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Rural mental health survey gives damning report on the Abbott government

Speeches in Parliament
Penny Wright 1 Dec 2014

Senator WRIGHT (South Australia) (22:10):  Those who have followed my contributions in this chamber and in the community would know I have an abiding interest in rural mental health. I have travelled widely across Australia, talking to people about the challenges of getting mental health support in the bush and what mental health services should-or could-look like for people who live outside city limits. We know that people in the country have unique pressures on their mental health and often do not have a psychologist or mental health nurse around the corner who can provide support. Even getting to a GP for primary care-or a referral-can mean a three-hour car trip and a great deal of stress. Too often people in the country are forgotten and fall victim to a crisis centred system where they cannot get access to mental health services until they are experiencing a crisis and then face being transferred away from their community for treatment.

One of my goals for my time in parliament is to keep a focus on mental health, and particularly rural mental health simply because, for those who live in country Australia, it can be a matter of life and death. Country Australians are losing people fathers, sisters, friends and children to suicide, and it shatters entire communities. During Mental Health Week in October, I conducted a survey to follow up on my rural mental health consultation. Technically my consultation concluded in 2013, but in many ways it has never really ended. The survey results were damning and dispiriting: of those who responded only six per cent of people working in the mental health sector felt their region had sufficient mental health services for the needs of their community and only seven per cent of people thought that those in their community were able to access care before reaching a crisis stage.

Poor access to sub-acute services-that is, services before a crisis hit-and the need for better community based care were two issues identified as key areas for improvement in the survey. This is consistent with the findings of my rural mental health consultation, where I was told that people wanted a 'mental health safety net-not an ambulance'. An overwhelming number of people said it was difficult to attract staff to work in rural areas. Again, this is one of the key issues which mental health workers in rural and remote areas have raised with me. They talk in terms of culturally appropriate care and the need to 'grow your own' workers so that workers understand the unique aspects of rural communities and will stay.

We need a rural mental health workforce plan to address the alarming shortage of rural mental health workers who are willing to go to country areas. A lack of training and support for mental health workers in rural areas was also identified by survey respondents as a significant issue in need of attention. Sixty-seven per cent of rural mental health workers said that rural mental health did not receive a lot of media attention. We saw during Mental Health Week, thanks to the ABC, what a difference it makes when the national conversation turns to mental health and we get to hear powerful stories of mental health challenges and recovery. It reinforces the reality that we all experience mental health peaks and troughs in our lifetime-and that is okay. The survey results provided a damning report card for the Abbott government when it comes to mental health. When asked to rank the Abbott government's performance on rural mental health to date, almost half gave the government the lowest possible score and 80 per cent gave an unfavourable ranking. Eighty-nine per cent of mental health workers who responded said there should be a dedicated federal mental health minister. When it came to respondents who have lived experience of mental ill-health, they rated stigma as one of the most significant issues faced by people in country areas.

People have said that the distress of the stigma they have experienced as a result of their mental ill health often stays with them long after they have recovered from the mental ill-health condition. Stigma is something that we, as a country, must address seriously. We are one of only two OECD countries without a national anti-stigma program. I will continue to put pressure on the government to take stigma seriously. I am not just talking about a glossy, temporary advertising campaign but a consistent, evidence-based education campaign that starts with young people and is informed by the experience of those who live with mental ill-health. Stigma is often acutely felt by young people in the country, many of whom turn to the Kids Helpline or online services-like the wonderful website-for support in the privacy of their own homes.

Just last week the National Children's Commissioner handed down her Children's rights report 2014, which focuses on self-harm and suicide among young people. This is yet another distressing report which details the extent of mental distress experienced by people as young as nine or 10 years old and, tragically, sometimes even younger. In her report, the commissioner identifies children and young people in rural areas as being disproportionately affected by intentional self-harm and suicide. Ratios for death due to intentional self-harm among young men are particularly high, with some estimates finding that it occurs at almost twice the rate as in metropolitan areas.

The National Children's Commissioner cites Suicide Prevention Australia, who suggest that factors like underemployment; lack of infrastructure, including health and education services; restricted social and career opportunities; drought; and cultural stoicism may contribute to the distress of young people in rural Australia. Children and young people with mental ill health also often experience a lack of services and access to information in rural Australia.

The data in the Children's rights report 2014 makes for bleak and confronting reading. It is clear we have a serious, serious problem in Australia. It shows that each week one child dies by suicide in Australia and between 50 and 60 are hospitalised for attempting to suicide. The data also shows that children from an Aboriginal or Torres Strait Islander background aged four to nine are twice as likely to suicide as others the same age-yes, I said four to nine. It shows that the suicide rate among Aboriginal teenagers is five times higher than for other teens. It also highlights other particularly vulnerable groups: rural youth, as I mentioned; children and young people who have a disability; those who are in out-of-home care; those from a CALD, a culturally and linguistically diverse background; and those who are sexuality or gender diverse.

What the data does not show is what it is that is leading our young people to harm or kill themselves in increasing numbers or why a generation of young people is apparently losing hope. This is the conversation we must have, the research we must do and the exploration we must pursue. The National Children's Commissioner has made some very practical and detailed recommendations to the government which indicate how this alarming loss of life and of hope can be addressed. These include a national research agenda and better, more consistent standardised data, reporting and surveillance from across the states and territories. I look forward to seeing the government's response to this comprehensive report so that we can work together in this parliament towards solutions to get our precious young people the support they need before it is too late.

I am concerned that since 2010, when mental health was a word on everybody's lips, mental health has gone off the federal government's radar. It is clear to me that we need a dedicated federal mental health minister to halt the decline, to show the Australian community that the federal government takes mental health seriously, to have national leadership and to ensure that mental health gets attention and funding commensurate with its impact and the burden of disease and lost productivity it brings with it. It affects all of us.

In the course of my rural mental health survey, it emerged that only eight per cent of mental health workers felt that mental health was a priority for their local parliamentarian. At a time when more teenagers are dying by suicide than in car accidents and given that nearly half of us will experience mental ill health at some point in our lifetime, mental health should be a priority for every parliamentarian across Australia. This is about the heart of our nation's wellbeing. I urge my colleagues here and in the other place to make it a priority.



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