Thursday, 18 August 2022

Bills

Mental Health and Wellbeing Bill 2022

Second reading

Debate resumed on motion of Ms STITT:

That the bill be now read a second time.

Ms CROZIER (Southern Metropolitan) (10:11): I rise to speak on this important piece of legislation that has been brought into the house this morning, the Mental Health and Wellbeing Bill 2022. It is a substantive piece of legislation, as is evidenced by the hundreds and hundreds of pages—over 650 pages—of this bill. It takes into consideration many, many aspects around what we will be debating this morning. It is timely, as I have just come from acknowledging and being with some Vietnam War veterans on this important day and being with my colleagues Tim Bull, Matthew Guy and our candidate for Richmond, Lucas Moon, who is also a returned veteran, talking about mental health impacts and the Liberal-Nationals’ commitment to reinstate ward 17 at the Austin Hospital in Heidelberg. This is a very important commitment that goes a long way to supporting these veterans. I note that the Liberal candidate Cynthia Watson, who hopefully will be representing that area, was also in attendance. We were there collectively with war veterans and the mother of a war veteran, who has a terrible story about her son. This issue is so significant because, whether it is those veterans who have tragically taken their lives or those with PTSD episodes that they experience on a regular basis, they have had nowhere to go. There has been no specialised care for their mental health needs. This announcement today of reinstating ward 17 I think is a tremendous announcement about what we will undertake should we form government in a few months time. My colleague Tim Bull has been talking about this issue for years—raising it. He understands the significant issues for those veterans. I have raised it in this house with the minister—this very issue, reinstating ward 17—so I am absolutely delighted that today we are making that commitment.

I say that at the outset because mental health obviously is a very, very significant issue. Back in 2010 Mary Wooldridge, a former minister in the Baillieu government, following our election win in 2010 made reform of the Mental Health Act 1986 a priority. She undertook extensive stakeholder consultation—round tables and exposure drafts of a bill, inviting submissions from a range of stakeholders—and in 2013 the coalition government then released Victoria’s Priorities for Mental Health Reform 2013–15. That reform required legislation, and the legislation that was then introduced under a Liberal-Nationals government was about strengthening clinical mental health services, improving community mental health support services, increasing connections between mental health services and other services, widening prevention and promotion and building a stronger and more sustainable workforce. Now, that was a significant amount of work that we did in just a few years, and former Minister Wooldridge did an enormous amount of work in this area. She really paved the way. That legislation was brought in, and it supported those objectives that I have just outlined. But you can see, after eight long years of this government, the workforce issues are still very, very profound and there has been an enormous shortfall in what the Andrews government has been able to achieve.

The government did undertake to have a royal commission into mental health, and that was a very good inquiry that went on. It was an extensive inquiry; there was a deep analysis of the issues. That was undertaken, and of course it had the support of the Liberals and Nationals. We have always supported more reform in this area. As I said, it was our government that really led the way in terms of having some significant reform and identifying those workforce shortages back in 2013.

What this bill does is it replaces the former act, the Mental Health Act 2014, that was introduced by the then minister, Minister Wooldridge, and it is an extensive piece of legislation, as I have highlighted. I want to go to some of the aspects of the bill and what the bill actually does. My colleague in the other place Emma Kealy outlined very succinctly in her second-reading contribution her support for the initiative of the government for the royal commission and the royal commission’s findings, but she also highlighted the many issues around the workforce shortages that the government has failed to address in its time in government.

This bill does a number of things. It reforms the system for the provision of mental health and wellbeing services; it improves the administration of the system for mental health and wellbeing services; it establishes the Mental Health Tribunal; it establishes the Mental Health and Wellbeing Commission; it establishes the Victorian Institute of Forensic Mental Health; it establishes the Victorian Collaborative Centre for Mental Health and Wellbeing; and it repeals—obviously, as I mentioned—the Mental Health Act 2014, which we brought in. The entire bill is to enact a new law relating to the treatment of persons living with mental illness or experiencing psychological distress.

The one area that I wanted to speak about in more depth is the establishment of Youth Mental Health and Wellbeing Victoria, which is also a main part of what this bill seeks to achieve. We know that the interim report was handed down in 2019, where five of the nine recommendations highlighted the desperate need to build the mental health workforce to ensure that there were sufficient personnel to effectively deliver mental health services in Victoria under this reformed system. We know that that interim report, which was handed down years ago, should have been acted upon. Obviously there has been a widening crisis within our mental health system. Some of those issues I spoke about at the start of the debate, like our initiative to reinstate ward 17—that could have been done by this government. It has not been done by the Andrews government. Those simple measures could have been achieved to enable a freeing up of other services for people that are experiencing specific mental illness and requiring specific treatments.

It is, as I said, a very extensive bill, and it does look at a new definition of a mental health and wellbeing professional. It does recognise that a broader range of professionals will be required to really be able to deliver on what the royal commission was trying to achieve. I have highlighted some of those in terms of what the main purposes of the bill are: to establish the tribunal and the wellbeing commission, the forensic mental health institute, a collaborative centre, and then having Youth Mental Health and Wellbeing Victoria established as well. So it does require significant personnel.

The bill also sets out obligations for the provision of a statement of rights and really looks at how it needs to have a broader range of circumstances and strengthen those obligations. It establishes obligations that all patients are provided written reasons when a treatment preference outlined in an advance statement is overridden or a second psychiatric opinion is not adopted, and it establishes the opt-out model of non-legal mental health advocacy. I am not going to go through every single thing that the bill seeks to do, but I want to just highlight a few more things that the bill does. It does provide for the chief psychiatrist to prepare guidelines on the application of the decision-making principles, and it regulates the use of chemical restraint for the first time in Victoria. I think that is something that is welcomed, because we need to ensure that those that are being restrained in such a way have treatments and protections in place. I want to make some more comments in terms of restraint, because it has been incredibly challenging over the last 2½ years with the numbers of Victorians presenting to our emergency departments with severe and acute mental illness and how police have had to be with those patients because there have been no staff to care for them. Some of the restraints that are required and the issues that will be around that I want to understand through the committee stage and by asking the government a couple of questions around that.

The bill also establishes a framework for obviously a health-led response to mental health crises in the community, and I have just highlighted the extent of the crises that we are seeing at the moment. It also embeds principles that, wherever possible, responses to mental health crises are led by health professionals rather than by police or protective services officers. Those restrictive powers should be exercised in the least restrictive way. I will have some questions around the administration of how the government intends to establish all of these entities. I also would like to understand an issue around the alcohol and drug sector, and I will come to that in a moment.

The bill also aims to have system-wide oversight of the quality and safety of mental health service delivery, and it will provide for monitoring and reporting on the system-wide quality. These are issues around community visitors and the Mental Health Victoria board and the Mental Health Tribunal. These various bodies will also be advising government on areas of concern and areas for improvement. The security of patients, forensic patients, and some of these very challenging areas can be very difficult, and there has to be a fine balance between managing some of the very complex patients that do have very significant mental health issues and are a harm not only to themselves but to the wider community. So those issues need to have a very thorough analysis in terms of how those patients are treated, how they are accommodated and who monitors and supervises those people with those complex needs, who are normally detained in facilities like the Thomas Embling facility.

The bill also provides for the Victorian Institute of Forensic Mental Health—Forensicare—board composition and states that the power of that board will be transferred to the secretary, who will then issue directions to Forensicare. I think that is something that the royal commission looked into and the disclosure of health information and codes of practice—really looking at the whole issue around improving consumer experiences and autonomy.

I could say a lot more because of the extent of this bill and how significant the reforms that the government have brought in through this bill are. But I just want to go to some of those issues that are of concern that we have raised in the other house—that my colleague Ms Kealy raised. The consultation on this process was limited with the number of stakeholders. Increasingly and concerningly, the government continues to not provide full draft exposures to the vast majority of stakeholders who are being impacted. The vast majority of the sector did not see the full bill as an exposure draft and first saw the bill when it was tabled in the Parliament. You need to be talking to a wide range of stakeholders. I grant you cannot get across every single organisation or speak to every single individual, but it should include the peak bodies that are predominantly involved and are affected by this bill. If that consultation is not thorough, then I do think that is, as I said, a concern. We have seen it not only with this bill but with many other bills that have been introduced into the Parliament by the Andrews government.

