government: please, please put your words into action, because mental health is something that is important to each and every one of us. We all know somebody, if it is not ourselves, who has suffered from extreme mental illness or from mental ill health. If we do not put our best foot forward and actually act to make a difference to these people’s lives, the problem is not going to get any better.

We are expecting the interim report from the royal commission into mental health to be delivered in November. It is something that of course we will welcome, but again, let us not wait. The final report will be in October next year. There are so many people who have been affected by mental illness in the state of Victoria—and their friends and families and their employers, experts in the area and workers. I think there have been over 8000 submissions now. It has been absolutely overwhelming. But let us see a key injection of funds in the near future.

More importantly, when we talk about the royal commission, I refer again to the ongoing statement from the government that ‘We’re going to implement all recommendations’, and of course that is something that we would want to see; we have put so much work into it. The government has been hiding behind the royal commission so avidly and hiding its budget cuts behind the royal commission, we do need to make sure it does not have the same result as we have seen for Victoria’s 10-year mental health plan. Once that was agreed, published and celebrated by the Labor government, it was just shelved and forgotten.

We cannot do this. We have had so many reports, reviews and recommendations around Victoria’s mental health system over the past five years that Labor has ignored. Do not ignore the recommendations from the royal commission into mental health. Make a commitment to properly implement it and make sure that the Department of Health and Human Services does its job in implementing it. There were so many references in the two Auditor-General’s reports tabled earlier in the year, Access to Mental Health Services and Child and Youth Mental Health, which referred to DHHS’s complete ignorance of and inability to manage the implementation of those recommendations. Frequently there had been recommendations made in previous reports about which the government had said, ‘Yes, we’ll do it’ and they never came to fruition. You are only further hurting people in Victoria if you continue to allow the department to get away with not doing its job and improving services for people with mental illness. That is something that is a key criterion. It does not matter what you say; you will be judged on what you do.

I do again urge the government to put their money where their mouth is. As the member for Ringwood said, let us make sure that the story lines become budget lines. Let us see a reversal of the significant cuts to community mental health that we have seen in the state of Victoria since the Andrews Labor government was elected but, most importantly, let us listen, let us act, let us make sure that we are providing mental health support and services that all Victorians deserve—because we are certainly not seeing that under the Andrews Labor government.

Mr DIMOPOULOS (Oakleigh) (14:31): It gives me pleasure to add my contribution to the matter of public importance (MPI). I want to start by acknowledging the bravery and the courage of the member for Ringwood in his contribution, and obviously other colleagues in previous contributions. I thought the member for Ringwood’s honesty was breathtaking. It always is, but it is even more difficult to do it under the circumstances of this MPI.

I will address the member for Lowan’s comments, which I think were unfair but also really distasteful, because the member for Essendon and I thought she very quickly got to politicising this issue, which is a real shame.

Ms Kealy: On a point of order, Speaker, I take extreme exception to the member’s comments and also the member for Essendon’s comments around me being disrespectful in this place. I was entirely respectful throughout my contribution.

A member: Distasteful.

Ms Kealy: I have been corrected—sorry, ‘distasteful’ comments. I was entirely supportive of the member for Ringwood. I was entirely supportive of people with mental illness in the state of Victoria, and I ask the member to withdraw.

The SPEAKER: Order! I did not hear any interjections, but I think this debate so far has been conducted without interjection. Some of the matters before the house on this MPI will invite comparisons around different policy positions and government performance and indeed further policy development in this space. There will be some debate on this MPI, so I expect members to respect each other’s position on this one, hopefully in a way, given the sensitive and important nature of the MPI before us today, that does not lead to a series of people asking for withdrawals.

The specific issue that the member for Oakleigh raised is a matter of debate regarding something that was put on the table by the member for Lowan, so I cannot ask him to withdraw it, but I do ask members to just be mindful of the spirit in which this debate has been conducted so far.

Mr DIMOPOULOS: Thank you, Speaker. At the risk of being interrupted again, before I go onto my contribution I will just be more expansive with the chamber and the Parliament about two aspects of what the member for Lowan said, which is not really for her but is for the people of Victoria and those living with mental illness and their carers. But nonetheless, there are two things that she said which I have a different version of reality on. Number one is that we developed a 10-year action plan that we left on the shelf. I can assure you that given that I chaired the mental health task force on behalf of the Victorian government for two years, actioning that action plan with at least 25 stakeholders around the table every month for two years, we did not just leave it on the shelf. In fact because of that work we ended up having at least eight pilots around Victoria, regional and metro, working towards halving youth suicide. We did a lot of work around the LGBTI community and a whole range of other communities, and that work is still underway, despite the royal commission.

Number two is that the other thing that the member for Lowan seemed to assume is that somehow we, the government, the minister and the Premier, are leaving this space vacant because we are waiting for the royal commission. That is not only false, it is so, so insulting to the sector, to the communities that are participating in policy development and to the list of investments that the member for Ringwood read out—I think $170 million-odd in last year’s budget. Sometimes in this place facts have to accord with what you say. You cannot get away with a gulf between what you say and the reality. It is just absolutely atrocious.

Ms Kealy interjected.

Mr DIMOPOULOS: Member for Lowan, I have read double what you have read on mental health, despite your history in public health in regional Victoria. Nonetheless, I now proceed to talk to people that actually—

Ms Kealy: On a point of order, Speaker, I think that personal comments made across the chamber that are directed to me as to how much reading I have or have not done, when the member for Oakleigh—

Members interjecting.

The SPEAKER: Order! The member for Mordialloc! The member for Lowan has the call.

Ms Kealy: Speaker, I am finding that elements of this debate are entirely personal around me. Given that our topic today is around mental illness—

Members interjecting.

The SPEAKER: Order! The member for Sydenham!

Ms Kealy: Given the topic of today’s matter of public importance was raised by the government around mental health, I find it absolutely disgusting to hear constant references to me personally. Whether it is through interjections across the chamber or whether it is through comments by the member for Oakleigh, I think it is an absolute disgrace that there is this chipping away and attempt at psychological warfare when we are talking about—

Members interjecting.

Ms Kealy: And I note the giggles from the Labor side of the chamber.

Ms Green interjected.

The SPEAKER: Order! The member for Yan Yean! The member for Lowan has the call.

Ms Kealy: I think that it is completely unacceptable when we are debating the importance of mental health that targeted and personalised comments are being made, directed at me by the member who is on his feet at the moment but also by other members of the government who are interjecting across the chamber. It is completely against what the purpose is of this MPI, which is around supporting people with mental illness, and I ask you to ensure that all members are respectful of one another in such a sensitive debate.

The SPEAKER: Order! The member for Oakleigh was referring in his contribution to points that you had raised in your contribution. There is a difference between the member for Oakleigh personally attacking or misrepresenting the member. In this case he was putting forward a counterargument to issues you had raised, which is not something I can counsel the member on. I have asked the chamber to respect the nature of this debate. I will listen carefully for any interjections that are raised that might be inappropriate.

Mr DIMOPOULOS: Thank you, Speaker. My comments on this matter of public importance are for those Victorians living with mental illness, the people who love them, their carers, their families and the workforce. They are the ones who deserve our time and our attention and the investments we are making. I want to say to them in the brief moments that I have left: you have in this Parliament generally, but specifically in this government, a group of people who are interested and listening and ready to help and walk down the path with you. They are not just empty words, because we have already made those investments.

