Mental Health Bill 2014

 

Ms Garrett (Brunswick)- It is a pleasure to rise to speak on the Mental Health Bill 2014, and again I echo the comments of previous speakers: the Leader of the Opposition in his lead speech on the bill, the member for Ballarat West and indeed the member for Hawthorn. This is an issue that touches everybody’s lives, and the more that we talk about it in the open and respond to the needs of those who are affected and the needs of their careers and families, the better we will be as a society.

As we have heard, some 10 000 Victorians a year receive involuntary treatment for mental illness. It is fair to say about some of the most vulnerable people in our community that what has led them to this situation — their illness — often means they are in dire circumstances in their personal lives, highly distressed, often frightened and quite often alone. They face a situation of involuntary treatment which in itself can be invasive, difficult and frightening.

This bill sets out a framework in which the presumption that patients have the capacity to make decisions and provide informed consent is a critical step forward in ensuring that these people, who are in very difficult circumstances, are given the full rights that any citizen would enjoy.

In that regard we support the changes in those presumptions: the right of patients to seek a second psychiatrist at any time and a set of mental health treatment principles. Of course, this bill began with a very comprehensive review set up by the former Labor government. I pay tribute to the former minister, Lisa Neville, who did an extraordinary amount of work in that regard. When we consider the vulnerable, often disadvantaged, often marginalised nature of those who are suffering from a mental illness, particularly a severe mental illness that sees them face involuntary treatment and often confinement against their will, we need to look at how the voice of that person or those people is going to be heard. Who is the advocate?

Who are the advocates for these people who clearly by the very nature of the circumstances in which they find themselves are perhaps not in a position to put their own case?

As we note, this bill establishes the Mental Health Tribunal. According to the government this establishment and the changes in this legislation could see some 8000 extra cases being managed by that Mental Health Tribunal, which is paramount for people who are seeking to have their rights fully heard and to have the presumption that they can make decisions about their own treatment.

Everyone has a journey, and everyone has a story about friends, family or others they know who have been in the system. My story relates to my mother-in-law, who worked in the mental health section of legal aid for some 20 years. She worked part time, apparently, but it was never a part-time job. While my two elder children were small she would often come over and help.

I witnessed firsthand, on her supposed days off, just how demanding and rigourous a job it is representing those with severe mental illness who are appearing before the board and are seeking to challenge involuntary treatment and confinement in mental health establishments. It is a very demanding and difficult job. It requires an enormous amount of expertise and energy to ensure that the instructions you are taking from people are able to be given, to ensure that their medical assessments and treatments are appropriate and to appear for them before the board. These people’s cases often come up again and again, depending on the individual circumstances and what may or may not befall them if they refuse treatment, are unable to receive their treatment or stop their treatment.

As the member for Ballarat West put so beautifully in her heartfelt speech, a bill and a framework is only as good as the resources behind it. People have spoken about many aspects of this bill, but it is absolutely critical that there be funding and appropriate support for the lawyers and advocates who will be representing these 8000 cases. These 8000 cases are all individuals facing difficult circumstances, and owing to the nature of their illness they are in need of people to advocate on their behalf.

It is of deep concern that this government has defunded the Mental Health Legal Centre. It is of deep concern that Victoria Legal Aid is facing a funding crisis. Often there is very strong family and financial support behind people who are suffering from severe mental illness, but sadly one of the side-effects of severe mental illness is a lack of ability to have full-time employment. People with mental illness often feel alienated from family and friends. They rely very much on governments, legal aid and mental health legal centres for the level of representation that is absolutely necessary if the presumption that they have the capacity to make their own decisions is going to be fully realised in the practicality of this legislation. We point that out very strongly.

The $37 million allocated by the previous government, fully costed and fully in the budget, seems to have disappeared under this government. That is to say nothing of the cuts to Victoria Legal Aid and the Mental Health Legal Centre. Without a robust, well-funded system of advocates and legal practitioners in this space, the rights of those who are suffering cannot be fully realised.

In a similar fashion we have raised concerns regarding the changes that this government has made to the previous framework regarding electroconvulsive treatment in relation to children under 12. These issues will be discussed at the consideration-in-detail stage. We look forward to those answers.

Finally, the points made by others, particularly our lead speaker, regarding the designated mental health services are important. We in opposition firmly believe this space is not for for-profit organisations or for-profit hospitals. These services are for some of the most vulnerable and disadvantaged people in our community, and we call on the government to absolutely rule out that for-profits could enter the space of treating people under this legislation.

In terms of resourcing I would like to echo the comments of the member for Ballarat West. From our work dealing with people we in this house know that people with a mental illness need integrated and localised support.

I would like to put on the record — and I am glad that the members for Broadmeadows and Pascoe Vale are here with me — my objection to the decision of this government last week to remove funding for Merri Community Health Services. This facility provides localised mental health services in Brunswick, Pascoe Vale and parts of Broadmeadows, and we know that the people who use these services often use more than one service. They are using dental health services, and they are getting assistance with housing in their area. It is very important that these services are localised. Merri Community Health Services has been providing these services for over 30 years and has just been told that it has not gotten through to the second stage of the round of funding. On the record again we note that without proper resourcing in this area there will only be a drop in the ocean to address how we are treating these people, who deserve a lot better.

In conclusion, we welcome the change in presumption and change in focus that this legislation brings to the rights of those who are often suffering severe mental illness. We have concerns about the resourcing around this issue. I have deep concerns that we will not have resourcing for proper advocacy so that people’s rights around community services and community health can be realised. Making sure that treatment of those with mental illness is local and integrated is of fundamental importance if we are going to ensure that people can lead full and productive lives, despite their condition.

Hansard, 12 March 2014