I said at the outset that the workforce issue is one of the biggest issues facing Victoria’s health system, whether it is the acute system or the mental health system. The health crisis, I should say, is the biggest issue, and the workforce issue obviously plays into that. The government has failed to address this over many years. There has been an underinvestment, a lack of planning and mismanagement in the entire health system for many, many years, and we know that because of the Productivity Commission’s findings in 2019, which was pre COVID. The government keeps blaming COVID, and of course COVID has delivered challenges. There have been challenges—I am not denying that—but to blame everything on COVID is an excuse. It is not good enough.

The government came out in March 2020 and said, ‘Don’t worry, we’ve got surge capacity in our workforce to deal with this’ or promised things like 4000 intensive care unit beds. Admittedly, that is nothing to do with mental health, that is acute care. But my point is the promises that were made—‘We’ve got our health system in place and we’re preparing it’—never eventuated. What we saw was Victoria having the harshest restrictions of anywhere in the country and the worst outcomes. We know that through the failures in mid-2020—contact tracing, hotel quarantine, security and over 801 Victorians losing their lives.

What we also saw with the six lockdowns—Melbourne was the longest locked-down city in the world at that point in time—was the huge impacts on children. The Pandemic Declaration Accountability and Oversight Committee, which I sit on, heard from so many people that really highlighted the failures of the government in relation to those impacts, that they just ignored the impacts of not having children attend school. I want to read something from the Review of the Pandemic (Visitors to Hospitals and Care Facilities) Orders minority report that the Liberals and Nationals presented. We said in that minority report regarding the mental illness that really affected millions and millions of Victorians:

The Committee heard dozens of compelling stories from parents regarding the impact of pandemic lockdowns and restrictions on their children’s mental health, and particularly, the impact of school closures.

…

The Committee also heard that funding provided by the … Government to deliver additional mental health support in schools would not be available in metropolitan schools for another two years, deemed “too late” by—

one particular group, which was a grassroots advocate group—

the Shadow Pandemic group.

We also heard from the AOD sector; the Victorian Alcohol and Drug Association made various comments. They shared key statistics regarding the impact of pandemic lockdowns and restrictions on the use and abuse of alcohol and other drugs and the demand that was put on their sector. The number of people calling helplines for alcohol and other drugs doubled from 2019 to 2020, and it has gone on and on. The fatal overdose data from the Coroners Court revealed that in 2020 the highest number of women overdosed from alcohol and that that number of overdoses was a very significant contributing factor to the overall statistics. The alcohol and other drug treatment agencies informed the committee that there was an increase in the number of people relapsing. During the pandemic closing the waitlist for treatment became more frequent, with the common refrain from agencies, ‘They have to close the counselling books for a couple of weeks’. Closing the waitlists meant no new clients could be seen. That has impacted the acute system because those people ended up in emergency departments and had to be cared for by police officers and others because there was no-one else to do it.

We heard again today that there are so many issues regarding the mental health of generations of people in this state, and it is just a pity that the government has never fully acknowledged the true impacts of the lockdowns. The World Health Organization states that lockdowns did not work and that there was an impact from lockdowns. Here in Victoria, when we went into lockdown after lockdown, we were promised we were going into lockdown to prepare our health system. Our health system is the worst it has ever been. Our health system is crumbling, our health system is failing Victorians. Victorians are dying because they cannot get through to 000, they have died because they could not get an ambulance, and they are dying because they cannot get their elective surgery. Now we have this mental health crisis where far too many people are suiciding or becoming drug dependent and their mental illness is increasing. These issues are very, very significant for the Victorian population.

I want to say, in the few moments that I have left, that the Liberals and Nationals want to move an amendment about the very area I am talking about, the alcohol and drug area. I want to state that there is feedback from this sector that they feel they are not included in this. They feel that they have been not fully acknowledged in the mental health reform. They feel like the government has just ignored them and what they are doing in dealing with their thousands of clients, and they ask why they have not been included in this significant reform. They understand that there has got to be some legislative reform, but they feel that they should be included in that reform. I would like to circulate, if I can, the amendment that deals with this.

Opposition amendment circulated by Ms CROZIER pursuant to standing orders.

Ms CROZIER: The amendment that has just been circulated is to amend clause 12. On page 36, line 9, where paragraph (vii) says:

connect and coordinate with other support services to respond to the broad range of circumstances that influence mental health and wellbeing …

we are seeking to insert, after ‘wellbeing’, ‘including alcohol and other drug support services and treatment’. It is a very simple amendment that will go a long way in including and acknowledging that sector in the reform that this legislation is proposing. I understand that the government may be supporting this, and I will be very pleased if that is the case. I will wait to hear from the government in terms of what they say about that. But again, as I say, this sector has been dealing with an enormous array of individuals and the connective services that they are dealing with, applying those for people with substance abuse and mental illness, and we are looking at how they can be included in this reform. It is a very simple amendment.

I have another few comments to make. Part of the bill, as I said at the outset, seeks to establish Youth Mental Health and Wellbeing Victoria. I acknowledge that because of what I have described around the massive impacts on children, who have been impacted significantly, especially over the last 2½ years, with lockdowns, with a lack of ability to go to school, the disgraceful locking up of playgrounds and the message that sent to children and the inability for children to be able to express themselves with one another because of mask wearing, and the government still wants masks to be worn in schools. I mean, we are not in March 2020 when there were no vaccines and no antivirals, we are three years into this pandemic, and these aspects are very, very significant.

What I want to say is I am concerned that there has been no agency establishment or acknowledgement for those elderly Victorians who have also suffered through the pandemic. There is no Elderly Wellbeing Victoria being established by the government, and I think that just goes to show the lack of understanding of the impacts of the pandemic on so many elderly Victorians. On Saturday, when I was out with the Liberal candidate for Kew, Jess Wilson, two elderly women came up to me—Helen and Jan were their names. Helen described to me that she has no family in Victoria. She had lost her son recently—her granddaughter was here, but she had no family. And the impacts of the lockdowns for her were significant. She feels that her cognitive ability and her self-confidence have declined. The only thing she could do was literally walk around the streets with her friend Jan. She said, ‘There’s nothing for us. There’s been no acknowledgement of the impacts of the lockdowns on us’. These impacts, the lockdown impacts, have been profound. That is why we need a royal commission in this state—to get to the bottom of what actually worked in the decisions that the government made and the multiple failures, so that we never have those failures again.

Ms Bath: Learning from it.

Ms CROZIER: Thank you, Ms Bath. We need to learn from those failures, because the failures were profound. Whether they were children or whether they were adults, people were impacted so significantly.

We have got a mental health crisis in this state that is feeding into our acute health crisis where the whole health system is broken because of decision-making by the Andrews Labor government. This is a very, very significant issue that needs to be addressed now, and I am very proud to be standing with Matthew Guy, Peter Walsh and all my colleagues to say that we will fix this system by reprioritising money—billions of dollars—from a rail line from Cheltenham to Box Hill to fixing what we are talking about today, the mental health crisis and the acute health crisis, because Victorians deserve to be able to get the treatment and support that they need when they need it. At the moment they are not getting any of that. They are not getting any that because the system has failed them and it is broken.

I say again, in conclusion, that this is an important piece of legislation. It builds on what former minister Mary Wooldridge did back in 2010 when we came into government, introducing a significant reform at that time—the work that she did in a very short period of time. She identified the workforce issues back then. The Andrews Labor government has failed to recognise that. They have had years to fix it. Prior to COVID they had years. No more excuses from COVID—they had years to fix it.

As I said, I do hope that the government will support the amendment put forward by the Liberals and Nationals today to ensure that the stakeholders in the alcohol and drug sector are acknowledged in this important reform. As I said, with 650 pages in the bill they deserve to be in it.