But we are making the biggest investment already, and that is the Royal Commission into Victoria’s Mental Health System. While I say it is the biggest investment, apart from the very nature of that being the highest form of political inquiry, the Premier has said numerous times that we will support its every recommendation prior to even knowing what the recommendations will be. That is how serious we are about mental health and supporting all those Victorians and their families. That is my message on this matter of public importance. I invite Victorians to hold us to account on that over the next several years. Like many other projects this government has commenced, these are long-term projects, because only through long-term projects do we change the face of Victoria.

Mental health is not easy. If it were easy it would have been fixed years ago. It is not easy. That is why we say we do not have all the answers, despite the extraordinary professionalism of the staff and the extraordinary professionalism of the carers and their commitment to their work. We do not have all the answers, so much so that the system in many respects is broken, as the Premier and the Minister for Mental Health have said.

I want to just take a couple of moments to leverage off what the member for Ringwood said effectively about leadership and making a difference in the lives of a whole range of people, even at the local level: your neighbour, your friend, your family member, your work colleague. I thought the member for Ringwood’s description of the excuses you need to make when you do not want to say that you have a mental health issue that day were profoundly honest and profoundly true. I faced that as a gay man in terms of making excuses as to why I did not want to go out on a blind date with a girl, or on a whole range of things. That was my everyday experience growing up. Your everyday experience in mental illness in many respects would be a living nightmare, and I had that experience with my cousin and I have had that with other friends.

I commend the leadership. I do not want to make it all about this place, but I am thinking of colleagues in this chamber on both sides and colleagues in the federal Parliament as well. I am reminded of the former member for Williamstown and people who have shown leadership in sports, in academia, in the community sector, in business and in politics who come out and say, ‘This is actually okay’. We will get there one day, as the member for Ringwood said on stigma, when it will be as easy to say to someone, ‘I’ve got a mental health issue today, I can’t do this’, as it is now to say, ‘I’ve got to go and get my leg checked out at the doctors’. That is what these debates are about. That is what our investments and the high-profile royal commission are about. I commend the MPI to the house.

Ms BRITNELL (South-West Coast) (14:41): Today this is a really serious matter of public importance, and I am quite disappointed already by the attack on my colleague because I thought she was very respectful. We are here to make sure we govern and do the best we possibly can with the money that comes into the state for the people who need it. I would like to begin by acknowledging the challenging environment that the carers and the sufferers of mental illness endure as we speak. This is probably one of the biggest things that comes into my office: people who are struggling with mental illness come into my office, they are trying to navigate the system and they are at their wits end.

Now the member for Oakleigh may have read a lot about mental health, but for at least 15 years of my nursing career I was at the front line of mental health, so I think I will spend a little bit of time just sharing how challenging that environment is. I have not actually practised for four years, but what I have seen in those four years whilst in my office, seeing what is happening from people coming into my office and telling me about the wrestle they have with the system, is that it has got so much worse.

If you have got a mental illness, it is really important for you to be able to access support: psychologists, mental health professionals, nurses and drug and alcohol support sometimes depending on the situation—not always but certainly sometimes there are very complex clients as we used to call them. What we need to do as a society is give the supports that are necessary. We have got this current government who spend a lot of time talking about how much they care and about how much they are prepared to do, and yet as it says in an Auditor-General’s report which I have here:

The Royal Commission into Mental Health will undoubtedly highlight many areas for improvement across the system. However, the need for planning and investment to meet demand is already known …

That is actually what I have been finding on the front line. For us to wait and to have this current Labor government saying, ‘We care so we are going to find out what is going on’—as the Auditor-General says, we should not await the recommendations of the royal commission. There is so much already known, and:

Further delay will only amplify the problems the Commission seeks to address.

Already I have been on two inquiries, and both those inquiries, the autism inquiry and the perinatal inquiry, highlighted a problem in the mental health system. This is what I saw when I worked with CAMHS—the Child and Adolescent Mental Health Services teams. Now I did not work with them—I was accessing the services for clients—but they were at their wits’ end. In Warrnambool, in Portland and in Hamilton, which is in the member for Lowan’s electorate but is in the catchment I was working in as a health professional, they were the services I was trying to access.

Staff are under enormous pressure and they cannot take extra clients. That is what we saw in Warrnambool a couple of weeks ago when a young man wanted to be admitted to a facility for mental health support and they just did not have the capacity to take on board anyone else. So he went into a shop and started opening up products and said, ‘Call the police, I want to be arrested’. He was then unable to get, even when arrested, a bed and facilities. We see that in the articles that are in the paper. There was one just last week about the Thomas Embling Hospital, where we have got people in prison for up to a year waiting to access mental health support. I actually had many a client steal a car, set fire to their apartment and do all sorts of extraordinary things to get help. They would even say to me, ‘Roma, I just need to get in the pen for a while, because that way I won’t kill myself’. This is extreme.

I have got a 16-year-old daughter and she tells me about kids—not at her school now and not where she was in school last year—who are cutting themselves. I had never heard of that. Twenty years ago and when I was at school, I had never really heard of self-harm. Munchausen syndrome has just come from the back of my mind from my training days. We all knew about that, but we did not see it in kids. You did not see it in the ways we are seeing it today. Principals are telling me about this.

We are seeing suicide rates of 3000 a year—the highest reason for death in young people. I was reading an article by John McGrath, a former member for Warrnambool, who had a son who lost his life to suicide. John says that 3000 people are dying every year from suicide. That is eight people a day. Now, I know for a fact that the GPs in Warrnambool that I talk to—and obviously I have worked with them for many years, so I know some of them fairly well—just say to me, ‘We are just throwing our hands in the air’. There is a massive load of evidence. This is what the reports of the autism inquiry, the perinatal inquiry and, I am sure, many other reports that the Auditor-General referred to tell us—that there is no point in waiting, that there are plenty of actions we could be taking right now.

This is what is so disappointing about what the member for Oakleigh said, because it was not the member for Lowan who was saying that the work has not been done. She was actually quoting out of the Auditor-General’s Access to Mental Health Services report from March 2019, which says the 10‐year plan outlines few actions that demonstrate how the government will address the demand challenge that the 10‐year plan articulates. That was what she was talking about. It is not her opinion; it is actually the Auditor-General’s opinion.

I really find it hard to hear this government constantly telling me how much they care. Get out there on the street and look and talk to the people, because you only have to scratch the surface and this proclamation of care is very scant in evidence that backs up that there is actual demonstrable action. Action in government is often about providing resources, and those resources have been severely cut. Their own budget shows us that in 2014 there was $123.4 million going into mental health community support services, and that has been reduced in 2018–19 to $98 million. That is a 20 per cent cut. The client support units were cut by 50 per cent by Labor from 2014 to 2018.

When I was training there was a facility called the Brierly Mental Hospital. Brierly was our mental health institution. It was an institution, and I am not advocating for one minute to go back to institutionalisation days, because there were clients there that should never have been there, like young men who had PKU, phenylketonuria, which is what you get from consuming Coke or other products when you have a gene that some people have and some people do not; it is that prick kids used to have on their heels but do not have any more. They grow up and are mentally affected by the PKU that they took in. Anyway, there were kids like that and there were Down syndrome children who had no place there and are much better in the community like we are doing today.

However, there were 200 beds in that facility. We now have, funded under the Napthine government, a new facility, but it is only 15 beds, and five of them are for aged care. We have been waiting. It was originally funded under the Napthine government, and the Labor government have continued with that facility, but there is a mother-child unit there, so if you have got postnatal depression or some mental health issue and you have got an infant, you can actually go to that facility. The resources and the funding have been built to house that situation, but they cannot access it because there is no funding for that. So here we have got a facility, and I do not know if they have actually got the funding now—I need to check—but for 12 months it has sat there without the ability to be utilised for what it was intended. So these are the sorts of things that the government are missing the opportunity for.

