Motion - Improving Regional Mental Health Services

Wednesday March 03, 2021

Mr BELL (Mount Gambier) (11:30): I move:

That this house—

(a) recognises the significant effects of the COVID-19 pandemic on the mental health and wellbeing of South Australians;

(b) ensures regional South Australians, with the unique challenges of living in rural and remote areas, are a strong focus of future planning and funding commitments; and

(c) funds and implements a five-year strategic plan to improve regional services and attract mental health professionals to the regions.

Since I began in this place some seven years ago, mental health has been a major focus of my work. In fact, in my maiden speech I talked about the inadequacies of South Australia's regional mental health services. Our state and our regions are facing some of their biggest challenges, and ensuring the mental health and wellbeing of people in the regions is paramount as we recover from the pandemic.

For many people the pandemic has been a perfect storm, with people facing uncertainty, job losses, border closures, an increase in alcohol usage, relationship breakdowns, financial concerns, etc. Last year made us very aware of our mental health, and perhaps for the first time the stigma of asking for and accessing help and support is beginning to lift. I would like to see a time when our mental health is given the same importance as our physical health and visiting your counsellor for a check-up is just as common as visiting your GP. But that coincides with a huge demand for services—services that cannot keep up and that just are not there for regional people.

It takes a fair amount of courage to acknowledge that you need help and to pick up the phone to make an appointment with your GP to get a mental health plan or to call a counsellor. I spoke to a counselling service in the Limestone Coast that reported a large increase of first-time clients accessing their services for the first time in their lives. However, people are having to wait months and months to get their first appointment. In the Limestone Coast, the waitlist to access services, including counselling and psychologists, is anywhere up to 12 months. I spoke to a child psychologist who said that their waitlist was 12 months.

If you cannot access services and support early, problems build and build until they reach an acute stage. This is having a major impact on our hospital system, which is seeing more and more people presenting for crisis care and putting existing services under demand. The Mount Gambier hospital has six dedicated mental health beds, which are frequently full, and medical beds that are used for mental health crises. If some of these people were able to access care and support early, they would not need to be in a crisis situation and accessing acute care.

In my electorate, we are very fortunate to have some passionate and dedicated people working in this space and putting forward solutions to bridge the gaps. Last year, Leah Griffin and Samantha Benton from Lifeline South East conducted a study to determine the need for a central mental health hub in the Limestone Coast. The idea of the hub was to provide a free service for anyone experiencing mental health challenges. It would be a first point of call to access face-to-face support, information and assistance in navigating local, state and national mental health services. With 1,045 participants, the local survey produced the following insights:

even though 86 per cent of respondents reported either knowing someone who had or had themselves used local mental health services, only 53 per cent said they felt confident they could locate appropriate mental health services in our region;

nearly half of respondents showed a significant preference for accessing mental health service information through face-to-face contact, with online at 29 per cent and over the phone at 15 per cent the least preferred methods; and

over 95 per cent of people surveyed agreed with the two following statements: we need more local mental health services, and more collaboration is needed between local mental health services.

In the comments, most spoke of their support for a central hub to coordinate existing services and provide a safe space for people to get face-to-face and immediate support. They shared personal stories, some of which are very concerning. People spoke of ending up in hospital emergency departments after waiting months for appointments and of being shuffled from one service to another. They spoke of spending considerable money travelling to Victoria to see any available psychologist about being cut off from services after their plan had ended. I will read a few of the comments to you now:

My local GP had no appointments available until next year for me to get myself a mental health plan and without financial support, I can't afford my psychologist visits. It's incredibly disheartening to call up and request an appointment specifically for a mental health plan and be turned away. More communication between GPs and mental health services needs to be established and different pathways to access these services need to be promoted.

Another said:

If you are dealing with a person with serious mental health issues, they need help the day they finally have the courage to speak up and say they need help. Not months down the track. If they are feeling suicidal, chances are they won't be here to need that appointment by the time they can get in.


I'm a psychology student so I'm fortunate to know the processes, services and steps required if I wished to access mental health services but unfortunately, I don't think many people are aware of these. A mental health hub would be so incredibly valuable in Mount Gambier and would have the potential to improve so many people's lives.

Following the results of this study, I received a statement from Lifeline Australia, which reads:

Based on the community engagement, and on Lifeline's long experience of supporting South Australians within this region we recommend a Central Hub focused on needs assessment and information and referral be situated in Mount Gambier.