Ms TERPSTRA (Eastern Metropolitan) (10:41): I rise to make a contribution on the Mental Health and Wellbeing Bill 2022. This is a very important milestone in the work that the Andrews Labor government is doing in regard to mental health. It is one of the recommendations that came from the Royal Commission into Victoria’s Mental Health System. I will address Ms Crozier’s contribution a bit later on. I want to approach my contribution today with a sense of optimism and positivity, because if you listen to all of them over there it is just shocking, we do nothing and all the rest of it. I want to correct the record, because we have done a significant amount of work. Ms Crozier should remember that it was this government that invested a lot of time, energy and effort in making sure that we could have a royal commission into mental health, and that royal commission made a number of recommendations, all of which we are implementing. In fact this bill represents the delivery of a key royal commission recommendation, recommendation 42. This bill will establish one of the three fundamental pillars of reform that was recommended by the royal commission, which is legislative transformation, significant workforce expansion and sustainable ongoing investment. If you just listened to the previous contribution, we are doing nothing about it.

I might just say from personal experience, I worked for the Australian Nursing and Midwifery Federation. I used to represent nurses out there in the field in the public health system but also in the field of mental health and in aged care as well. Workforce is always a challenge in health. Listening to Ms Crozier’s contribution, it is like all of a sudden it is new and we have failed to understand it and do anything about it. These are completely wrong, incorrect assertions over there from Ms Crozier. But that is what you get from the Liberal Party—it is like night and day. I am going to talk about all the great things that we are doing, and I am also going to correct the record about the views of Ms Crozier on what Victorians have been saying about and experiencing with mental health, because there is also a flip side to that; there is a different side to that. I want to make sure I also talk about mental health in terms of what people’s trajectory is and how, if they get the right treatment and intervention, they can have a positive outcome, rather than hearing all the rubbish that has been talked about over there today.

In terms of getting back to the purposes of this bill—like I said, I am going to address the negative misinformation that was put forward over there earlier as I go on—the track record of this government’s investment in mental health services is unprecedented. I am going to go through it in a moment; the investment is billions of dollars. One of the highlights of the 2021–22 state budget was $3.8 billion in investment. It is unprecedented investment, because what we know is the royal commission highlighted that our mental health system was broken and in urgent need of repair. It was unequivocal that our system was broken and failing Victorians. The final report laid out the blueprint for building a compassionate and effective mental health and wellbeing system from the ground up. While the royal commission undertook its important work, we did not stand idly by. We made a record investment of $869 million in November 2020 to address critical demand and improve the mental health system while we awaited the final report. We jumped in. We got in early. We did not waste a minute. We said, ‘Quick, we need to get some urgent investment in, and then we’ll await the final recommendations and the final report’. In total we have invested more than $252 million in additional mental health support since April 2020 to help meet demand and ensure Victorians get the care they need during and well beyond COVID-19. This was in keeping with the expert advice on how best to manage traumatic events, such as a viral pandemic. This is a one-in-100-year event, okay?

I recall one of the press conferences that we had during the pandemic where the chief psychiatrist addressed the media in regard to mental health, and this is why I want to approach this with a sense of optimism. There is no doubt that people suffer from mental health conditions. I mean, all of us at some point in our lives may suffer with some mental health affliction, whether it be minor, moderate or severe, and sometimes events—traumatic events like the pandemic—can actually bring out underlying mental health conditions that were there anyway but are brought out by a severe traumatic event. What is really key and important is that people get the help and support that they need when they need it.

I was talking to principals of schools in my region, Eastern Metropolitan Region, and some of the key messages that were coming out prior to the pandemic—and this is not related to the pandemic—were that they were seeing more complex behaviours presenting earlier in children, in primary years, and so we responded to that by making sure we could get mental health supports into primary schools. They were there for secondary schools, but we have also invested in that as well. What that means is that kids can get earlier intervention and their trajectories can be better. What was happening under the previous, old system was people were being dealt with at a crisis point, so when it was effectively too late. They had gone into crisis, they had some kind of traumatic event and they might have needed to be hospitalised to get their lives back on track. So the whole point is, if you can get earlier intervention, the better your trajectory.

Some people are born with a trajectory where they are going to end up with a mental illness, and some are not. We have all got different experiences, and I find it really frustrating and offensive for the Liberal Party to lump everyone in together and say, ‘It’s all the same. It’s all bad’. That is not the case. People have very different trajectories. Some people can make recoveries from whatever mental health condition they are suffering, and some people sadly will have to manage a long and ongoing serious mental health condition for most, if not all, of their lives. So there is a lot of nuance in this, but those opposite suggest that it is all just about the pandemic and it is all bad or good. I spoke to children in my region who were saying they actually loved learning from home during the pandemic. There were people who were neurodiverse who loved being away from all the brightness, the noise and the lights of the school environment and were quite happy. In fact some children thrived during lockdown because they were learning online. So again, there is lots of diversity in the way that people come to experience life and in what they may have experienced in their own environments. We are having this debate, and I am coming at this as a person who is not neurodiverse, so I can cope with bright lights, I can cope with noise and I can cope with lots of things coming and going, but not everyone has that experience.

It just shows the ignorance of Ms Crozier in her kind of approach to this debate. It is ignorant and ill informed to approach this debate and say that everyone’s experience is the same. It is not. Everyone has a diverse experience—

Ms Crozier: I never said that.

Ms TERPSTRA: Yes, you did. I listened quite carefully. You did not support the mental health royal commission, and all you want to do is go on and attack this government for the—

Ms Crozier: On a point of order, President—sorry to interrupt, I know that you are dealing with something—Ms Terpstra is verballing me, and I would ask her not to throw around ridiculous claims. It is an important debate, and there is no need to verbal.

The PRESIDENT: I am sorry, I was not aware of it because I was talking to Ms Maxwell. Ms Terpstra, I did not hear anything. I will ask: did you?

Ms TERPSTRA: No, there was nothing that was—

The PRESIDENT: Okay, thank you.

Ms TERPSTRA: There was no point of order.

The PRESIDENT: I decide that, thank you.

Ms TERPSTRA: Yes, I know, but further to the point of order, there is a problem in this chamber. Whenever something is said by the government speakers on these benches that they do not agree with, they raise a point of order. It is an abuse of the standing orders, and I raise this to—

Ms Crozier interjected.

Ms TERPSTRA: I just want to finish what I am saying without interjection and be heard. What I am saying is that, whenever there is something that is challenged by the government speakers on this bench, they continually raise fake points of order. It is something that is an abuse of the standing orders, and I bring it to your attention.

The PRESIDENT: Now we are debating, and I do not want to get involved in debate.

Ms TERPSTRA: Again, we have made record investments in this area, and it is something that the Liberals and those opposite will never do. What they want to do is just criticise constantly without foundation, without any points and without any substance at all, because they have got nothing to offer other than just constant criticism. I am really grateful for the fact that Victorians are not listening to that. Victorians want to move on from the pandemic, they want to move on from COVID, and what they are looking for is support from a government that knows and understands what Victorians need. That is why we had the royal commission into mental health.

Again, a record-breaking investment in the 2021–22 budget provided an enormous $3.8 billion to kick-start the next decade of mental health reform, focusing on the funding of services to provide greater clinical care and community support to Victorians in need. We then further backed that in, as I said earlier, with billions of dollars of investment. In the 2022–23 budget there is another $1.3 billion for further investment, building on the foundations created the year before and continuing to build the momentum necessary to further deliver on the royal commission. This investment will be turning the tide for mental health in Victoria, and this government is immeasurably proud to be the one that can deliver it. This cannot be achieved overnight, and in order to secure the future of Victoria’s mental health system we need the opposition to actually come to the table and explain how they intend to continue to support this vital work if not through the sustainable funding mechanisms, including the mental health levy.

I am going to leave some of this for other speakers to comment on. I know Mr Gepp might want to go through some of the billions of dollars of record investment that we have outlaid here—there are pages and pages of it. As I said, $3.8 billion was set aside in the 2021–22 budget. I will just touch on a couple of things: 20 new local services for adults and older adults supporting people in their communities—but again, if you listen to Ms Crozier, we are doing nothing about that; supports for mental health and wellbeing of young people—again, those opposite said we are doing nothing about that; new models of care for bed-based services that are safe and compassionate; a government- and community-wide suicide prevention response; reform in education, setting up children and young people to thrive and survive; supporting Aboriginal social and emotional wellbeing; and enabling the mental health and wellbeing workforce to be delivered and reformed. As I said earlier, as someone who worked for the nurses union, I know how challenging building that pipeline of skilled workers is—it take years; it does not happen overnight. That is why we are funding and investing in that to happen and to continue to happen. Also, there is asset funding to expand mental health treatment options for Victoria’s youth.