What we have got is a community in my part of the world and, I am sure, right across Victoria who are saying, ‘We can’t wait. Why is the government saying, “We’re going to wait till the end of a royal commission?”. We are going to do things’. And they are. They are doing things like the Nurturing Room at Warrnambool East Primary School, which is really helping settle children who were traumatised so they can actually go into a learning environment, and the Big Life program, which is addressing the issue of children at school who have suicidal tendencies or are self-harming. The community themselves are actually asking for support. There is even the Standing Tall project. This demonstrates that the schools are saying, ‘We actually need to put an environment of support around our kids before we can educate them’, but the government just does not come to the party and recognise that mental illness and mental health need more funding for schools to be able to put those supports around people.

I will never forget a young man, who is now dead, who was found on the side of the road about five days after he died because nobody helped him. His mum begged me—absolutely begged me—to help her support him, but we could not get her the support, and he died. That mother to this day leaves a mark on my life because we need to do more.

Ms GREEN (Yan Yean) (14:52): It is with great pleasure that I join the debate on this matter of public importance (MPI) advanced by the outstanding member for Ringwood. We have seen his courage not only today but over the whole time that he has been in this place. One of the things that I really love about this MPI is that it encourages all of us in this place to have conversations with people in the community so that we can get rid of the stigma of mental illness. And I think that we should be really grateful to the member for Ringwood for saying that. It is one in two of us in our lifetime that will have some experience of it—well, nearly half of all of us—and one in five Victorians who will experience mental illness this year alone. They are huge figures.

I had really hoped that this matter of public importance would have been conducted in a really, really bipartisan way, and I am getting a bit sick of the member for Lowan, I must say. She just really feels that if she advances an opinion in here and someone says that they disagree with her opinion, that is a personal attack. I think she really needs to look in the mirror. It is not a personal attack when you disagree with someone. This place is about debate, but she also needs to be held accountable when she says things that are wrong and need to be responded to. I am not going to make this matter of public importance about her, but she really does need to have a look in the mirror.

It is interesting that I am the third speaker in a row with some experience of south-west Victoria, and I am sorry that the member for South-West Coast has just had to leave the chamber. I want to congratulate her on her work as a mental health professional and for speaking about her work as a mental health professional. Indeed my first experience and intersection with the mental health world was with Kevin Goodger, who was my mentor. He was a mental health nurse and a navy veteran, and he worked at Brierly, the mental health institution that the member for South-West Coast referred to. Kevin was one of the mentors who encouraged me to get involved in politics, to be concerned about mental health and people with mental health illness and also to be involved in a union. Kevin is a life member of the Health and Community Services Union. He is still alive. He is over 90. So thank you, Kevin. One of my school friends, Paul Healey, from Warrnambool, was also a trained mental health nurse mentored by Kevin, and he is now the state secretary of the Health and Community Services Union.

Despite those early connections to mental health, it was only ever talked about in hushed tones. My mum lost a baby boy at full term in the 1960s and my dad nearly died having two open-heart surgeries. Mum was then later wrongly diagnosed with postnatal depression. We moved to Mildura when I was 16, and I became homeless due to my mother’s mental illness and her turfing me out of the house. Dad had a fatal heart attack on the cricket field aged 44, leaving Mum as a widow at 40, so that meant it was really difficult for her to get the care she needed. She finally received treatment and a diagnosis of schizophrenia. A cruel conversation had by a nurse, overheard by my sister, in the pub in Mildura added great pain to my siblings’ and to my mother’s recovery.

The day after we buried Dad, before we had discovered Mum’s mental illness, or the proper diagnosis, was Ash Wednesday. Four family friends died. I will come back to what that meant and what I have learned since then. It was a long road for Mum to finally get a diagnosis—and a great deal of trauma for me and my siblings. It took two years of angst and pain, but my mum went on to study youth affairs and is now quite a well-regarded artist. She has barely had a mental health episode in 25 years, but the shame lives on. She still cannot say that she has a mental illness, despite most other people being able to say ‘I have diabetes’, ‘I have a heart condition’ or ‘I’ve broken my leg’. What I learned from Ash Wednesday and from my mum and her intersection with the mental health system really helped me—not that I wanted it—when all my worlds collided on Black Saturday. In the almost 11 years since, I have seen hundreds of people who have struggled with that trauma, and I want to continue to be a voice for those people.

I want to thank the Minister for Mental Health for his absolute understanding and other ministers who provided support in the lead-up to the 10th anniversary, understanding that there would be more of a challenge on mental health. I want to particularly thank the Minister for Mental Health for extending support services in the Kinglake Ranges, which are finally being accessed. Some people are accessing them for the first time, and particularly first responders. One of the things that I know will be fixed with the Royal Commission into Victoria’s Mental Health System is the fact that unlike any other—

Members interjecting.

Ms GREEN: Sorry, the minister at the table, could you please be quiet? I am trying to speak. I cannot hear.

People are actually now able to have services in the ranges. Also, with what I was saying about the catchments, there is no other health problem where people have to be directed to a particular catchment. For example, half the students at Diamond Valley College and Whittlesea Secondary College come from the Kinglake Ranges, and almost all of them are from Black Saturday-impacted families. It has been a constant struggle for them and for the educational professionals to actually have the Department of Education and Training understand the additional supports that they need. That was until the Minister for Mental Health recognised that we needed to relax the catchments, and I am so, so grateful for that.

If students or teachers at those schools had a mental health episode, they would have had to have been shipped off to Shepparton. That is inhumane. That means at the moment they can actually go to the child and adolescent mental health service at the Austin or at the Northern should they need it. They have a choice of where they can go. But we went down the path of a royal commission because we acknowledged—the Premier acknowledged—that the system is broken. The member for Lowan and the member for South-West Coast outlined some aspects of the system being broken as if we were being lectured about it being broken. We have put our hands up and said that it is broken, just like when Julia Gillard referred the disability services to the Productivity Commission and it was found that the cost of not acting was actually more than the cost of acting. I think that is what we will find with this royal commission. This is not the time to actually be finding fault with each other and saying that this government is not doing enough. We have said that we know more needs to be done and that every single recommendation will be funded.

The member for Lowan and others want to waste their time, rather than looking at how we should do things in the future, saying that this is the only government from their point of view that has not supported people in the community adequately. I would draw to the attention of both the member for South-West Coast and the member for Lowan that there were significant cuts in their electorates from 2010 to 2014, so let us not try to be the only pure people in the henhouse. There were certainly cuts under that government. On the one hand people on this side of the house, a little bit further around from me, seem to be constantly talking about the need to cut budgets and to cut back and then at the same time are saying that services are not being delivered. We are the government that has put the runs on the board and that is enabling people to speak about their experience before a royal commission, and we will act on those things.

I want to assure the people in my community—the first responders, the police, the fireys, the ambos, those still affected by Black Saturday and the serving Australian Defence Force members—that I will stand up for them as part of a government who will stand up for them. I commend this MPI to the house.

Mr WAKELING (Ferntree Gully) (15:02): I am very pleased to contribute to this very important matter of public importance (MPI) on a very important topic. Can I also place on record my thoughts and congratulations to the member for Ringwood for sharing his personal story. That was certainly very brave—well, I would not say brave; I would say that he showed great courage to stand up in this place to tell us his story, and I wish to place on record my congratulations to him.