A central hub would provide the following benefits to the Limestone Coast community:

support, information and advice being delivered for local community members by well-trained and supported local community members employed within the central hub—'by locals, for locals' is the hashtag;

recognising the very strong preference expressed by the community, the hub would offer face-to-face service to community members;

a single point of entry for local residents seeking information regarding mental health and counselling support services;

facilitating interservice collaboration and further developing help-seeker pathways to better match services to need;

maintaining up-to-date information regarding the mental health and counselling ecosystem within the Limestone Coast region;

needs assessment and initial triage and, where required, needs-matched referral to the right level of care in the right time frame; and

provision of non-clinical care and practical support to help-seekers and their families.

There will be unprecedented demand for mental health services in the years to come. Before the pandemic, the South Australian Mental Health Services Plan 2020-2025 recognised a potential workforce crisis looming and major shortages in country South Australia. To quote from the plan:

Workforce shortages, particularly in some geographic areas, are already a problem and this is expected to get worse.

The significant risk this poses to achieving improved mental health outcomes in the future cannot be overstated. Effort and resources need to be directed towards workforce planning to mitigate this risk.

In parts of our system, we are unable to fill vacancies and there are major shortages in country South Australia. There are not enough graduates coming through the training system and no strategic oversight of how many graduates we need in what disciplines to meet population needs.

Last year, I spoke to the house on regional mental health being a focus of the 2021 state budget. Obviously the state's response and recovery to COVID-19 has been the focus, and rightly so; however, now is the time to focus on long-term planning and a region-by-region approach. The needs of the Limestone Coast are different from those of metropolitan Adelaide. It is no use announcing funding for mental health services when we cannot staff the existing services we have.

There need to be retention and recruitment strategies for mental health workers in regional centres. Right now, in regional cities like Mount Gambier it is an ongoing challenge to find experienced staff, such as mental health nurses. Not only does there need to be retention and relocation support to fill these positions but there also need to be career progression opportunities. We cannot expect to keep highly skilled people if there are not the jobs for them to progress to.

On the Limestone Coast, we are lucky to have groups like Lifeboat, The Junction, the Mount Gambier and Districts Suicide Prevention Network, and the Mount Gambier and Districts Health Advisory Council. But many of these services, particularly Lifeboat and The Junction, are volunteer run and receive no state government support. These are headed by dedicated and passionate people, such as Matthew Brookes, Maureen Klintberg and Nel Jans.

We are also lucky to have huge community support behind events such as the Full Monty, which raised more than $50,000 for local mental health organisations; however, this should not be the main funding source for this early intervention. To continue their important work, they need a long-term funding commitment by the state government. I have spoken to the health minister many times on this issue, and I take this opportunity to invite the health minister to the Limestone Coast to look at the hub model.

In today's Advertiser, the Victorian government is fast-tracking mental health treatment centres due to a landmark report that highlighted that the state's mental health provision is a fractured system. Quite coincidentally, the new system will focus on providing a front door for people to access care and initiatives that are there, so it is very similar to exactly what this study was aiming to achieve and what I am talking about today. I will quote a few little parts from this because I think it is informative for our South Australian system. It states:

Victoria's mental health system will be torn up and transformed after a two-year Royal Commission found the state had been failed by an 'antiquated' system that was driven by crisis.

A new Mental Health Commission will be established, services will be moved and expanded into local communities…sweeping changes to the state's patchwork of struggling services.

In a damning 3,000 page report tabled to parliament on Tuesday morning, the Royal Commission found the current system was overwhelmed and that more than 95,000 people missed out on needed services during the 2019-20 financial year.

The report found this was vital to ensure people with poor mental health were picked up early, did not slip through the cracks of the system and received the right treatment.

Again, that is exactly what I am aiming to highlight here today in this parliament. The report also found that under-resourcing has led to an over-reliance on medication. That is certainly very similar to the experience I am seeing in people coming into my electorate office talking about their loved ones or their experiences. It continues:

We know a collection of discrete reforms to an antiquated system is not enough. We have recommended a fundamental redesign.

I encourage people to read the stories in today's Advertiser of people who have fallen through the cracks and, unfortunately, in many instances highlighted here and similarly in our regions, that falling through the cracks can result in people taking their own lives.

I want to highlight the work that has gone on in Victoria, the work that Lifeline in the South-East has done with this one-stop shop, this face-to-face referral where people can come in, understand the services that are already offered and they are matched with those services. But, of course, it highlights a greater need in the mental health space, and that is that without serious focus from the state government on this issue we are going to continue to see people falling through the cracks.

I see it as a workforce development issue in terms of working with the universities to train more and more people in this area, attraction packages to regional areas to attract those skills to our region, a retention package and career progression so that we retain those skills in our regional areas long term, and, of course, early intervention.

We need to make sure we fund early intervention adequately so that, where possible, we reduce the number of people who are progressing through to an acute stage that ends up with hospitalisation and, of course, reduce the most tragic of circumstances, where people who have fallen through the cracks take their own life. With those words, I commend the motion to the house.