So again, these are complex things. If you listen to those opposite, somehow we should just be able to wave a magic wand and have it all magically appear and function well. No. What those opposite want is not something that is publicly funded. What those opposite want is something that they can just pump out to the private sector and have their rich mates make money out of it. It is just disgraceful.

Ms Crozier interjected.

Ms TERPSTRA: Ridiculous. The most recent budget, as I said, invests in the critical workforce needs of the system, developing a pipeline of skilled mental health professionals to deliver compassionate care to Victorians, with over 1500 new jobs being supported by that investment, with over 100 psychiatrists, 300-plus psychologists, more than 400 mental health nurses and over 600 allied health professionals taking up roles in our new system. That means that since the royal commission’s report over 2500 mental health jobs have been created in Victoria, delivering on exactly what our mental health workforce strategy identified as necessary for this reform, for without caring mental health workers there can be no mental health system at all—because, as we know, it is the people that make up the care that people need to be provided with. So it is critically important that we have these people skilled and trained up to be able to step into the system to help care for Victorians.

Dr Astha Tomar, chair of the Victorian branch of the Royal Australian and New Zealand College of Psychiatrists, is reported as saying:

… the $372 million committed to implementing and resourcing a stable and well-resourced workforce will be key to the success of the Government’s ambitious reform agenda of the Royal Commission into Victoria’s Mental Health System.

We are also investing $490 million into acute and inpatient care, which includes opening 82 new beds across the Sunshine and Northern hospitals, helping an additional 1600 Victorians get help at their most vulnerable time.

These are just a few items I have laid out about the foundational aspects, and this bill, as I said earlier, is one of the key pillars. We are starting on legislative reform, which, again, was recommended in recommendation 42 of the royal commission. So it is about legislative transformation, significant workforce expansion and sustainable ongoing investment. I will come back to those three key pillars that we are starting. There is lots of work to do, but as I said earlier in my contribution, we got in early with some early investment to get things underway and we are continuing to build on that investment as we go along.

Also, in their budget statement Mental Health Victoria commented that the budget:

… builds on the $3.8 billion committed in the 2021/22 State Budget, and demonstrates the Victorian Government’s ongoing political and fiscal commitment to implementing the recommendations of the Royal Commission into Victoria’s Mental Health System … in full, and on time.

Professor Pat McGorry, executive director of Orygen, welcomed the investment and reflected:

This approach will mean that Victorians, and in particular young Victorians, will be able to bounce back from the adversities experienced over the past two years and go on to lead healthy and contributing lives.

I reflect on the comments of experts in the field—expert psychiatrists—who treat people for a living. It is what they do. I reflect on the comments of the chief psychiatrist, who addressed the media at one of the conferences during the pandemic. The majority of people are well equipped to deal with adversities in life. Most of us will bounce back; it is what happens. There is elasticity in the way that we deal with trauma and problems that we encounter in life. There are some people who do not have that capacity and will need help when they need it. What has been said by Ms Crozier today is a sad reflection of her understanding of people’s capacity to deal with trauma. This bill is an optimistic bill that provides all the framework and the support necessary for people to move forward and recover from mental ill health when they need to. I commend this bill to the house.

Ms MAXWELL (Northern Victoria) (10:56): I rise to speak on the Mental Health and Wellbeing Bill 2022. The Royal Commission into Victoria’s Mental Health System was announced on 24 October 2018 as a pre-election commitment of the Andrews government. At the time, renowned and respected psychiatrist Pat McGorry described Victoria’s mental health system as ‘crumbling, threadbare, overwhelmed and obsolete’. Professor Ian Hickie said Victoria’s mental health system has plunged from being regarded as one of the strongest in the 1990s to one of the most flawed. What a harrowing starting point for a review. I really despair for the thousands of people who needed help over two decades and could not access it. I despair for the families desperate for support who encountered long waitlists, were turned away from emergency departments or were stuck in a cycle of referrals to nowhere. I despair for the workers in the mental health sector who felt hamstrung, frustrated, overstretched and often unsafe, and I despair for the lives that were lost.

The chair of the royal commission, Penny Armytage, said when handing down the final report:

Good mental health and wellbeing have been a low priority of governments for decades, despite the high prevalence of mental illness and poor mental health in our community.

She said the system had ‘catastrophically failed’. How is it and why is it that a public system should get to such a low point before it becomes a priority? We are seeing similarities now with our child protection system and in our broader health system. We cannot let these systems continue to teeter on the verge of collapse and then expect the public to be grateful for the rebuild.

The bill before Parliament is considered to be delivering on the royal commission’s recommendations for a new mental health and wellbeing act. With more than 600 pages to absorb, I must say that in many respects we have to take the government’s word for it because to critically compare the bill to the existing act has been a fairly difficult exercise when so much of it is enabling legislation and questions we have raised point to yet-to-be drafted regulations and implementation, hence my motion this week.

I have no doubt that an enormous amount of work has been put into drafting this bill and that it is extremely complex work. I thank the people who are involved in redesigning the system and recognise that they have on their shoulders the weight of millions of Victorians who are relying on a better system being available in the future. I acknowledge the longstanding important role of mental health workers, paramedics, police and the alcohol and other drugs and social services sectors who work in this space every day. They have battled within a broken system for too long, so have the families and carers of people affected by mental illness. The system has to be better for all of them.

I would like to express my thanks to the people who engaged with us on this bill, including those with lived experience, sector workers, the great team at the Health and Community Services Union, the AMA, the Royal Australian and New Zealand College of Psychiatrists, paramedics’ unions, community paramedics, police and health services. Given the size of this bill and the time available I will limit my focus to a few parts of the bill that hold particular interest for me as a member for Northern Victoria and as a member of Derryn Hinch’s Justice Party and that have been brought to us as concerns by stakeholders.

Stakeholders have expressed some frustration with what they consider was a rushed consultation process. The royal commission recommended a new act be delivered in 2022, and we respect that the government wants to meet this deadline, but it has put pressure on the consultation process and prevented stakeholders from properly engaging with their frontline workers and giving robust and detailed feedback.

The royal commission acknowledged the struggle that people in regional areas face every day in accessing services close to home. This is even more pronounced for those needing youth mental health services. The royal commission report noted that changes to the framework must consider the challenges of delivering services in rural and regional areas. Regional areas must not be left behind or be given lower priority or be put at the bottom of the funding list. I hope the new regional mental health and wellbeing boards and multi-agency panels will be strong advocates for regional areas and that their work and advice will be transparent to support public confidence.

There is also a sense of scepticism in how new models of care will be delivered in regional areas. Establishing health-led responses rather than relying on police is a positive aspiration: it is better for patient care and to focus police resources back on their core business. But we asked a few questions about how this would work in implementation in regional areas, and the reality is that it will fall back on police if a health-led response is not available. In regional areas a lot of police time is spent supporting the ambulance service to transport mental health patients to a hospital, which could be an hour away. Police then might sit with a patient for hours in the ED until they are seen, only to return them home and be called to do it all again in a few days time. This takes police away from other important work.

Our ambulance service is already stretched, and this takes our paramedics away from other code 1 call-outs. Regional areas are also particularly vulnerable to natural disaster, with substantial flow-on effects for the mental health of these communities. The royal commission said the system needs to reflect and provide for these vulnerabilities. This backs up research that was conducted after the Black Saturday fires, which identified a need for policymakers to strategically target regions with a high risk of persistent mental health distress and to ensure services are available to those communities.

