Wednesday, 21 June 2023

Mental health

Debate resumed on motion of Georgie Crozier:

That this house:

(1) condemns the Andrews–Allan government for failing to:

(a) act on independent advice on trauma caused by the mental health system, published in the report commissioned by the Andrews government Not Before Time: Lived Experience-Led Justice and Repair (the report);

(b) implement the report’s recommendations to:

(i) undertake a truth and reconciliation process;

(ii) apologise to the communities identified through a restorative justice process;

(2) notes that the author of the report claims that:

(a) senior bureaucrats interfered and pressured the author to amend the report;

(b) senior bureaucrats in the Department of Health (DH) repeatedly attempted to alter the report’s scope, including forcing authors to provide recommendations to the DH rather than to the then responsible Minister for Mental Health;

(c) the Andrews government attempted to ban the author from making the report public, including threatening the author’s future employment opportunities with the government if they published the report;

(3) further notes that these interactions indicate a failure by the Minister for Mental Health to avoid discrimination in the workplace on the basis of mental health and victimisation of a person with disclosed mental ill health, which would constitute a breach of the Equal Opportunity Act 2010;

(4) requests the Minister for Mental Health to provide to the house a full and proper account of the actions taken by senior bureaucrats in DH in relation to the handling of the report; and

(5) requests that the Victorian equal opportunity and human rights commissioner urgently investigate these matters.

Ryan BATCHELOR (Southern Metropolitan) (16:40): I am pleased to rise to contribute further to the motion from Ms Crozier in relation to mental health. The debate on this motion commenced earlier today, and then we took a slight break for other proceedings and are now coming back to it. Essentially Ms Crozier’s motion in relation to mental health seeks to make some reasonably significant claims about a recent harm reduction report, Not Before Time, which was the subject of some coverage in the newspapers.

Others, in contributing to this debate, have reflected on the importance of work like this. I think it is important to say at the start of this debate that it is an important part of the policymaking process in the state of Victoria that our public service, in this case the Department of Health –

Members interjecting.

Harriet Shing: On a point of order, President, Mr Batchelor is making a really significant contribution. He is quite literally sitting directly behind me, and I cannot hear him.

The PRESIDENT: I uphold the point of order, and I ask the chamber if we could be quiet for Mr Batchelor’s contribution. He can decide whether he would like to go from the top.

Ryan BATCHELOR: I think I will continue from where I am, thank you, President.

As I was saying, an important part of the policy development process and the policy implementation process in the state of Victoria is that departments – in this case the Department of Health is the lead agency – routinely engage external parties to conduct research and consultation. In many cases that occurs independently of the considerations of ministers. It is often an important and best-practice part of program implementation that such material is commissioned to help inform both the department’s understanding of issues and the broader policy development process. The report which is the subject of today’s motion from Ms Crozier is an important and meaningful piece of work, and a lot of important and meaningful work went into the preparation of the acknowledgement of harm report Not Before Time. It was indeed commissioned by the Department of Health to inform their policy development and the understanding of issues relevant to mental health and mental health reform here in Victoria. This is a standard and routine part of the practice of good governing and good government in Victoria.

The government does value these contributions. We value the work that was undertaken. It is important, and we greatly appreciate the work of those Victorians with lived experience of mental health and those others who volunteered their time to share their experiences so that our mental health system can be improved in line with the very important recommendations that were made by the Royal Commission into Victoria’s Mental Health System – the royal commission, I might add, that was established by this government as a key election commitment, that was delivered by this government and whose recommendations are being implemented by this government. No-one should doubt this government’s commitment to mental health and to building the mental health system from the ground up. This report, in its commissioning by the department to help guide its internal development processes, is a very important part of that.

The challenge we have before us today is that the terms of Ms Crozier’s motion attempt to make something out of the development and commissioning process of this report but in a little bit of a sloppy way, because the entire motion and what it details in its contents are riddled with a range of inaccuracies and conflate many issues. I think probably, in deciding who has a better understanding of the things that have happened here, it is important to read into the record the words of the author of the Not Before Time report, Mr Katterl, who obviously has made a range of public comments. He said earlier:

I don’t support that motion from the opposition but accept I don’t have control.