Mental health is a very significant issue that affects this state. It affects communities and it affects towns, but it also affects families and it affects individuals. Behind every incidence of mental health is a person, is a parent, is a family member, is a family network and is a friend network, and they are all impacted in some way, shape or form by mental health. Many in this house, either personally or through their family or through their friends, will have seen the impact of mental health. I am no different, having seen it through my own family, having seen the impact of mental health in my own family and having seen the impact of drug use in my own family and how it impacts not only the individual but also family members.

I still recall a time when I had a grieving mother in my office telling me of a situation where her son entered the emergency department at a government hospital seeking assistance, waiting for an extended period of time, subsequently leaving because of not being seen and then taking their life. I am not here to pass commentary on hospitals and I am not here to pass commentary on that specific situation, but what I am drawn to is the mother and the grief that that mother faced and still faces even to this day. So I know that there are personal circumstances where mental health is about more than just funding and it is about more than just services; it is about ensuring we have a system that supports this important sector, because it is about people, it is about families and it is about communities.

I support and congratulate the government on its actions with respect to the establishment of the Royal Commission into Victoria’s Mental Health System. I do sincerely hope that the courage and the convictions of those that appeared before this royal commission and the recommendations that are handed down and provided to this Parliament are picked up by the government and acted on by the government. I say that not just because that is the expectation of a government, but because the government has an obligation and a responsibility to put in place the support that is needed to deal with this very significant issue. Whether it is young people in my community or whether it is young people in the member for Gembrook’s community—and the prevalence of mental health and suicide is well reported in his community—we as legislators have an obligation to do what we can.

Commentary has been made by my colleagues previously with respect to the current predicament in the mental health space. Yes, there have been reductions in funding, and yes, those issues have been identified by the Auditor-General, but what this is about, the purpose of this debate, is that if we are going to use the MPI to shine a light on the predicament that is mental health and if, as we heard the member for Yan Yean just say, there is more to be done and that is the reason why the royal commission is helping to shine a further light on what is needed in the sector—to provide better support, improvements and outcomes for those who are afflicted by mental health but also for the ongoing impact on families—then it is important that the government looks at those issues that have been raised through the Auditor-General’s reports, because funding in and of itself is figures on paper, figures in a budget document. But what they are actually about is funding services to provide support so that those within our community that need that support can access those services and can access help and so that a mother can know that their child can access the help that they so desperately need and that a mother can know that when they are seeking for their child to get assistance they are not going to be on a list, they are not going to be in a queue and they are not going to be in a situation where they cannot get the treatment and the support they need.

We understand the difficulties of this system. We understand that you are never going to have a situation where every person who has an affliction can be treated at that point in time. Victorians understand that. But Victorians also know that governments of all persuasions have now recognised the scourge of mental health. When we go back and we look at the creation of Beyond Blue, a former Liberal Premier received support from an incoming Labor Premier to fund a program to shine a light on depression. This is an issue that is well beyond politics. It is about ensuring we have the necessary systems in place to support people.

As I said, the support that Victorian governments provide today and communities provide today are far better than they were just 20 years ago. That is the reason why it is so important that we look at the Auditor-General’s reports and other reports. Yes, it is imperative that we look at what happens through the royal commission. The royal commission is going to make a series of recommendations, and it is imperative that the government takes those recommendations and does what it can within its budgetary process to ensure that the funding is provided and that the actual services are coordinated in a way to better meet the needs of Victorians.

But we have also got issues today. We have got people who are dying today. We have got people who are suffering today. We have family members who are grieving today. We have family members who are at their wits’ end, who are calling their members of Parliament in the vain hope that someone somewhere will listen and do something to help a family member. We know that it is not a perfect system, but we all have an obligation, each and every one of us has an obligation, to look at the Auditor-General’s report and seek advice from experts to identify where the gaps are, to identify where funding shortfalls are, to identify how we can make systems better and to identify how we can all work together better to provide a better system. Sometimes it is about money, but often it is not. It is just about commitment. It is just about talking. It is about the way in which we structure our networks. It is the way in which levels of government work together. That is what we need to be focused on, and that is why an MPI like this helps us all to shine a light on this very important issue.

I know that the government knows that this is an important issue. Everybody knows that this is an important issue. The Minister for Mental Health, who is at the table, knows it is an extremely important issue. But we all have an obligation to look at the advice we receive from those that we empower, such as the Auditor-General and others who make recommendations to government, because at the end of the day it is not about politics, it is not about members of Parliament and it is not about political parties. It is about people, it is about families and it is about communities, and that is what I want to see come out of this matter of public importance.

Ms SETTLE (Buninyong) (15:12): I rise to speak on this matter of public importance. I would also like to acknowledge the member for Ringwood’s outstanding contribution and also of course for him bringing this MPI to the house. He talks in the MPI about the need for us all to break down the stigma and barriers around people seeking help. He talks about the role that each of us can play in going out into our communities and breaking that stigma down.

On a personal level, Mental Health Week this year coincided with Gambling Harm Awareness Week, and in my frame I believe they belong very much in the same category. During that week I decided to speak to the local newspaper in Ballarat, the Courier, about my own experience and my family’s experience of suffering from gambling harm and in particular my ex-husband’s grappling with his own mental health. It was not an easy thing to do. It does take something to stand up and say it, but I think, as the member for Ringwood points out, we really need to stand up. We are in a position to stand up, and we need to do it. So I was very proud to have been able to contribute to that discussion within the Ballarat area.

This government recognises mental health is a key issue, and that is very clear. One in five Australians is living with mental illness at any one time, and around half of us will experience mental illness in our lifetime. For every person that is experiencing mental health issues there are of course five or six family members and friends around them who are impacted as well. Last week I met with two really extraordinary women from the Family Advisory Council at Ballarat Health Services. Both these women are the prime carers for their adult children with mental health issues. You could see in their eyes the love they feel for their children—absolutely evident—but you could also see the pain. They talked about that fear that one day they might not get home in time.

We are losing too many Victorians to suicide. It is the leading cause of death for people aged 15 to 44. There is a lot of stigma and there are still problems in accessing support and care for people experiencing mental health issues. We need to bring this issue out into the open to deal with the stigma and to understand the shortcomings of the current system.

As someone who has worked in the community health space in Ballarat, I know how widespread these issues are and their impacts on our community. We see the impacts of mental health issues in many areas, such as domestic violence, substance abuse and homelessness. We need to stand back and look at the whole sector and how it is or is not working. That is why I was so incredibly grateful when this government announced a Royal Commission into Victoria’s Mental Health System. Many people have their own views on the issues that they would like to see addressed at the royal commission. For me it is about services for those with a gambling addiction. In an area as diverse as mental health, and with an issue that impacts so many Victorians, it is so important that a royal commission has been established, and at its conclusion we will have a clear set of recommendations to get the system right. This is a real opportunity to look closely at the care and services we provide for those in need of support. We have called this royal commission to get all the facts.

I do take objection to some on the other side suggesting that this government, in calling the royal commission, is sitting on its hands and waiting for the recommendations to come out of that royal commission. I absolutely refute that position. We have done an enormous amount of work and continue to do an enormous amount of work. Since 2014 the Victorian government has increased funding to mental health by 181 per cent. That is an enormous increase in funding. Our nation-first suicide prevention framework is delivering us one of the nation’s lowest suicide rates, but of course as suicide is preventable we want to halve that rate by 2025. Our 2017–18 budget made a landmark investment of $325 million, and the 2018–19 budget delivered a record $705 million for mental health, so to suggest that nothing is being done in this space could not be any more incorrect.