The royal commission said the new system will be designed to attract, develop and retain a sustainable workforce. Professor Ian Hickie has noted that 80 per cent of people exiting a treatment centre will need ongoing care, but there is neither the workforce nor capacity at the state level to look after them. These shortages are keenly felt in many settings in regional Victoria: mental health, family services, child protection, alcohol and other drug services, aged care, nursing, GPs—the list is long. Where professionals are recruited there is now great pressure to house them, and I know that while the family services and AOD sectors are supportive of the mental health reforms, there is some sense of dread that their workforces are going to be depleted as a result, particularly in those regional areas. This will make their work even more challenging. Already stretched services in these sectors will be harder to access, the wait times will be longer, and this will have a roll-on impact on the future demand for mental health services.

The definition of ‘paramedics’ is limited in this bill to those who are employed by Ambulance Victoria. While I understand the arguments for this, I am told that there are around 3500 paramedics in Victoria who do not work for Ambulance Victoria and are a resource that we could tap into. I have been advocating for them to be utilised more broadly in regional Victoria to help take pressure off our hospitals and our ambulance service. Community paramedics want to be part of the solution and be part of the system where it is safe and appropriate to do so, but they say that this bill does not facilitate that potential.

This bill includes an aspiration to eliminate the use of restrictive interventions within 10 years, an ideal which is suggested by those working on the front line to be dangerously flawed. This was reflected in the department’s report on its engagement process in 2021, where 58 per cent of respondents said the seclusion and restraint proposals do not meet the royal commission’s recommendations. While I recognise this is an aspirational statement, we listened intently to a range of stakeholders—in particular frontline workers—about restrictive interventions and the important role they can play as a last resort to keep a patient, workers and the public safe. While we support endeavours to reduce removing restrictive interventions as much as possible, serious consideration of eliminating the use of restrictive interventions requires substantial consideration and consultation. The royal commission report noted that it is likely that demand for inpatient services, including more people presenting in crisis and pressure on the model of care, is contributing to the use of restrictive practices. So it is incumbent on the system to provide a safe environment and resourcing to reduce restrictive interventions rather than simply taking it all out of the toolkit.

Moving on to forensic mental health, as the Forensicare submission to the royal commission notes:

Although the vast majority of people with mental illnesses do not offend or become violent, people with serious mental illnesses are three times more likely to engage in offending and four times as likely to commit violent offences compared to other Victorians.

The tragedy is felt from all angles when someone commits a violent offence, most notably the victims and their families. Our party works with a number of those families who are severely impacted, and their pain is raw and enduring. People living with severe mental illness are also 11 times more likely to be a victim of violent crime compared with the general population.

The royal commission heard that 56 per cent of offenders on a community correctional order had a mental health treatment rehabilitation condition. But the imposition of a mental health treatment condition does not mean that treatment is received. Lack of services means that offenders often complete a CCO without receiving treatment. As Ms Stitt said in her second-reading speech, it took many years of underinvestment to get the system to breaking point and it will take a decade of unwavering commitment to workforce, legislation and sustainable investment to rebuild.

I greatly respect the work of the royal commission. I have great confidence in the capable, dedicated people that are working to reshape our mental health system, and I hope for success. There are certainly many people who are counting on it so they can get the help they so deeply need. As chair of the royal commission, Penny Armytage, said when delivering the final report:

I hope that with the full implementation of the reforms … an inquiry of this nature will never need to be repeated.

I commend this bill to the house.

Mr GEPP (Northern Victoria) (11:07): I am pleased to rise to speak on the Mental Health and Wellbeing Bill 2022. As has been said by many of the speakers, this bill is extensive, it is comprehensive and it contains a lot of technical and clinical aspects. But it is an important bill, isn’t it? It is an important bill because here we are in 2022 going back to the royal commission in 2018, and we are starting to understand as a society and as a community the impact of mental health and how it touches just about all of our lives. I was interested when reading the notes for this bill to see that there are some 60 000 people being cared for by people in this state for their mental health issues. Some 5000 people each year will be impacted, and I think that is probably underestimating the impact of mental health and probably under-reporting.

I was just talking to Mr Barton about this—unfortunately while Ms Maxwell was making her contribution, so I apologise. We were talking about how you can see a broken arm and you can see a broken leg—there is a cast, there is a moon boot, there is a bandage—but those hidden illnesses for many, many years, certainly as I was coming through as a young union official, were dismissed by everybody. If you cannot see it, then surely it does not exist. But of course we know that that, sadly, is not the case, that there are so many people in our communities that are battling with mental health and wellbeing issues.

As we know from the royal commission announced back in 2018, the system is broken. There can be no doubt that it is broken. As Ms Maxwell said and as was reported by many others, it was stated that for decades governments refused to acknowledge the impact of mental health and wellbeing and were very happy to leave that side of our health system sitting on the shelf, and inevitably we ended up with a system that was not functioning and was not working for everybody. It particularly was not helping those Victorians who were in desperate need of assistance in dealing with their health issues. That royal commission was such a landmark royal commission, and I think in years to come it will go down in history as one of the most important pieces of work that has been done in this state because it shone a light on a very, very complex and very, very difficult area of public health, one that had been neglected for such a long period of time.

I am very proud of the efforts of the Andrews Labor government in this space and the work that we have done in response to that royal commission—and not for the political kudos. That is not what I am proud of. I am proud that we have responded to an independent review of a part of our health system which said unequivocally, ‘It is broken. It is in desperate need of attention, it is in desperate need of reform and it is in desperate need of investment’. I am proud that our government has taken up the challenge, and I hope that it gets the support of everybody in this place—not just now but in the decades to come—and that we all commit now and into the future to continue to fund this very, very important area of our public health system.

I do want to talk a little bit about some of the highlights of the record $3.8 billion that the government invested through the 2021–22 state budget. It is important because $3.8 billion is a lot of money, but it is the component pieces of that $3.8 billion which go directly to the recommendations made in the royal commission. It is targeted investment, and it is the beginning. It is not the end, it is the beginning. It is targeted at addressing those areas of the royal commission recommendations to ensure that we are improving the lives of Victorians.

I want to give some of the context and some of the breakdown of some of those services. There is $954 million to reform area services to better support the mental health and wellbeing of adults and older adults. There is $264 million for 20 new local services for adults and older adults, supporting people in their communities, and that is important. I said at the commencement of my contribution that 60 000 people are providing care in this state for people with mental health and wellbeing issues. There is $266 million for supporting the mental health and wellbeing of our young people. Many of us have spoken in this place, and it is interesting. I am as guilty as anybody. You know, you come in here and you talk, and in the hyperbole of the debate you talk as if you are talking on behalf of all Victorians, all young people. But we know it anecdotally—as we go around our various electorates we do talk to young people and they tell us the challenges that they have experienced just in the last few years, particularly in the last couple over the COVID period. We know anecdotally from those conversations that our young people need our support, and importantly through this program of investment they will get that support.

There is $196 million to support the mental health and wellbeing of infants, children and families, and $370 million for new models of care for bed-based services that are safe and compassionate. We have all seen some of those Hollywood movies, haven’t we, about some of those institutions in the past, and they were frightening. And we all hoped that those films were just fabricated fiction from the minds of a producer or a screenwriter, but alas what we know from the royal commission is that unfortunately some of those horrific stories were absolutely true and occurring right under our very noses, so this important investment for those new models of care for those bed-based services is so welcome.

There is $173 million for government- and community-wide suicide prevention and response. It is heartbreaking when you read the newspaper just about every day and at the end of a story you see the reference to Lifeline or Beyond Blue and you just know that somebody has taken their life, very sadly, and we cannot do enough in this space.

There is $218 million for mental health reform and education, setting up our children and our young people to thrive. There is $116 million supporting Aboriginal social and emotional wellbeing. I had the occasion recently of being in Robinvale and talking to our First Nations people in Robinvale—excellent people. They are fantastic people. What a wonderful community they are—and so supportive of each other. I was talking to the elders there about mental health and how young people in their community were doing, and they said, ‘Well, often what we have to do when somebody is experiencing these sorts of issues is we take them off country, but the best place for them is on country, with the support of their community’, and that is so important. The point here of course is that there have to be different models of service for different communities to fit their cultural circumstances.

