Mental Health Matters of Public Interest

I rise to speak on this matter of public importance on mental health, and I welcome the comments by Senator Faulkner that it is an issue where there is bipartisan concern, and that previous governments have made substantial and, might I add, effective commitments in this area. I think that is the point where government speakers have missed the heart of this MPI from the coalition’s perspective. We share the desire to do something and we share the desire to make sure it is bipartisan. But that does not absolve us from our responsibility to hold the government to account when they are not delivering on their promises, or when they are not working effectively with the funds that they have committed. This is an area where we cannot fail. We cannot fail the many individuals and families who entrust us to come to this place to use their taxes effectively to provide the support that our community needs.

Almost 45 per cent, or 7.3 million, of Australians aged between 16 and 85 report that they would have met the criteria for a diagnosis of a mental health disorder at some time. One in five Australians will experience a mental illness this year. Anxiety disorders affect some 14 per cent of people aged between 16 and 85; they are the most common disorders. It is perhaps not until you know someone who has been affected by that that you realise how debilitating it can be for them, for their families and for the work that they do, and why we as a community need to support them.

Mental health accounts for nearly 13 per cent of the total burden of disease in Australia, but only about six per cent of the health budget goes to mental healthcare services. The coalition, in holding the government to account, was successful in initiating a Senate inquiry looking at the funding and the administration of mental health services. I bring those two points out deliberately because it is great to have a vision, and this government has been very good about putting forward its vision, but vision without dollars is hallucination. One of the things where people are hurting is that this government talks, as Senator Faulkner did then, about $2.2 billion over five years, but the question is: when is that money being spent? The bulk of it is in year 5, and there have been cuts to programs—successful programs—in the meantime that have hurt people.

The package of measures announced in 2011 had that headline figure, but only $583 million of that $2.2 billion is to be spent over the forward estimates in the four years. In the 2011-12 financial year, the total amount spent was only $47 million. The government cut mental health funding by ripping $580 million from GP mental health services and the allied health treatment sections from the Better Access initiative. Some 1,500 submissions to the inquiry were received. I have had phone calls and emails from many people in South Australia talking about the impact that this has had, both from families and from providers who recognise that mental health is often not something that can be cured just overnight. It requires ongoing and consistent support and a relationship to be built up between the person providing the service and support and the person who needs it.

A survey of 404 GPs that the AMA did found that the proportion of doctors bulk-billing patients for preparing mental health plans had dropped from 78 per cent prior to the cuts to only 38 per cent following the cuts. The Better Access program had provided care for more than one million people before the program was cut, and the AMA’s conclusion was that the 2011-12 budget cuts were clearly all about the budget bottom line and did not actually have improved outcomes for mental health patients as their priority.

In terms of administration, not only is there a problem there with the funding but the other criticism that the coalition has is of the way that the government is going about it. Senator Faulkner made the comment then that the Labor Party works closely with all the stakeholder groups. But I have to say that, in the Senate inquiry looking at the way it undertook changes to the Better Access program, one of the very clear messages that came through from the stakeholders was that there had been scant consultation. The government relied heavily on a Better Access evaluation which has been widely criticised for deficiencies in both its methodology and its data set.

The coalition is concerned about the consequences of a shift from Better Access to the ATAPS, and that they have not been fully considered. This is particularly worrying given the challenges that the ATAPS are facing, which are highlighted in the ANAO report. Fundamentally, there is the question as to whether the ATAPS structure is going to be sufficient to meet this demand.

I would like particularly to talk about some of the challenges that people in rural areas face. I have spoken in this place before, in June this year, about things like the Mental Health Nurse Incentive Program. People in South Australia—from Clare, for example—highlight the value that this program has provided in providing local access to mental health care that prevents people deteriorating to the point where they need to go to Adelaide to seek deeper care. And yet, despite the widely recognised success of this program around Australia, this is one of the programs that have been capped by the government as opposed to being built on.

Good leadership theory tells you that if you want to succeed you build on your strengths. This has been one of the areas that have been a strength as well as the Better Access program, and I would encourage the government to seriously look at removing that cap and boosting these programs that are helping rural communities.

The other area of implementation is making sure that the bureaucracy does not get in the way. During a recent visit to the Riverland, when I was speaking to a GP who delivered headspace programs, she talked about the frustration of being restricted to providing the service in one location where most of her clients were young people who had no ability to travel there from regional towns. She was happy to travel and provide the service but the system would not let her. This government needs to improve and deliver its promise on funding better mental health outcomes.