While I was working at Ballarat Community Health, I was privileged to share office space with the School Focused Youth Service, and I saw the daily commitment and passion that Rozi and Jo, who ran the program for Ballarat Community Health, brought to the program—an incredibly important program which reaches out to children in a school situation who may be vulnerable. In 2013 the School Focused Youth Service was threatened with closure under the Napthine government. The providers had previously been informed by the Napthine government that they would not be funded past June. Then there was a flip-flop as people raised objections. So it is incorrect to suggest that this government is not doing anything. We continue to fund those wonderful services and have made record investments into mental health funding.

Locally, for me it has been quite extraordinary to watch it all unfold. In fact we have been absolutely delighted to welcome the Minister for Mental Health to Ballarat on quite a few occasions in the short time—one year—that I have been in Parliament. Just to give you a snapshot of some of the things that have gone on in Ballarat, the Minister for Prevention of Family Violence visited in April, with a $5 million funding boost for the Ballarat Centre Against Sexual Assault. That was in response to an increase in cases coming to CASA, because our region, as many people know, suffered very heavily through the clergy abuse trials and there was an increase in people seeking help.

In May the Minister for Mental Health announced $2.3 million over two years for Ballarat Health Services and Uniting Ballarat to deliver support to locals who have a significant, enduring psychosocial disability but cannot yet access the national disability insurance scheme. The NDIS is obviously a federal issue, but I am so proud that this government will not stand by and let people fall through the cracks.

Earlier this month I was very happy to announce the completed rollout of the Mental Health Advice and Response Service program in the Ballarat region. Courts across Victoria are being helped to identify and provide extra support for offenders suffering from mental illness. It is about having a health professional there to assist magistrates. This government has funded that program with $12.2 million over four years. It is a really crucial program, helping people to get the support they need.

Of course we are in the design process now for a new prevention and recovery care facility in Ballarat. Recently the Ballarat and District Aboriginal Cooperative was part of a demonstration projects program that is about supporting Aboriginal and Torres Strait Islander parents of children in or at high risk of entering the child protection system where unaddressed parental mental illness is a significant risk factor.

In Gambling Harm Awareness Week, on 10 October, I announced with Ballarat Community Health that the Andrews government is committing $100 000 to our region to tackle gambling harm, and most specifically to tackle it on the front of stigma. Stigma is really one of the major barriers to people seeking help for addiction and mental health issues.

The launch of our new campaign It’s Time to Talk About Mental Health will help to break down that stigma surrounding mental health. It’s Time to Talk About Mental Health videos will help to normalise mental illness and give permission to people to share their own experiences. I hope it leads to discussions regarding the importance of looking after our mental health and raises awareness around the prevalence of these issues.

On behalf of my community, I would like to thank the Minister for Mental Health for his absolute commitment to addressing the issues within the system. As a mother, I would like to thank this government for its commitment to breaking down the stigma around mental health. My sons’ generation seem more open to talking about their mental health, and it gives me comfort to know that if they should ever need help, they will feel supported to reach out. As the previous partner of someone who suffered mental health issues, I applaud the minister and this government for acknowledging that the system needs fixing and for their absolute commitment to implementing all of the recommendations of the royal commission. This is what good governments do, and this is what a good Labor government does.

Ms CUPPER (Mildura) (15:22): It gives me great pleasure to speak on this matter of public importance, that being to acknowledge the Royal Commission into Victoria’s Mental Health System and for all of us in this place to take up the challenge of starting up conversations about mental health in our own electorates to destigmatise mental health and to reflect the fact that nearly half of all Australians experience a mental health episode at some point in their lives.

Can I start by acknowledging some of my colleagues in this house who have at times in this term of government since I was elected shared their personal stories about their experiences with mental illness. I hope this matter of public importance debate today allows more of us to share those stories. Mental illness is compounded by silence and isolation. May we be role models for the opposite approach—speaking up and working together in a safe, supported environment.

I believe we have an obligation as a progressive, developed and humane society to provide support services to those in our community who are dealing with mental illness, and this is where actions like the Victorian government’s royal commission into mental health is so important. Mental health, like many conditions, exists on a spectrum. Some mental health conditions are low impact; others are more serious. The type of intervention required depends on the condition and its severity. As with other health conditions, our state-funded health services, particularly the acute mental health services in our hospitals, are called upon when mental illness escalates to a point of being dangerous to the individual, or emerges rapidly, requiring an emergency response. I acknowledge the hardworking staff of our state-funded acute mental health services.

In my electorate of Mildura our main hospital, and the only acute mental health service, is the Mildura Base Hospital. Our need for a hospital that can handle a multitude of complex mental illnesses is magnified by our distance from Melbourne. I suspect most members of this house would say that the acute mental health services in their electorates are underfunded, and my community is in the same boat. But the difference, I suggest, is our remoteness in Mildura, which means that our mental health services cannot readily refer patients elsewhere. They cannot access more complex care support, and they have to deal with whatever is thrown their way. The statistics are clear: the further away you get from a capital city, the more likely you are to suffer from mental illness. This can be linked both to other social and economic determinants and to the accessibility of mental health services.

In the coming months, thanks to the government’s decision to bring our public hospital back into public hands, I will be chairing a community consultative committee that will be looking at service planning for our Mildura Base Hospital as it is brought back into public hands in September 2020, an issue that this house knows is very close to my heart. I expect that the dire need for increased acute mental health services, as well as drug and alcohol services, at Mildura Base Hospital will be a top priority emerging from that committee. I want our new public Mildura Base Hospital to become a leader in rural and regional mental health service provision, recognising the challenges of our remoteness but also highlighting opportunities for unique and innovative approaches to mental health service provision.

This leads me to my next point: acute mental health services are just part of the equation. We must also recognise, and I certainly hope that this will be reflected in the findings of the mental health royal commission, that funding for primary mental health care is of critical importance to better mental health outcomes in our communities. For many other illnesses, our general practitioner is our first port of call. The implementation of Medicare programs like Better Access and other federal programs like Access to Allied Psychological Services, or ATAPS, have given GPs referral options for low-impact, high-prevalence mental health conditions such as anxiety and depression, but the investment in these programs is nowhere near enough to meet the need.

There are people in my electorate who have to wait up to two months to see a psychologist. This wait could be enough to escalate a low-impact mental illness into a more serious episode that requires acute care, otherwise known as an avoidable hospitalisation. In addition to the shortage of entry-level psychology services, there is a distinct lack of support for people with more complex conditions within the community setting. This lack of services means that people with mid-range mental illnesses who should be accessing regular treatment instead cycle between acute episodes.

While I acknowledge the investment of the Victorian government into prevention and recovery care facilities across the state, including in Mildura, that have provided a stepped-care approach to acute care, there is more to be done to prevent unnecessary hospitalisations. Community connectedness, destigmatisation and sharing stories, social inclusion and high-quality primary and acute mental health service provision are all ingredients for reducing mental illness. As leaders in our communities, and as members of this house, we have an obligation to pursue these outcomes.

I want to acknowledge that while mental illness can strike anyone, there are some segments of our community that are particularly susceptible to mental illness, and one of those segments is the disability community. That includes people with disabilities and their families and the carers, and I want to talk about this section of the community because I know it well.