There is $206 million to enable the mental health and wellbeing workforce to deliver a reformed system. I know it has been said on a number of occasions during the debate so far and will be said again, I am sure, that our workforce in the mental health and wellbeing space are fantastic people, as they are right across our health system. They are overworked. They are underpaid. They are stretched to the nth degree, but they pony up every day because they care. They are committed to their work. They are committed to supporting their fellow community, and they do an extraordinary job. There is also $141 million in asset funding to expand mental health treatment options for Victoria’s youth.

The 2022–23 Victorian state budget is also investing $1.3 billion for brand new initiatives, which will build on last year’s $3.8 billion. That investment focuses on funding for mental health services to provide a greater level of clinical care and community support to Victorians in need. Again, I want to give some of the breakdown of that expenditure, because it is important that people understand that this is not just a pot of money where you just dive in when somebody has a good idea—this is targeted investment.

There is $372 million for workforce initiatives, which include training an additional 1500 mental health workers, including 400 mental health nurses, 100 psychiatrists and 300 psychologists. There is $490 million for acute hospital-based care, including 82 new mental health beds in key growth areas at the Northern Hospital and the Sunshine Hospital. There is $9.1 million to establish social inclusion action groups in 10 LGAs. There is $12 million in mental health and wellbeing support for families whose infants or kids and young people are accessing acute care in regional Victoria. That is so important, because, as has been mentioned, particularly by Ms Maxwell, in regional Victoria they are not around the corner, some of these services. You need to travel a distance to get to them, and it is so important that we support the families of these young people who are experiencing mental health issues and in need of those services. It is important that we support them in providing support for their loved ones.

There is also $20 million to provide tailored support for people with eating disorders—we have all seen for many, many years some of those terrible stories, particularly amongst young people; $21 million to support suicide prevention; $3.5 million invested in partnership with Aboriginal community controlled health organisations to keep Aboriginal Victorians safe and well; and $29.3 million to support the implementation of the new mental health and wellbeing act, including training for the mental health sector to deliver those new models of care.

This is an ongoing area of public policy that I absolutely guarantee the Andrews Labor government is committed to. We have signed up for it. We are committed to delivering reforms so that for all Victorians suffering mental health and wellbeing issues, or those Victorians supporting those that are suffering those issues, we can improve their lives, we can improve the services and we can improve their circumstances. We are committed to this area of public policy, we are committed to this area of public health, and I commend the bill to the house.

Mr BARTON (Eastern Metropolitan) (11:22): I rise to speak on the Mental Health and Wellbeing Bill 2022. This bill is so very important, and I am proud to stand here and support it today. Though you may not believe it, I came to this Parliament at 60 years of age.

Members interjecting.

Mr BARTON: I know. I managed through those 60 years to accrue a bit of life experience. About 45 per cent of all Australian adults will be affected by a mental illness at some time in their life—almost one in two—and I am not immune from that. There have been times in my life when I had to reach out and ask for help. I have seen many family members and friends have to do the same. Mental ill health can affect anyone. You can never know truly what is going on in a person’s life. If you need to reach out, you do not need to feel ashamed.

From a policy perspective, there are many changes to be made that can support the mental health and wellbeing of Victorians. The Royal Commission into Victoria’s Mental Health System made 65 recommendations, and I am pleased to see some of these critical recommendations included within this bill today. And the timing is right: we need these changes now. Victorians have had it tough. COVID-19 has had an enormous impact on people’s mental health. That harm continues today. We know that with restrictions it was a tricky balance between what was required to keep the community safe, people’s mental health and the economy. We are recovering, but more always needs to be done.

The $1.3 billion investment made in the most recent budget to support our mental health and wellbeing system is a great start, and so is this bill. I look forward to seeing the rest of the royal commission’s recommendations being implemented as part of the 10-year plan to rebuild our mental health system from the ground up.

This bill will replace the current Mental Health Act 2014, creating a new foundation for mental health support in Victoria. This bill acts as an enabling piece, establishing the principles of our new mental health as well as the powers and functions of entities and others in the system. Critical to this are the rights-based mental health principles. These are modern principles that will guide service providers, ensuring the dignity and autonomy of people living with mental illnesses are upheld. So it is important that people are involved in decisions about the treatment, care and support they receive while also recognising the role of their families, carers and supporters in their treatment journey. Victorians will have rights under this new system for their preferences and their needs to be heard, understood and acted on.

The bill also introduces a non-legal mental health advocacy service for people who may be subject to or at risk of compulsory treatment. This will be an opt-out service and will support consumers in understanding and exercising their rights with regard to their treatment. Of course this is an incredibly complex aspect of our mental health system, and this advocacy service, which was recommended by the royal commission, will increase the uptake of safeguards such as advance statements of preference and nominating support persons. These safeguards are there to protect some of our most vulnerable Victorians.

There are several new entities and offices established in this bill that will govern and provide oversight for the mental health and wellbeing system. These include the Mental Health and Wellbeing Commission, which will provide oversight of the system to manage complaints—this will be an independent body that reports directly to Parliament; the regional mental health and wellbeing boards, which are eight boards that will engage with local communities and provide advice to the minister regarding mental health services in their regions; and the chief officer for mental health and wellbeing, who will report directly to the Secretary of the Department of Health and will spotlight mental health within the department.

What we have learned in the last couple of years is that these young Victorians need more support when it comes to their mental health. More than one in four people aged between 16 and 24 are affected by mental illness at some time—I know about this—and 75 per cent of severe mental health problems emerge before the age of 25. That is why early intervention is critical to an effective mental health system and can prevent lifelong mental health illnesses. This bill acknowledges and seeks to address this fact by introducing Youth Mental Health and Wellbeing Victoria. This entity will give young people agency to share their mental health experiences and through this process assist their peers. This platform will champion the voice of young people, with the membership of its board including young people with lived experience. Mental health services will not work unless they are tailored to suit the individual. Youth Mental Health and Wellbeing Victoria will be that voice for young people, ensuring their mental health system caters for their diverse and complex needs.

This new mental health and wellbeing system will be focused on ensuring there is a health-led response to mental health crises in the community. Unfortunately we have seen emergency services responses to people experiencing mental health crises led by the police rather than a health service. This will change. The bill will enable a number of functions that provide more options for how the system can respond to people in crisis. Provisions will better protect the rights of people who require emergency support as well as improve the efficiency of emergency services. This will go a long way to reducing trauma for those who need treatment and support.

When creating legislation it is of course important to listen to those in the industry. In this case the mental health nurses have identified a number of concerns that I will outline for consideration. Firstly, the bill states that it intends to ultimately eliminate the use of seclusion and restrictive intervention. They have raised some concerns that the pressure to not use restrictive interventions, for fear of repercussions, could potentially increase risks to mental health staff.

It has also been expressed to me that there may be a need for a chief mental health and wellbeing nurse that reports to the chief psychiatrist. This is to prevent mental health nursing being diluted under a general nursing structure. Lastly, mental health nurses want to see an accreditation process defined by the chief psychiatrist to ensure mental health workers have the skills and the competency to safely enact powers under the act. It is always important to consider the views of those who this legislation will impact. Our mental health workers play a really important role in our community and must be heard. I understand that Ms Patten will be moving some amendments to address some of these matters, and I will certainly be supporting those amendments.

This bill is the beginning, not the end, of the reform of our mental health system. It lays the foundation for a system that enables people to be involved in decisions around their care and treatment. It enables their ability to express their wants and their needs and puts lived experience at the centre of decision-making. I expect to see more conversations around what the future of Victoria’s mental health and wellbeing services looks like.

On that note, I would like to bring attention specifically to the issue of men’s mental health. We know that often men find it difficult to reach out and ask for help. Because of this men’s mental health issues have gone undiagnosed, often for a very long time. Social norms, upbringing and role models have contributed to this issue. ‘Toughen up, Princess’ is a phrase that comes to mind from my generation. This culture of dismissal stops us from addressing what are truly serious issues. Every week a woman dies at the hands of a partner that once loved her—or does love her—and it is such a serious issue. I urge all men: if you are angry and you do not know why, if you are hurting the ones you love, you have to reach out. You are not tough by not doing it; you are a better man when you do it. Many fall through the cracks before being able to be access the support they need. In fact 75 per cent of those who take their own lives in Australia are male. The number of men who die by suicide in Australia every year is nearly double the national road toll. This is devastating and impacts families, friends and whole communities. This is an area that I hope to see prioritised in the new mental health and wellbeing system, as I look to our bureaucrats there to keep us going that way.

