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More Support for our Mental Health Care System

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Samantha Ratnam
Leader of the Victorian Greens
23 August 2022

The Greens welcome the Mental Health and Wellbeing Bill 2022. We need to create a properly funded, well staffed mental health care system that centres prevention, early intervention, lived experience and cares for people when they need it the most.

 

Speech given in support of the Mental Health and Wellbeing Bill 2022: 

The Greens welcome the Mental Health and Wellbeing Bill 2022.

For a long time, Victorians facing a mental health challenge stood a very real chance of getting inadequate support, or no support at all. Our mental health sector has been desperately underfunded, with very real consequences for our friends, neighbours and family, and sometimes ourselves. The royal commission and big increases in funding have seen things start to change, and this bill is the next step in that journey.

The Bill implements some of the key recommendations of the Royal Commission into Mental Health. This landmark investigation was the culmination of decades of hard work by the mental health workforce and people experiencing mental health issues who have known for years that the system was falling apart. As someone who previously worked in the sector, I experienced this first hand. 

The Bill creates a new Mental Health Act as recommended by the Royal Commission. This recommendation was made to redress the previously narrow focus on medication and compulsory treatment.This emphasis on medication and compulsory treatment, combined with an under-resourced sector led to many people having very negative and often traumatic experiences of mental health treatment. This new framework now emphasises having people with lived experience of mental health issues as part of the system, to help address this.

The Bill seeks to address these concerns through a new set of principles which we support which are welcome.  

We do note however, that these principles can only be realised with proper funding and the cultural shift that is needed for governments to move away from only focussing on tertiary treatment to actually funding proper preventative and early intervention work. So we can’t rest here. These principles are a good start, but they must be met with urgent funding support as well as the shift to proper preventative and early intervention care as well. 

The bill also legislates a number of new entities that are welcome. 

The bill legislates the 10 year target for an end to seclusion and restraint which the royal commission recommended. And I note the careful work that is needed to consider the decisions concerning compulsory, seclusion and restraint. 

We also note that those on the ground in the sector have raised a series of concerns. And I will speak to these briefly. 

At the moment if you have a psychotic episode in the middle of a shopping centre, it's the police who are likely to be called. The royal commission recommended that this shift to health care workers taking the lead instead. 

This is a sentiment that is widely supported, including by the Greens, but the practicalities of it are more complicated. Both the Health and Community Services Union and the Victorian Ambulance Union are concerned that health workers are already overstretched and need assurance that these shifts are properly resourced with staff and other support. 

Others have questioned if the wording in the bill really reflects the royal commission’s intent, given the commission called for responses to be “led by” health professionals, not for health professionals to be exercising these powers on their own. The Victorian Aboriginal Legal Service is concerned that despite the shift away from police, this bill expands the power of PSOs to respond to mental health crises. They question if they have the training to be the right people to deal with someone in distress.

The Aboriginal Legal Service has also raised other concerns, including about the Statement of Recognition and the Cultural Safety Principle. They would also like to see rules on locking people in a room on their own not exceed maximum solitary confinement periods in prisons.

We hope that some of these concerns are taken on board, in the debate in this chamber, in the writing of regulation, and in the implementation of the bill.

While it’s important to get the rules right around how our mental health system deals with people in distress, it’s worth remembering that funding is also key. The last few budgets have included significant increases in mental health funding, which the Greens welcome. However they are yet to make a real difference on the ground. 

I recently had the pleasure of meeting with some of the mental health workers represented by the Health and Community Services Union, who described working in what is still a very challenging environment. Thank you Liam, Lisa, Rachel, Kate, Jason, Clare, Lee, Phil, David, Marissa, and Noah for taking the time to help me understand your experiences and for the work that you do. These workers told me they’re understaffed and working long hours, and struggling to find the time to take leave. And that’s just in the city, with worse understaffing problems outside Melbourne. People move out of the sector because they feel undervalued, and allied health staff don’t get the pay they deserve. The sector is gradually employing more people with lived experience of mental health issues, but is still struggling to provide them proper supervision. Without enough staff, mental health workers often find themselves unable to give the quality care that helps avert a crisis, instead having to rely on physical restraint when things go badly, to stop people getting injured. 

The mental health workers I met with also told me about people being discharged too soon from mental health wards into the under-resourced community mental health sector, which often sees them back in the ward before long. And they told me about people being discharged into appalling rooming houses, because there isn’t the affordable housing and public housing we need to look after people in crisis.

They are putting forward suggestions to address some of these issues that we encourage the government to consider including establishing a Chief Mental Health and Wellbeing Nurse, with delegated responsibilities related to nursing that reports to the Chief Psychiatrist. Also ensuring funded professional development for all staff so the reforms in the bill can be applied in practice with confidence. (They also recommend proper representation of allied health workers at Safer Care Victoria)

It is also disappointing that some of the allied health professionals so important to providing care in our mental health system have been caught in lengthy negotiations over pay and conditions. Fair pay and conditions for mental health workers will be crucial in making the mental health system work yet some allied health workers working alongside nurses in the community - doing the same job - are paid significantly less. In fact as I understand there are some allied health workers who even manage nurses but get paid less. It is time allied health workers were no longer treated the “poor cousins” in the system. Indeed addressing these workforce issues to maintain and grow the allied mental health workforce will be necessary to the effective implementation of the reforms to improve the mental health system so people get the care they need.

It’s a challenging situation, but these are hard working people who are doing what they can to look after the people they care for. I’d like to thank them both for the work they do and for taking the time to make sure people in this parliament understand some of the realities of the sector.

While there are some issues with this bill, the Greens sincerely hope that the changes it makes, as well as the extra funding which is working its way through the mental health sector, will soon be making a real difference, not just to workers but also for people seeking mental health support. Whether they be our friends, neighbours, family or ourselves.

It cannot be overstated enough - our mental health support system is more important than it has ever been. After years of chronic neglect of the system by governments coupled with structural forces such as rising inequality, precarious work and weakening universal health and community services that we know lead to poor mental health - more and more people will require the support of our mental health system at some point in their lifetime. 

The decision the government has  before it now is if it chooses to rise to the opportunity that we have - to help create a properly funded, well staffed mental health care system that centres prevention, early intervention, lived experience and cares for people when they need it the most.

 

Watch the full speech on YouTube here. 

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Samantha Ratnam
Leader of the Victorian Greens
23 August 2022
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