Some quick statistics: according to the Australian Institute of Family Studies, 32 per cent of adults with a disability experience high or very high psychological distress, compared to 8 per cent without a disability; 59 per cent of parents identify anxiety in their children without a disability within disability families; 84 per cent of adult siblings of someone with a disability reported family stress and distress being an issue during their childhood; 66 per cent of adult siblings reported anxiety during childhood; and 54 per cent of adult siblings reported depression during childhood.

The reason we all need to be concerned about the mental health of this cohort and the services available is not just about compassion for those less fortunate but also self-interest because disability can strike anyone at any time. You might be relieved that your three kids are healthy and typical in their development and you might look at families struggling with a child with special needs and think, ‘Thank God, I dodged that bullet’, but ‘they’ could become ‘you’ at any time with an out-of-the-blue diagnosis or a freak accident that leads to chronic symptoms or permanent physical or intellectual disability.

My brother’s autism diagnosis came as a bolt from the blue for my family, and our lives have been irreparably changed. It has had a profound impact on my development. And while society likes to hear disability siblings talk of the fabulous gifts and lessons that disability has taught them and that they would not have it any other way, I cannot say that. The grief and trauma associated with disability in my early life led to long-term struggles with mental health, particularly depression as a teenager and anxiety as an adult.

No service can ever fix the private pain associated with many forms of disability, but it can do a lot to help those affected have a better quality of life. Had I been identified, as a child, at high risk for mental health issues and had support been available to me early on, it would have improved my mental health outcomes and saved the system from the cost of my mental health treatment over the years. I am lucky that my symptoms have always been relatively mild in the scheme of things and that my treatment has been relatively straightforward—in the form of sporadic psych sessions and medication—but for some families the mental health issues of their children are more acute.

Since I was elected my office has doubled as a crisis centre for clients of the national disability insurance scheme. The defunding of the NDIS by at least $3.4 billion this year is exacerbating the mental health crisis in our state and my community. Last week I spoke to a single mum called Gail. She has three children. Two are on the autism spectrum and one is neurotypical. Her children on the autism spectrum are high needs. Their symptoms include violent outbursts, speech delays and in the case of her nine-year-old daughter suicidal ideation. Gail was originally told she would have around $30 000 to cover all the baseline multidisciplinary services that her daughter needs. This was not ideal but it was enough for the basics. Then Gail was informed that the amount would be more than halved. This means that her daughter, who is nine, who wants to kill herself, will not be funded to receive the basic fortnightly psych sessions that she needs to keep her head above water.

I know some people, some leaders, are fixated on tax being an evil imposition on our society. But when I hear ads on Spotify about the federal government’s tax cuts and I consider the defunding of the NDIS and I think about that nine-year-old kid, I draw a very different conclusion about what evil is.

I know another single mum who is a talented entrepreneur and who works hard to support her three children. She struggles every day with two boys with special needs. Her youngest child, who is five, is developmentally typical but her mental health is under constant strain. Her mum knows when the stress is becoming unbearable because this little girl starts to pull out her hair. This little girl needs respite from her brothers’ violence, but NDIS funds to support her brothers’ respite are limited. Despite the best efforts of the children’s mother, this little girl’s mental health trajectory is not good. It is in the best interests of all of us that this child does not slip through the net like I did. It is in the best interests of the state and the nation that this little girl is able to meet her full potential and have a smooth run into adulthood without episodes of debilitating panic attacks like I had.

Against this backdrop, thank God the Andrews government has committed to this royal commission. Thank God for the advocacy of people like the member for Ringwood, who spoke in his maiden speech about his own mental health struggles. Mental illness is not a matter of us and them; it is a matter of all of us.

My office is systematically compiling statements of every constituent who comes to us about issues associated with the NDIS. We want our disability families to know that even though this is a federal issue, my office has their backs. I can only hope the Prime Minister heeds our call. We are talking about the most vulnerable members of our community who are struggling with profound challenges they have no control over. If the Prime Minister fails this test, I suspect God will judge him harshly.

Mr PEARSON (Essendon) (15:32): I certainly feel the weight of expectation on my shoulders in making this contribution today. At the outset I want to acknowledge the outstanding contribution made by the member for Mildura. The member has not been here very long, but I think she has demonstrated time and time again in her contributions in this place that she brings to this place an honesty, a sincerity and a passion. She has worked very well for her community. She has achieved many great things in a very short period of time, and listening to that contribution then I think that the people of Mildura are indeed fortunate to have her as their elected representative.

My good friend the member for Ringwood commenced this debate. I cannot for a moment imagine what courage and what strength it took for him to write that speech, to prepare for that speech, to get to his feet and to deliver that speech over the course of 15 minutes. It is unthinkable that a speech like that could have been given in this Parliament 10 years ago, 20 years ago, maybe five years ago. It was an incredible contribution that the member made.

As members, we are all the richer for having people like the member for Mildura and the member for Ringwood amongst our ranks. It brings out the very best of the Parliament because it provides us with a much broader and richer perspective. I think with their actions we are demonstrating that we have created here a kinder and gentler place, a place where people can have the courage to be able to talk about their lived experience, even with a degree of trepidation, because who would not be nervous or anxious about giving a speech like the member for Ringwood or the member for Mildura just made or indeed the member for Buninyong made earlier? We have evolved, we have come a long way and we are able to have people speak in this way and for there not to be that sense of judgement which would have been there not that long ago.

I am very pleased that the Minister for Mental Health is at the table. The minister and I have known each other for many years, and what I have learned about the minister is that he is a dedicated and passionate reformer. He has always brought that drive or that vision or that wish to improve things in every portfolio that he has held in the time that he has had the honour of being a minister of the Crown in the Andrews Labor government. The work that he is doing today in fostering, encouraging and supporting the royal commission into mental health is absolutely consistent with his pattern of behaviour and the diligence he has brought to bear in his time here.

So I am really pleased to be able to rise and speak on this matter of public importance. I am really proud of our government. I am proud that our government has sought to tackle really tough and difficult subjects like family violence and like mental health head-on, topics which have historically been very much taboo subjects. We did not talk really that openly and publicly about family violence. We did not talk publicly and openly about mental health. We did not do it in the 1980s when I was growing up, we were not doing it in the 90s and I do not think we were doing it in the early part of this century, but I think by the collective efforts of all of us we are starting to change that dialogue and discussion.

For me it reaffirms my belief in this great institution of the Parliament. The Parliament provides us with an opportunity to canvass these issues. It provides for elected representatives to come together collectively and to seek to tackle these issues head-on and to use the power of the state to effect social change. That has always been the reason why I wanted to join the Labor Party—and why I always want to be active in the Labor Party—because I absolutely had a keen appreciation that if you want to make real, meaningful change, then you have got to occupy the Treasury benches and you have got to be prepared to work diligently and collectively with a degree of unity and a degree of discipline and purpose in order to make these changes.

It is because we have been doing these things, because we have been unified, because we have been disciplined, because we have been focused and because we have been given this great gift of being in government that we can do these great things. We are changing this state, and potentially we are changing this nation through the leadership that we are showing by working together, identifying the problem and then finding a way forward.

I have listened to the contributions over the course of the afternoon. I have been here since 2 o’clock, and I think it is really important to note that what is currently in place is not working. I think there is broad agreement, whether it is in this place or whether it is with practitioners, whether it is with families or whether it is with victims, that things as they are constructed currently are not working. That is precisely why we are doing this royal commission, to try and understand how you actually change the system and how you try and make things better. You can throw more money at a problem, but if the structural integrity of the body with which you are trying to effect change is broken, then I question the efficacy of those resources and the outcome. I think that is exactly why we have embarked upon this course and why we are trying to tackle this.