The system, yes, is there to provide treatment and support, but it also must focus on early intervention and engagement with those at risk of experiencing mental health issues. Not everyone knows how to ask for help. It is something I struggled with. I am very happy to see this bill go through this place today, and I commend this bill to the house.

Ms BATH (Eastern Victoria) (11:34): I am pleased to rise to show my support this afternoon for the Mental Health and Wellbeing Bill 2022. If I had more allotted time, I would certainly take all of that allotted time to thank the various members, both paid and unpaid, of our community that support people with mental health. From the very acute and pointy end of Victoria Police and Ambulance Victoria, who pick people up on the side of the road or in dark places and who answer the call and go into people’s homes or the streets to triage and send them, hopefully, to hospital, to the various and many organisations in my Eastern Victoria electorate, as I said both paid and unpaid, both government and non-government, there are many people out in our state doing the most amazing, heroic deeds every day under stress to support their fellow human beings’ mental health and improve their fellow human beings’ mental health. I want to speak to a couple of those today, but I want to put on the record my thanks to all in this space.

I would not be me if I did not start to talk about Gippsland, and I will. The Gippsland Regional Mental Health and Suicide Prevention: Foundational Plan provides an estimate in a 2019–22 report that almost 24 per cent of the Gippsland population had been categorised as at risk; almost a quarter of people in Gippsland in my electorate have either mild, moderate or severe mental illness, and that is both the reality and the unfortunate nature of mental health. For Latrobe the ABS statistics reveal that approximately 33 000, or 11 per cent of that population, suffer from a mental health condition, which includes depression or anxiety. That same report states that that is 11 per cent, but across the whole of Victoria the percentage of the Victorian population with a mental health condition is roughly 8.8 per cent. So unfortunately again central Victoria is represented in a higher capacity in terms of mental health vulnerability.

The Royal Commission into Victoria’s Mental Health System was established in 2019, and my colleague the Shadow Minister for Health, Georgie Crozier, has really in her time advanced our position on a lot of those issues. I thank her for all the work she has done in this space and also our Shadow Minister for Mental Health, Emma Kealy, my Nationals colleague in the lower house. I thank them for their considerable time and effort in delving into this space but also in speaking with the sector, speaking with the very real and vulnerable people and working on solutions.

During the course of the royal commission, the commissioners—there were multiple—went out into the regions. I attended the Warragul roundtable session with a number of my constituents. We went together. There was nothing more tragic than seeing a father crying at one of those sessions because of his sincere frustration about his adult child over multiple years, the effect it had had on his family and the desperate desire he was trying to communicate—the need for these improvements. The fix needs to be long term, it needs to be focused and it needs to happen. I thank all the constituents who have come to me and shared their stories. As you can see, one sits very heavily, and I thank him for the work he has done in his own space and for his family.

Recommendation 42 is really at the heart of this very comprehensive bill today. Also I would like to put my thanks on record to a former minister, Mary Wooldridge, for the work that she did in terms of the Mental Health Act back in 2014 and in the lead-up to that. But this bill looks at improving on that. I know we all went to the Royal Exhibition Building and we listened; we saw the cameras, we saw the media, we saw the fanfare and we saw and listened to people talk about their lived experience of mental health. What this government and what the Liberals and Nationals government will do and commit to do is honour their need, honour their comments, honour their wishes and make improvements in this space. A 2019 Victorian Auditor-General’s report states in conclusion:

The lack of sufficient and appropriate system‐level planning, investment, and monitoring over many years means the mental health system in Victoria lags significantly behind other jurisdictions in the available funding and infrastructure, and the percentage of the population supported.

We see that the government has failed in many, many respects, and they have admitted that. What we see on the ground is that our fantastic organisations such as Lifeline, such as Beyond Blue, such as services for kids’ mental health are under pressure. Lifeline Victoria in their 2020 report stated there had been a 22 per cent increase in calls originating from Victoria, so in our region. The chairman said, and I quote:

Our thoughts are with the people of Victoria. Lockdown means many of the important opportunities for people to connect with each other and do things they enjoy are being stopped. For someone who is already struggling, this can be a huge blow.

That was from the chairman of Lifeline Australia, John Brogden, and I thank him for sharing what many people know now and knew at the time.

I have often conversations—but recently we went back around to have a conversation—with the Gippsland Lifeline CEO, Michelle Possingham, and we appreciate the very hard work that she has given over successive years. In fact Gippsland Lifeline is about to next year celebrate I think 60 years of serving the community in the very, very dark corners where people are at their wit’s end in terms of mental health. The Nationals candidate for Morwell, Martin Cameron, and the shadow minister, as I have said, Emma Kealy, went and listened. During that period of time, during the lockdowns, there was a 45 per cent increase in triage, an increase in calls to call centres.

We know that Lifeline Gippsland services the whole of Australia and calls do not come in from their exact area. There are rationales behind that—and we certainly accept those—so that you do not walk down the street and necessarily speak to the same person that you did on the phone. Each call costs around $39 and they received 11 000 calls. We are talking about almost half a million dollars worth of calls in one year. Lifeline Gippsland have state government funding of $150 000, and because of and through the COVID lockdowns their avenue for earning—their fantastic op shops—was curtailed. They are facing real problems. Certainly I put that to the attention of all governments, and we are very mindful of that as well. Barrier Breakers has unfortunately recently closed in Gippsland. This is a sign of the times, and unfortunately it is not good.

In relation to a constituent that I spoke about in this place in terms of an adjournment debate a little while ago, a mother of a 17-year-old son who was admitted to an adult bed in Flynn ward, upon him being discharged she went to consult the outpatient service. The member on the line, the service provider, whether it was out of sheer frustration or fact, their words to the mother were, ‘You can get your next available booking in 2025’. We know from the royal commission report that regional Victoria has been severely disadvantaged, and I need to stand up for those people—and I will—in terms of getting our fair share.

The breadth of support services and commitment from our regional people is amazing. We have heard it in here today—old people, young people, men, women, youth and children as well. Heather Baird is based in Sale, and A Better Life for Foster Kids does an amazing job, again on the smell of an oily rag, if I can be so bold as to say that. She did a census of all her home-based carers a short time ago. The report showed that 69 per cent of these young people coming into kinship or foster care arrangements have a history of trauma. That is understandable. Unsurprisingly, 56 per cent have behavioural issues, 44 per cent have attachment issues and 40 per cent have mental health difficulties. That is unsurprising, but they are human beings—little human beings, vulnerable human beings—at the end of those statistics. What she wants to see I am putting on the record. When they come into the kinship foster care arrangement they have got a medical check, but she wants mental triage. She wants to see those little children have a mental health assessment at the very start and then a pathway to planning that healing and support and triage ongoing. If they come in with a bruise, a broken arm or something wrong with their eyes, ears, hearing or whatever, it is not good enough just to fix those. We must also fix the mental side, otherwise we are going to see a perpetuation of their condition throughout their life, and unfortunately they may well end up in the youth justice system and going down a path that serves no-one—not them or our society.

We have also seen that there have been cuts to the mental health programs, and indeed the Minister for Mental Health said at a Public Accounts and Estimates Committee hearing recently that these programs were ‘no longer required’. But we have seen blowouts in a whole raft of things—in the Labor government’s projects in the city—yet there is a severe need for a whole raft of programs, including for drug and alcohol abuse. Again I thank those people who are very much at the pointy end of dealing with this. Our constructive and very real amendment that Ms Crozier has flagged and will certainly move in the committee stage and speak to relates to alcohol and other drug services. Indeed it is one of the key issues that was raised in the Review of the Pandemic (Visitors to Hospitals and Care Facilities) Orders report. The Victorian Alcohol and Drug Association testified, they provided their feedback to the committee, and this is from the minority report:

They shared key statistics regarding the impact of pandemic lockdowns and restrictions on use … of alcohol and other drugs … and demand for AOD treatment and support:

• The number of people calling helplines for alcohol and other drugs doubled …

during the pandemic. And:

• Worryingly, fatal overdose data from the Victorian Coroners Court revealed that 2020 had the highest number of women fatally overdose from alcohol and more generally, the highest number of overdoses where alcohol was the sole contributing drug.