I think there is probably a moment for us to reflect on the words of the author of the report, the 87-page report which has made an in-depth and worthy discussion of the issues of lived experience. He has said quite, I think, succinctly and clearly, that he does not support the motion from the opposition and accepts that he does not have control. I think the next piece of his comment is also important to read. It is:

I just hope that you take the time to read our report …

I think that is a worthy sentiment, and I think it is something that all of us who are contributing to the debate reflect on. I have had the chance to read the report – not fully, I have not got through all 87 pages yet, but the report clearly does a thoughtful task of acknowledging the harm that is caused by those who have lived experience of mental health here in Victoria, the consumers of our mental health services and the mental health system, and obviously makes some recommendations to government about the matters before it, because it is an important task the government is undertaking to fix the broken mental health system that has existed in Victoria for far too long. We know and we understand that just tinkering around the edges is not going to deliver the sort of change that Victorians need from the mental health system. That fundamentally was why we as a government made the commitment to holding the mental health royal commission, and that is why as a government we committed to implementing all 74 recommendations that that royal commission made. It is not a simple task and it is not a quick task, but it is a serious task and a task that all members of the government, led by the Minister for Mental Health, are taking exceptionally seriously.

The royal commission gave us a 10-year blueprint to rebuild the mental health and wellbeing system here in Victoria, and in the two years since that royal commission delivered its road map to the government we have backed in our commitment to implementing the recommendations with serious funding, serious policy reform and serious systems reform. Six billion dollars has been invested over the last couple of years to realise the vision of a better mental health system here in Victoria, and it is the largest investment that has been made in mental health in Australia’s history.

The royal commission’s process provided an important opportunity for Victorians with lived and living experience of mental ill health to tell their story and be heard and to incorporate their experiences into the reform directions of the mental health system. Those lived and living experiences of mental ill health are an important part of the forward reform journey.

Some of the most powerful contributions that were made to the mental health royal commission were from people with lived experience, and it is important that these people came forward as part of this process. I personally want to thank those who made those contributions – those who stepped forward as part of the royal commission’s processes and as part of these more recent processes initiated by the Department of Health to make sure those lived-experience voices are considered. The work of the acknowledgement-of-harm report Not Before Time is an important part of this debate and an important part of our reform journey going forward. I am very glad this government is so committed to mental health reform in Victoria.

Melina BATH (Eastern Victoria) (16:51): I rise this afternoon to make a contribution on motion 123 in the name of Ms Crozier. In doing so, I want to express my thanks to those who have been prepared to provide an insight into the lived experience of those who have survived abuse in the mental health space or survived a condition that leads them into a better place – those who are still in a very confronting and life-diminishing space but also those who have had to weather far less than perfect interactions with either government staff or the system. I will just call it the system.

I would like to thank Mr Katterl for his commissioned report, Not Before Time. The state government requested that he investigate certain areas. I would like to thank him for his investigations and speak to some of those investigations. He found that people with mental illness were subjected to – this has been stated a lot in media and also in the report – compulsory treatments, including seclusion, restraint and the use of induced comas. There were extreme levels of intervention. Were they the best levels for the wellbeing of the person? Were they the best levels for the safety of the community? These are the questions.

The report is being treated, to my mind, a bit like a hot potato now that the government has it in their hands. We have seen through reporting in the Age newspaper recently that the Premier has not read it. The Minister for Mental Health is getting questions in relation to this report, but nobody in particular wants to embrace it or adopt what is within it.

The report was produced in response to the Royal Commission into Victoria’s Mental Health System to investigate and to provide the minister with an options paper for acknowledging the harm reflected in the views of the lived-experience community and also to produce best-practice evidence. What was the status quo for those who lived through it – those on the inside? Not Before Time certainly acknowledges that Victoria’s mental health system was built on imperfect foundations and was designed without the input or expertise of people with lived experience.

The reference group that was established produced recommendations for the minister. Seven of the members were identified as speaking from a survivor perspective – those with lived experience – and three of the members spoke from the family or supporter and carer point of view. I certainly know that sometimes people with lived experience, people who have lived through the system, can have different views to their families or carer supporters, or they can have very much a similar point of view. In many cases reliving those experiences can cause very deep and painful distress to people, and I appreciate them having to delve into them on behalf of the investigations to produce this report.

In terms of recommendations, the Not Before Time report looked at six major recommendations: truth and reconciliation processes; public apologies; individual reparations; collective reparations; symbolic reparations; and guarantees of non-repetition. When we look at that first recommendation and delve into it in slightly greater detail, truth and reconciliation is part of that restorative process. If one feels valued about the truth that is being told and believed and respected, then acknowledge the harms that have been done. It can certainly start to improve relationships and create that level of understanding and hopefully, in this report, reduce the prevalence of human rights violations.

