Royal Commission into Victoria’s Mental Health System
Ms THEOPHANOUS (Northcote): Thank you, Acting Speaker Carbines, for this opportunity to speak on this take-note motion on the Royal Commission into Victoria’s Mental Health System. I consider it a great honour to be able to take this moment in this Parliament to reflect on something which goes to the very core of our human experience: our mental health. One in five people will suffer from a mental health illness in their lives, but every single one of us has experienced the distress and impact of this, whether it is ourselves, our loved ones, our colleagues or our friends. These are deeply personal experiences. They are difficult to speak about, not least because of the pervasive stigma associated with mental health—stigma that all too often dismisses mental health issues as flippant, shames us for being weak, demands we toughen up or paints us as irrational, broken or not worthy of our own agency.
For decades in that darkness amidst that trauma people have sought to reach out for help to our mental health system. What they have been met with is a system so overburdened, so miscalibrated and so alienating that it barely warrants being called a system at all. The royal commission has been a historic opportunity to shine a light on this failed system. It is the first of its kind in Australia, and it has given us an opportunity to elevate the voices of those courageous Victorians who have told us with rawness and honesty of their experiences in trying to seek help. Their voices are powerful. They speak of barrier after barrier after barrier to seeking care, of convoluted pathways that are almost impossible to navigate, of being turned away because their conditions are too severe or not severe enough, of impossible case loads and workforce exhaustion and of an overwhelming sense of frustration, isolation and disempowerment. As a government we have not shied away from this confronting picture but faced it head-on because we demand more for Victorians.
The royal commission’s final report makes 65 recommendations to reform our mental health system, along with nine recommendation in the interim report. We have committed to implementing every single one of them. More than that, we have invested more than $4.6 billion over the last two state budgets to deliver the lasting and comprehensive reform that we need to get this system right. That is a monumental figure, the likes of which we have not seen invested in mental health before.
In practical terms it means we are building a new mental health system. The system envisaged by the royal commission is very, very different to the one that exists now. It will be a mental health and wellbeing system that is strongly oriented towards community-based treatment, care and support, where people seeking help need not turn up at the emergency room but instead can access the full range of supports they need close to their homes, families and support networks. This system will be tiered, building in that missing middle of the system that has left so many people with nowhere to turn; it will be targeted, with service streams dedicated to infants, children and young people and a separate one for adults and older adults; and it will tailored, allowing for culturally appropriate responses, for community-controlled First Nations responses and for LGBTIQ-informed responses.
We are building a system for every Victorian, because the truth is that it does not matter who you are or where you come from or what your circumstances might be. You could be that person who normally weathers every obstacle with strength and determination. You could be the one with thick skin or the one who normally floats through life carefree or the one who likes to tell the loudest jokes. We do not always know the when or how of mental ill health, but we do know its impacts.
In my own community of Northcote, one in five residents report experiencing anxiety and depression, over one in 10 say they suffer high levels of psychological distress and 18 per cent say they feel deep social isolation. That is why one of the very first things that I did when I became the member for Northcote was to write a submission on behalf of my community to the Royal Commission into Victoria’s Mental Health System. My submission was by no means exhaustive but pointed to some of the key issues and considerations I wanted the commission to zero in on. Amongst them I highlighted the need for more perinatal mental health supports. I wrote:
… there are many added risk factors that occur pre and post birth, such as reproductive issues, birth trauma, complex or difficult pregnancies, premature or sick babies, feeding and settling issues as well as the understanding that women are at higher risk of intimate partner violence during pregnancy and shortly after birth.
It was heartening to see the royal commission acknowledge this, though it brought into even starker relief the needs that exist. Indeed they found that women are at greater risk of developing mental illness during the perinatal period than at any other time. They also found that the mental health of mothers and the health and wellbeing of children are inextricably linked and emphasised the importance of supporting the parent-child relationship to prevent, support and treat mental health conditions in both the parent and the child. The royal commission has called for the establishment of dedicated infant, child and family health and wellbeing hubs and an expansion of perinatal mental health services. This is welcome news for the inner north, where we know there are very clear service gaps and barriers to accessing care. A lack of public services, long waitlists, stigma and fear all play a part. With no local mother-baby units, no local early parenting centres and no public perinatal mental health services in the electorate, too many parents and children in my community are falling through the cracks. I am hopeful that the new dedicated centres recommended by the commission, along with the network of local and area mental health hubs, will change the trajectory for families in my community who need support.
There were other issues I wanted to draw to the attention of the royal commission in my submission. I am conscious that I do not have time to talk about all of them, but another issue I raised on behalf of my community was the need for tailored mental health support for our young people. The Northcote electorate is home to many children and young people, with 27 per cent of the population under 25 years old. Recently I was able to meet with Headspace Greensborough and Headspace Plenty Valley, who service the Darebin area. One of the things they conveyed to me was their deep concern at the lack of mid-level mental health services available to young people in Darebin. They told me that, unlike the vast majority of municipalities, Darebin does not have mid-level youth-specific community mental health services. The YETTI—Youth Engagement and Treatment Team Initiative—provided by the Austin Hospital services Banyule and Nillumbik but not Darebin. Neami YFlex, a service for young people aged 12 to 25, services Whittlesea but not Darebin. I am hopeful that the recommendations arising out of the royal commission will address these significant service gaps and give young people in the inner north genuine referral pathways to access the care that they need, and I want to assure my community that I will not stop pushing for this to happen.
I cannot speak on this take-note motion without acknowledging that our mental health system is buttressed by the unrecognised labour of tens of thousands of carers, and they come in many forms: parents, partners, siblings, friends. Research suggests that about 25 per cent of children are living with a parent who has a mental illness. The future mental health system will acknowledge and involve these carers, giving them access to dedicated supports and respite. Eight new carer centres will be established, providing information and resources to families and connecting them with support.
We also know from the royal commission that recruiting and retaining the mental health workforce is a major obstacle. These workers, and they come from many different professions, report excessive, unsustainable workloads. They speak of the deep sadness and guilt of not being able to commit enough time to the people they treat. They speak of fatigue and vicarious trauma and few opportunities for professional development and career progression. The royal commission has made significant recommendations to support these wonderful people who spend their working lives supporting others. Recommendations include a dedicated workforce strategy and new incentives and supports for mental health professionals to train, live and work in the communities where they are needed.
In the time I have left I want to thank both the current and former ministers for mental health who have shepherded these once-in-a-generation reforms which will make such an extraordinary difference to the lives of so many people. This is truly Labor reform at its best. It is the kind of reform that takes guts. We are going to reform Victoria’s mental health system and rebuild it from the ground up.