I think that we are different in Victoria. I know that might sound conceited and arrogant to people outside of Victoria, but we have got a fantastic track record in this state of driving innovative public policy solutions to effect real change. You can see that in terms of the 1061 road toll campaign, you can see it in terms of the family violence royal commission and now with this royal commission into mental health, because what we are seeing here is not just a Victorian phenomenon. It is not just an Australian phenomenon.

There was an article written in the Atlantic,and it would have been published, I reckon, around about 2017. It talked about the youth of America today. What the article outlined was that in terms of young Americans, you have got the lowest rates of teen pregnancies in a generation, you have got low rates of drug use, you have got low rates of alcohol consumption and you have got low rates of road trauma. For parents, they invariably see their children in the home environment with their friends or on their phones talking with their friends and engaging in that way. So the parents feel comforted and reassured: ‘My children are at home. My children are with me. My children are safe. They’re not out drinking and driving. They’re not out taking drugs. They’re not having unprotected sex’. Yet the mental health outcomes in America today amongst young people are just as bad as they are here.

The Atlantic’s thesis is that one of the primary reasons for this is the ubiquity of smartphones and the fact that young Americans are having smartphones in their rooms, they are on their phones late at night and they are not sleeping properly. Why this resonated with me was because I remember speaking with Major Brendan Nottle from the Salvation Army. I said, ‘What is it? Is it that people get mentally ill and then they become homeless, or are people homeless and then they get mentally ill? What do you reckon is the factor at play?’. Nottle’s response to me was, ‘It is homelessness that leads to poor mental health outcomes, because when you’re homeless you don’t sleep properly because you’re frightened and you’re scared. So at night you’re active and you’re moving around because you’re fearful for your safety, and you’re fitfully trying to sleep during the day and you don’t sleep properly. It’s through a lack of sleep that you therefore have poor mental health outcomes’.

In raising this and bringing this to the house’s attention I am not for a moment suggesting that all people need to do is get a good night’s rest and their mental health problems will be solved. What I am trying to do here is to identify that there are global challenges that we are confronting, and there are widespread problems that we are confronting and that a royal commission, which has been championed by this government and supported by this minister, will play a key role in testing these hypotheses further. We will be in a position to work out what is an appropriate response to address that. It is through these initiatives and these endeavours that we will be able to try and change the system, and we might be able to show the world how you do it. We might be able to do that. This could be like the road safety campaigns of the 1970s and the 80s.

I am really pleased and delighted to be afforded this opportunity to make this contribution, but I want to again highlight and emphasise the outstanding contributions made by the members for Mildura and Ringwood.

Mr NEWBURY (Brighton) (15:42): Our mental health is as important as our physical health, yet our focus is often on our physical health. So too has been the historic focus of government, the development of policy and the investment of public funding. This may be partly because, as the recent Productivity Commission paper The Social and Economic Benefits of Improving Mental Health noted, many of the costs of mental ill health are intangible. The commission set out the very tangible costs of mental ill health, including psychological distress, social isolation, lower social participation, stigma and discrimination.

It is worth spending a moment outlining the breadth of mental ill health both in our country and beyond our borders. The Australian Bureau of Statistics National Survey of Mental Health and Wellbeing estimates that 45 per cent of Australians will experience a mental health condition and, further, that in the 2017–18 financial year there were 4.8 million people—which roughly represents 20 per cent of all Australians—with a mental or behavioural condition.

The most common mental illnesses are anxiety and depressive-related issues. Around 1 million Australian adults have depression. That represents one in seven experiencing depression in their lifetime. Over 2 million Australians have anxiety, which represents one in four experiencing anxiety in their lifetime. These statistics are not cold numbers but show that we will all know a family member, friend or colleague who suffers mental ill health. In fact we will know many.

The picture in Australia is not unique to the one within our borders. The World Health Organization has identified depression as one of the leading worldwide health problems. They estimate that 300 million people suffer from depression worldwide—300 million people. A paper published by the team at the Queensland Centre for Mental Health Research at the University of Queensland called Burden of Depressive Illnesses by Country, Sex, Age, and Year found that the Middle Eastern and Northern African regions suffer the highest rates of depression. The report, which also called for more research to be done quantifying the broader costs of mental ill health, concluded that ‘depressive disorders are a global health priority’ which ‘reinforces the importance of implementing cost-effectiveness interventions to reduce its ubiquitous burden’. Although it is limited, there is some research that has quantified the material costs. The National Mental Health Commission has estimated that the economic cost of mental ill health in Australia is more than $60 billion each year. The Productivity Commission has highlighted that the costs:

… of lower participation and productivity are about double the level of healthcare expenditure on people with a mental illness.

The current work of the Productivity Commission on mental health will no doubt be groundbreaking, and I note the draft report is due to be published tomorrow. In terms of government spending on mental health services, the commission estimates that in 2016–17 the federal government contributed at least $12 billion to mental health-related services and payments while the state and territory governments contributed at least $4 billion. Internationally the commission states that expenditure by our combined governments on mental health services is moderate.

Rather than only focus on the broader issue, I would like to take the opportunity to raise an aspect of depression that affects many young families in our community every day, that being postnatal depression. Up to four of every five women are estimated to develop the baby blues shortly after childbirth. The baby blues usually occur between two and 10 days after childbirth and bring a strong emotional feeling. These feelings tend to dissipate within two weeks. Beyond Blue estimates that for one in six women these feelings continue and develop into postnatal depression. Usually this form of depression comes within weeks of birth, but it can manifest itself within a year of a child being born. Mothers have described the at times crippling feelings of anxiety and inadequacy but most of all the overwhelming feeling of guilt and shame. Many mothers have described to me the shame they feel for experiencing depression. These conversations are difficult and confronting, but as a community these conversations are important to have.

These conversations are important for both new mothers and new fathers. A number of fathers from my community have approached me to speak about this issue. All of those fathers asked to speak to me separately and privately. Each came from a different walk of life and all had a different story. All had a partner who had been touched by depression after the birth of a child, and many had been touched themselves. In fact one in 10 men will experience postnatal depression themselves. Although there is some degree of public discussion about postnatal depression, there is no doubt that postnatal depression in men is less prominently addressed, and one wonders whether the cold statistics under-report the incidence in fathers.

These conversations with the men who approached me were extremely difficult because most of them saw their role in the family unit as being the supporter of their partner. But as we spoke it was clear the toll upon them was profound and had a profound impact upon them all. Some were overcome by emotion. All loved their partners, even the one whose relationship has since broken down. All of the men said clearly that they had completely misunderstood postnatal depression. All had not seen the signs in themselves and none knew that treatment paths were available to them too. In fact those fathers all similarly described their guilt in failing their partners and failing their families.

It did take time in some cases, but all of the affected families did seek help, though most of the men did not seek help from a health professional. Those men who approached me felt that they could have been better equipped. All of those men had attended pre-birth courses and suggested that those courses could be enhanced. In their report Healthy Dads? The Challenge of Being a New Father Beyond Blue found 45 per cent of fathers are not aware that men can experience postnatal depression, and 43 per cent of first-time fathers see anxiety and depression after having a baby as a sign of weakness—that is, half. These findings clearly illustrate that there is one policy area where we can and should do better.