The report goes to three particular aims: that the state government should hear and acknowledge the harms of the mental health system; formally document these harms for the public record – so not only should they be listened to but they should be documented for the public record for people to see; and, where possible, there should be reconciliation. That is reconciliation between the consumer, the survivors, the families, the carers, the supporters and, where possible, reconciliation between mental health practitioners and the Victorian government. That can be a considerable can of worms. The restorative justice process should be led by lived experience and commissioners with the Mental Health and Wellbeing Commission interlocked, so a general understanding. It is really challenging, and we need to ensure that everybody who has suffered any mental harm within the mental health system has their voice heard and respected and that recommendations are fully enacted by government. It has been really quite frustrating, I am sure, that someone produces this report in good faith and then it is seen as something that needs to gather dust rather than be enacted.

Mental health in my region is a significant issue for families across the socio-economic divide. The Gippsland Mental Health and Suicide Prevention: Foundational Plan provides an estimate that for 2019–22 almost a quarter of the Gippsland population could be categorised as at risk. A quarter of those people had either a mild, moderate or severe mental illness. It is a considerable concern. I know I have spoken about in this place before that the services are just not there or they are on the never-never, and I will give you an example. A Moe mother’s 17-year-old son was identified in the school as having a major mental condition, compromised mental health, and was told there were no mental health beds in the local Latrobe Regional Hospital available for that young person. They could go into the adult ward or they could go all the way to Melbourne. The mother said to me she was not driving at the time, so she said it was not an option to go to a youth mental health service, a youth mental health bed; they had to go into the adult service. This might be an anomaly, but I tend to think that the constrained services are there on a regular basis. The next part was that follow-up service, and literally when they rang the youth space service they said it would be months and months, just again showing that big concern that they have.

It is also very disappointing to see that a really great space that we have in the Latrobe Valley – and indeed I will give the acknowledgement where it is due: Latrobe Youth Space was set up during COVID, in May 2021 – has now had its funding removed. I concur with my colleague Mr Martin Cameron, who has visited the youth space. He is really concerned because they are really concerned about how they will provide that support, often at the front of house. It is a place where people can go in and have a shower, have a meal, sit down, communicate and reset their mental health from sometimes a very vulnerable space. That will be closed. That funding is withdrawn. So unless there can be some manna from heaven – and I am more than happy to thank the government if there is manna from heaven – that youth space will be closed in the very near future.

I thank Mr Katterl for the work that he has done, and I am sorry that he had a very unfortunate experience. I urge the government to accept the recommendations and to act upon them immediately.

Michael GALEA (South-Eastern Metropolitan) (17:01): I rise to speak on the motion moved by Ms Crozier. Mental health is an undeniably important issue. There can be no doubt that historically mental health has taken a back seat. The approach of successive governments in successive jurisdictions has been seriously lacking. I thank Ms Crozier for bringing this issue before the house. Whilst I am glad for the opportunity to discuss the importance of addressing the need for well-funded mental health services and support across the state, it is nevertheless disappointing that rather than focusing on the substantive issue and the substantive policy of what we can actually achieve, the opposition has once again sought to politicise an issue, this time in the mental health space and this time in relation to the author of the aforementioned report that many speakers have referred to, Not Before Time.

I note that the author of that report actually came out today and said that he does not support the opposition’s motion. It is just disappointing, I guess, to see time and time again an opposition more interested in scoring cheap political points over the government than working on substantive policy reform – not to mention that the motion is also riddled with factual inaccuracies and conflates several issues. The report in question was commissioned by the Department of Health to inform its policy development and understanding of an array of issues, and it forms a component of a broader suite of work. Out of respect for what happened to the author and for his wishes, whilst remaining relevant to the subject area of mental health I will concentrate my remarks on the actual policy work that has been done and not get into this game of back and forth that Ms Crozier seems more interested in playing.

The Andrews Labor government has taken up the challenge and the duty of comprehensive reform of our mental health services. There has been a real commitment to providing the much-needed funding within this sector. Much was done during the previous term of Parliament of course too. That commitment towards addressing the need for reform and funding towards mental health continues under the Andrews Labor government in this term, in the 60th Parliament, as well. The record levels of investment, including the substantial boost to mental health funding in the 2023–24 state budget, are a testament to this government’s ongoing commitment to doing the right thing when it comes to mental health funding. We are committed to building our mental health system – rebuilding it, in fact ‍– from the ground up, implementing every single recommendation of the royal commission. $5.7 billion across three budgets has been invested in transforming our mental health system as part of our 10-year overhaul of how we address mental health in Victoria.

In the 2023–24 state budget we also invested a further $776 million for critical bed-based services, alcohol and other drug services, infrastructure, earlier support in community mental health services and the rollout of the Mental Health and Wellbeing Act 2022, which I will go into in a little bit more detail later on. I would also like to note we have invested in a number of wellbeing locals too, including three more in this budget, one of which is in Narre Warren in the South-Eastern Metropolitan Region, which has been absolutely fantastic – that is going to make a huge difference to my community – in addition to which there is also planning funding for some further mental health locals in and across the south-east, including in that outer south-east area in Officer and in Cranbourne.

