HON ALISON XAMON (North Metropolitan) [5.45 pm]: I rise to draw the house’s attention to a really important piece of research that was released only last week titled “Beyond the Emergency”, which is a world-first study that has investigated the scale and the nature of ambulance call-outs to men who are presenting with acute mental health issues, self-harm and suicidal behaviour. It is an incredibly sobering but very important piece of work. It gives us an insight into the scale and nature of the mental health crisis across Australia. Although the research itself does not include Western Australian data, there is no reason to suggest that the situation that has been described is any different here, particularly when we know that WA has the third-highest suicide rate in the country.
The research was funded by Movember and Beyond Blue. It sought to quantify the magnitude and outline the characteristics of acute male mental health presentations to ambulance services, to examine the paramedics’ and the men’s experiences, and to identify opportunities to improve mental health support for men. Alarmingly, the research found that suicidal behaviour in men could be as much as three times higher than was previously understood. Over the study period, there were over 30 000 ambulance attendances for male self-harm behaviours and 9 999 hospitalisations for male intentional self-harm. A staggering 42 per cent of attendances were men who were re-presenting to ambulance services, with 7.4 per cent re-presenting 10 times or more. Of the 112 000 call-outs made during the study period, 78 per cent resulted in the person being taken to hospital, 60 per cent of call-outs involved alcohol or other drugs, and 30 per cent also involved the police. The interviews with paramedics found that despite this very large number of call-outs, fewer than 14 per cent of paramedics who took part in the study reported having had comprehensive training for mental health responses. More than two-thirds of these paramedics felt underprepared to use communication skills as a response to the presenting person’s need. Many believed that their primary role in supporting a person experiencing mental health issues was to simply transport them to hospital, and they did not feel adequately resourced to do anything more than this.
Critically, this research also included the experiences of the men who had been attended to. The men who accessed ambulance services for mental health issues felt they required much more support than simply being transported to hospital. They spoke about how much the ambulance officers’ approach to them both at the initial point of contact and again at the hospital handover affected their experiences and, critically, their ongoing recovery.
Given these findings, the report authors have made recommendations around three key themes, which I think we need to take heed of here in Western Australia. We need to enhance paramedic capacity to respond effectively. Paramedics need to be supported to feel confident in communicating with people who are experiencing mental health issues. They also need to be supported to provide mental health resources that help to connect men with appropriate and timely treatment, and they should explore the feasibility of alternative models of service delivery. I would add that although it was not covered in the report as such, we know that first responders themselves are at high risk of suicide because of the extremely stressful nature of their work. We need to acknowledge this and be doing much more to support the people who are doing the hard yards on the frontline. We cannot just continue to add more and more responsibilities, of course, without acknowledging the personal impacts on them as well.
The report also recommended that ambulance data should be used on an ongoing basis for the monitoring and surveying of community mental health needs. The study has shown that looking at ambulance call-outs helps to enhance our understanding of the prevalence of mental distress in the community.
The third big recommendation was that the findings add further weight to our calls to rebalance the mental health system. With most mental health–related attendances occurring outside business hours, there is a clear need to offer more treatment options at such times that do not rely solely on emergency services—something that those of us who have had contact with people in the regions know all too well. Also, we need to have alternate models of care and more appropriate community support that helps to avoid unnecessary transport to hospital.
The “Beyond the Emergency” report adds very valuable quantitative data about the full extent of men presenting with acute mental health issues, self-harm or suicidal behaviour. There is further evidence that Australia-wide the system is failing. Often these men are calling the ambulance over and over again, with 7.4 per cent calling ambulances 10 or more times. We are not linking them with community services to resolve whatever underlying issues are creating their distress. More than numbers, the report also adds qualitative data about the experience of both paramedics and the men themselves. This information is very important, and hopefully it serves to inform and enhance our system responses.