Internationally, mental health is now a key policy issue. The World Health Organization’s Mental Health Atlas sets out up-to-date information on mental health services available worldwide. It is a significant, ongoing document that encourages countries to:

… provide comprehensive, integrated and responsive mental health and social care services in community-based settings …

In its issues paper the Productivity Commission draws out community-based responses to mental ill health and draws a link between that issue and homelessness. The paper states:

Mental ill health is closely linked with housing problems and homelessness … In 2017–18, about one-third of people who had accessed specialist homelessness services were experiencing mental ill-health.

To that end, last year the government opened five emergency accommodation shelters in Brighton East as part of its Towards Home program. The accommodation is based at South Road. At the time the policy was announced my community raised two significant concerns: firstly, that the shelters were temporary structures and not permanent buildings and, secondly, that the shelters were many kilometres away from adequate services. In short, the program lacked the integrated service focus encouraged by the World Health Organization. Tenants have been living at South Road for much of the year, a number of whom have significant mental health issues. One of the tenants at the site recently met with me to speak about a fellow tenant with serious mental health issues, for whom they believe the government has not provided access to proper services at the site.

Without nearby services to assist, there have been serious issues there at South Road. For example, at 1.00 am on 9 October an assault occurred involving two residents. Police attended the incident after reports of screaming. At least one of those involved in the incident required medical attention. After the incident one of the residents hung blood-covered clothing on the external wall of their property. This has understandably led to distress for neighbours and especially to distress for neighbouring children, who saw the clothing. This was all within sight of streams of young children who use South Road as a thoroughfare to nearby schools each day.

Adjacent neighbours have also reported antisocial behaviour both at the site and in the surrounding area. In fact neighbours have reported damage to their properties, including damage to guttering, damage to roof sheets, broken mailbox locks, plants being ripped out and residents or their associates jumping over neighbours’ fences into their private property.

Our mental health is as important as our physical health, and governments have rightly shifted their focus to the development of policy and investment in this space. But there is more to be done, in terms of both destigmatising issues like postnatal depression and making sure that our policy responses, including the way that we integrate solutions in a community setting, are adequate and take into account the broader community.

Mr STAIKOS (Bentleigh) (15:51): I think the last contribution went a little bit off track, but the contribution that I want to focus on today is that of my friend the member for Ringwood, who I think did a phenomenal job in sharing his story. We do thank him for being the government’s lead speaker, because sharing something so personal with so many people leads to a much-needed destigmatisation of this issue. It was certainly understood by members on our side of the house that in the act of being so public with a mental health challenge the member for Ringwood has made it that little bit easier for others with similar mental health issues to seek help and to be open about it, because stigma is the major problem when it comes to mental illness, and perhaps I will talk a little bit more about that a bit later.

Unlike the member for Ringwood, I cannot say that I come to this debate with any personal experience of Victoria’s mental health system. Any experience I do have with Victoria’s mental health system is really my experience as a local member of Parliament, assisting my constituents. Over the five years I have been in this place there have been many constituents who have come to see me about Victoria’s mental health system, mainly parents struggling to deal with a mental health issue concerning their child. I have had grown men and women cry on my shoulder over that period of time. I have had parents come to me whose children had taken their own lives, many in the most horrific of circumstances, which I will not go into today.

Recently we advertised a mental health forum that I held with the member for Oakleigh in the local community. Just in the promotion of that forum I heard from a lot of people—that I knew and had known for many years in the local community—who opened up to me about some issues going on in their own homes. It just made me think. This issue has been so stigmatised. There are people you think you know well, but you just do not know what is going on in somebody’s home and the struggles that they are experiencing.

I think it is really important that we are having this debate just before we are about to commemorate Remembrance Day, because I know that every time I visit an RSL, every time I lay a wreath at an Anzac Day service or a Remembrance Day service, I do not only think of those people we have lost in active combat, I think of the people who returned and were never the same and many who took their own lives because they could not recover from what they saw. The war in Afghanistan ran for 13 years, and in those 13 years Australia lost 41 people from the services. But in 2015 alone we lost the same number of veterans to PTSD-related suicide. Since 2001, when that battle began, we have lost nine times the number of veterans to suicide as we did on a battlefield in those years.

You have to wonder why so many people who visit these services, who commemorate these important occasions and who visit our RSLs, do not know these statistics. It all comes back to one thing: stigma. It is something we should all be aware of. I think one of the best things about the government announcing the Royal Commission into Victoria’s Mental Health System, the highest level of political inquiry, is that it shines a much-needed light on an issue that has been swept under the carpet for far too long. And of course the minister at the table, the Minister for Mental Health, is the minister responsible for that, and I commend him for the work that he has done on this issue so far.

In preparation for this royal commission, namely the release of the interim report in November, the member for Oakleigh and I—as I mentioned earlier—decided to hold a forum so that we could facilitate a way in which our local community could express their own views of and also their unique experiences with the mental health system. I thank the Minister for Mental Health for spending a few hours at that forum, talking to people and listening to their experiences. It was very much a worthwhile thing to do. I know that the member for Oakleigh and I have made sure that all of the feedback given to us at that forum, all the examples and the unique experiences of the participants, has been passed on to the government through the minister’s office so that we can make sure that our local community is well represented in that process.

What we have already been doing, though, prior to the royal commission is substantial. What I want to point to is our initiative for mental health workers in every secondary school. I am very fortunate that the region that my electorate is located in has been first cab off the rank to receive mental health workers in our secondary schools. Both McKinnon Secondary College and Bentleigh Secondary College now have mental health workers there every week. When I promoted this new initiative of the government on Facebook, I was genuinely surprised by the significant reaction I got to it. It just made me think. It is not as sexy as a new school or a level crossing removal—it is not as flashy as any of those things—but it is something that is on the mind of every Victorian. Mental health and how we deal with it is definitely on the mind of every Victorian.

I am very proud of my local community. My local community has been working very, very hard to eliminate the stigma of mental illness. I want to make mention of one young man in particular. His name is Ash Nathan. He is a student at McKinnon Secondary College. He came to see me earlier this year with an idea of riding his bike from Melbourne to Adelaide, which is around a 700-kilometre journey, to raise awareness of mental illness but also to raise funds for Beyond Blue, a wonderful organisation that no doubt has saved countless lives. He completed that journey. He raised over $10 000 for Beyond Blue, but more importantly, he raised awareness. He is in year 12 this year and we are so, so very proud—his entire community is very proud—of what he has achieved.

I want to spend the last couple of minutes of my contribution reflecting on perhaps the past, the last term of Parliament, because I am hoping that it will inform the future, inform in particular how we deal with the royal commission into mental health. The government in the last term of course established the Royal Commission into Family Violence and implemented every single one of its more than 200 recommendations. We did that unfortunately without the support of those opposite. That was very, very disappointing—that was bitterly disappointing.

I also spent four years in this chamber listening to some revolting things from the other side on the Safe Schools program. Now, we know that LGBTI young people aged 16 to 27 are five times more likely to attempt suicide. Transgender people aged 18 and over are nearly 11 times more likely to attempt suicide. We know that the Safe Schools program saves lives. But the opposition, for base political reasons, decided that they would spend four years not only campaigning against the Safe Schools program but also spreading untruths about it, all for base political reasons, even though it is a program that we know assists a significant group of people in our community who are significantly over-represented in these statistics. So I think it is an opportunity now for those opposite to learn from those tactics of the last term and make sure that they, like the government, endorse every single one of the recommendations of this royal commission.