We have established a dedicated capital investment fund to provide Victorians with mental health infrastructure. The Mental Health Capital Fund is investing $10 million this year to upgrade infrastructure across a range of health services to keep delivering the services Victorians need most in their local communities, with over $1.5 billion invested in mental health infrastructure to meet the recommendation of the royal commission and build the mental health system that our state needs.

Going back to these mental health and wellbeing locals, the royal commission told us that these local services are a critical step in assisting people to find the mental health care and support that they need. As part of this we invested $264 million in local care to focus on early intervention and ensure Victorians get the care they need much sooner and closer to their families and communities. I think it is just really important, and I am sure we can all understand as members that it is one thing to have a great new service – it might be at the Monash Medical Centre, and if you are in that part of the south-east that is absolutely fantastic, but if you are in Pakenham or if you are in Clyde North or if you are in Frankston, that is not quite so convenient, and every little further kilometre can be an added deterrent to seeking support. That is what these mental health and wellbeing locals will seek to address, and it is good to see that six of these mental health locals are already in fact open. There are 21, including all those under planning at the moment, which are on the way and funded as well.

The royal commission recommended we replace the former Mental Health Act 2014 with a new fit-for-purpose mental health and wellbeing act that serves as the foundation for a world-class mental health system. The Andrews Labor government acted on this key recommendation, and the Mental Health and Wellbeing Act 2022 has already been legislated. The reforms that this act instituted puts people, their families, carers and supporters with lived experience of mental illness and psychological distress at the centre of our system. It does this by establishing rights-based objectives and principles and including designated lived-experience roles at the highest levels of new and existing governance and oversight entities. The act establishes critical new elements of the system architecture, including the chief officer for mental health and wellbeing’s role, 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 as well. Youth Mental Health and Wellbeing Victoria, which will provide systemic leadership in youth mental health, is an essential measure in acknowledging the disproportionate impact that the pandemic had on young people.

The importance of these measures is not just in addressing a historical lack of focus towards the mental health system in Victoria, which undeniably has meant that many people have been unable to access the care that they have needed. The new system’s framework will ensure a connected and coordinated system that does not let people fall through the cracks. The mechanisms in the Mental Health and Wellbeing Act will focus on ensuring people receive the treatment, support and care that they need and deserve.

The previous act, the 2014 one, had many shortfalls highlighted by the royal commission which are addressed under the new act. The old act focused on people who appear to have mental illness and compulsory treatment. There was a distinct lack of focus on wellbeing. There is a reason that the royal commission recommended that this new legislation come into effect: to rectify the flaws in the system that meant that the mental health system in Victoria did not meet the expectations that we would have for it. In meeting this challenge of rebuilding the system we have also established a stronger focus on the protection of rights, including introducing an opt-out mental health advocacy service. We are focusing on moving towards eliminating restrictive interventions, reducing the use of compulsory treatments and chemical restraints, and introducing a health-led response to the mental health crisis. These and other changes will support a health-led response to mental health crises, and the royal commission recommended that, wherever possible, emergency service responses to people experiencing a time-critical mental health crisis are led by health professionals rather than by police.

There is still much more to be done and more work that this government will continue to do to achieve the mental health infrastructure, responses, supports and overall health system that Victorians expect and that our communities deserve. Actions speak louder than words. I support and commend the Andrews Labor government’s ongoing commitment to implementing the key recommendations of the royal commission. This government is delivering the funding and reforms that are transforming Victoria’s mental health system into one that delivers the care, the wellbeing and the support that is needed.

Council divided on motion:

Ayes (12): Matthew Bach, Melina Bath, Jeff Bourman, Gaelle Broad, Georgie Crozier, Renee Heath, Ann-Marie Hermans, Wendy Lovell, Trung Luu, Joe McCracken, Evan Mulholland, Rikkie-Lee Tyrrell

Noes (20): Ryan Batchelor, John Berger, Lizzie Blandthorn, Katherine Copsey, Jacinta Ermacora, David Ettershank, Michael Galea, Shaun Leane, Sarah Mansfield, Tom McIntosh, Rachel Payne, Aiv Puglielli, Georgie Purcell, Samantha Ratnam, Harriet Shing, Jaclyn Symes, Lee Tarlamis, Sonja Terpstra, Gayle Tierney, Sheena Watt

Motion negatived.

Business interrupted pursuant to sessional orders.