We can see that there is a need in this space, and we can see that there is a need for better communications and to have that embedded into this legislation. So I thank both the crossbench and the government for considering our amendments in good conscience. The other final thing I would like to put on the record is that we will commit to drug and alcohol centres across the state. There is one in Latrobe Valley, and it has been very well received.

The other issue is Vietnam veterans. It is Vietnam Veterans Day today, and I commend the Honourable Tim Bull, the Shadow Minister for Veterans Affairs, for announcing that the Liberals and The Nationals will reinstate high-dependency beds with specialised support in Heidelberg to help address this sector and this need for our Vietnam veterans. We should respect them, honour them, thank them and serve their mental health and wellbeing. With this I commend this bill to the house.

Mr ERDOGAN (Southern Metropolitan) (11:49): I rise to also speak in support of the Mental Health and Wellbeing Bill 2022. This bill delivers on a key recommendation of the Royal Commission into Victoria’s Mental Health System, in particular recommendation 42. It is an important milestone in the 10-year mental health reform program required to give full effect to the royal commission’s vision.

The bill puts people with lived and living experience of mental illness and psychological distress and their families, carers and supporters at the centre of our mental health and wellbeing system. It does this through the establishment of new rights-based objectives and principles and the inclusion of designated lived experience roles at the highest levels of new and existing governance and oversight entities. The bill establishes key new elements of the system architecture, including the chief officer for mental health and wellbeing, statutory regional mental health and wellbeing boards to provide advice on the planning and commissioning of services at the local level, and the new Mental Health and Wellbeing Commission and Youth Mental Health and Wellbeing Victoria. The bill sets out the foundations for the future of mental health and wellbeing services across Victoria, one where lived experience voices are at the centre and mental health professionals are supported to deliver treatment, support and care in facilities that actually help people recover. The new system framework will ensure that the legislative mechanisms reach beyond merely authorising and regulating the use of compulsory treatment and restrictive interventions and enable a connected and coordinated system where people do not fall through the cracks but receive the treatment, support and care they need and deserve.

Before getting into some of the changes, I want to thank all the previous speakers and contributors who have touched upon the importance of this bill, in particular Mr Barton for sharing his lived experience and informing the chamber about his experiences. It gave me an opportunity to reflect on my experiences growing up, when awareness of issues of mental health was not as widely spoken about. In particular male mental health was not at the forefront of many people’s minds and did not have the attention or focus and resources we have now in addressing this issue. It is an issue that affects so many people—I can say me and my family as well. I know members of my family have had tough periods as well. It does not affect just the person experiencing it; it affects their family, their supporters and their friends. It is very difficult. It is important that this bill does get passed today and is implemented as soon as possible because it is an important piece in the whole raft of reforms that our government is making.

This has made me reflect on a topical discussion today about spending on mental health and health and having foresight that this is not just a quick fix. It is a 10-year program looking to the future. We want our system to be a lot better than what it is today, not just today but also 10 years into the future. That is what this is about. It is not just about people that are suffering today, it is about people in the future that will come across these issues of mental health so they have the resources and support needed. I like that this is just one part of a bigger program that we are implementing.

There are many significant changes from the Mental Health Act 2014. This bill has a wider focus. The 2014 act has a focus on people who appear to have mental illness and compulsory treatment. It does not deal necessarily with wellbeing. The bill remakes many aspects of the 2014 act. For example, it provides for the appointment of the chief psychiatrist and establishes the Mental Health Tribunal and the Victorian Institute of Forensic Mental Health. The bill will also continue the Victorian Collaborative Centre for Mental Health and Wellbeing.

Some of the key new developments under this bill are a stronger focus on the protection of rights; the introduction of an opt-out, non-legal mental health advocacy service; a focus on moving towards elimination of restrictive interventions and a reduction in the use of compulsory treatment; regulation of chemical restraint such as sedation; introduction of health-led responses to mental health crises; establishment of new roles and entities—a chief officer for mental health and wellbeing, the Mental Health and Wellbeing Commission providing independent oversight of the system, regional multi-agency panels and Youth Mental Health and Wellbeing Victoria, which I will elaborate on a bit later; a broader definition of ‘mental health and wellbeing service provider’, widening the range of organisations which fall under the act; extending the oversight of the chief psychiatrist to mental health and wellbeing services in custodial settings; and acknowledgement in statute of the harms that may be caused by compulsory assessment and treatment and requirements that these harms be balanced against the harms to be prevented by their use.

The bill in some respects goes beyond the royal commission’s recommendations. In general, it does reflect the royal commission; however, it goes beyond them for a number of reasons and in a number of ways. The establishment of Youth Mental Health and Wellbeing Victoria responds to the significant mental health challenges faced by young people and the fact that the primary focus of Victoria’s collaborative centre will be on adults and older adults.

There is the inclusion of specific decision-making principles in relation to compulsory assessment and treatment and restrictive interventions. Although this was not a direct recommendation, the royal commission did state that the bill should include principles that reflect concepts of autonomy, supported decision-making, recovery-oriented practice, the protection and promotion of human rights and the use of compulsory treatment as a last resort and that provide guidance for decision-makers and service providers on how treatment, care and support should be delivered. The royal commission recognised that specific principles and accountability mechanisms may also be needed for different parts of the new act—for example, compulsory assessment and treatment.

The reduced maximum duration of community treatment orders from 12 months to six months—a change which was on the recommendation of the expert advisory committee established to support development of the bill—will provide for more frequent oversight by the Mental Health Tribunal. This is consistent with the royal commission’s vision for a reduction in the use and duration of compulsory treatment and is considered more rights protective than allowing for community treatment orders to continue for 12 months without independent oversight.

There are changes to support a health-led response to mental health crises. The royal commission recommended that, wherever possible, emergency services responses to people experiencing a time-critical mental health crisis are led by health professionals rather than by police—a topic that some of our previous speakers have commented on. Implementation of this recommendation requires legislative changes to enable health professionals to respond to people experiencing a mental health crisis in the community. To this end the bill will enable more authorised persons to take a person experiencing a mental health crisis into their care and control for the purpose of arranging for a mental health examination. Initially this will be by registered paramedics employed by an ambulance service. The bill will also allow for more flexible options for examination locations and transport and modernised provisions to afford better protection of people’s privacy and dignity when being searched.

One aspect that I stated I wish to touch upon is Youth Mental Health and Wellbeing Victoria. It is an important part of the jigsaw—a crucial part in fact—because in part of my work on the Pandemic Declaration Accountability and Oversight Committee I did hear about the disproportionate effect on young people that the pandemic has had. Obviously much-needed public health restrictions were in place, but as a result young people were disconnected from friends and family and from their school environment. Recognising the specific needs of young people, Youth Mental Health and Wellbeing Victoria is going to be established and will establish a response to some of the significant impacts of the pandemic but also the mental health impact on young people in general. Youth have been singled out because of the disproportionate impact of the pandemic and the initial primary focus of the Victorian collaborative centre. Youth Mental Health and Wellbeing Victoria will provide system leadership in youth mental health and wellbeing. This will complement the work of the VCC. The board of Youth Mental Health and Wellbeing Victoria will work closely with the VCC to identify and promote opportunities to increase collaborative translational research between multiple organisations and multidisciplinary experts and people with lived experience to improve the mental health and wellbeing of young people across Victoria.

The oversight functions in relation to declared operators will enable them to seek out and integrate a range of specialist youth mental health services and researchers in a way that is more adaptive than traditional hospital-like models. Our initial understanding is that the focus of this youth body will be on people aged between 12 and 25. That is, I think, a good catchment. You get a lot of the older adolescents, teenagers and a whole cohort of really—

Business interrupted pursuant to sessional orders.