CHIEF PSYCHIATRIST — ANNUAL REPORT

HON ALISON XAMON (North Metropolitan) [2.30 pm]: This is, of course, annual report season. A lot of annual reports have already been tabled, and some of those will undoubtedly be subject to further scrutiny through the estimates process. I am aware that we do not often get to speak about a number of reports that are tabled.

I want to draw members’ attention to a number of issues that are covered in the annual report of the Chief Psychiatrist of Western Australia. As expected from the Chief Psychiatrist—whom I hold in the highest regard—the report is fearless, but thoughtful, in its considerations and what he is attempting to bring to the attention of the public. There is a lot in this report. It goes up to 30 June this year. At that point, it was anticipated that the Criminal Law (Mentally Impaired Accused) Amendment Bill would have been introduced in this Parliament. As we know, that has not happened. The report makes some important commentary about the lack of forensic beds, and about the intersection between intellectual disability and mental health. The report also makes some quite damning comments about the poor monitoring of the practice of prone restraint, the lack of sexual safety for people in mental health facilities, and the use of seclusion.

I particularly want to make some comments about access to the National Disability Insurance Scheme. I understand, of course, that the NDIS is a federal body. However, it has a huge impact on the delivery of services at the state level. When the NDIS fails, it has to be picked up through the state system, and that is highly problematic. The report refers to residents with the most complex mental health needs. The report takes a dashboard approach to looking at people who live in private psychiatric hostels. The most prevalent diagnosis for these people is schizophrenia, as well as other serious psychosocial disabilities. It is deeply concerning to discover from the report that of the residents of private psychiatric hostels who have the most complex mental health needs, 16 per cent have had their application for NDIS services declined and 27 per cent are not actively involved with a community mental health service. Those figures are not only very concerning, but also very damning. I point out again that we are talking about critically and chronically mentally unwell people who are desperately in need of support but are being failed by the NDIS. The report does not refer specifically to where these failings lie. However, it has been suggested to me that part of the problem is that residents who need support in order to apply for the NDIS are dependent upon people to assist them with that process. Sometimes service providers are good at being able to assist and sometimes they are not so good. The support from advocates can be all over the place. I am very concerned about that. People’s access to the NDIS should not be contingent upon their capacity to make an application.

I am trying to support a vulnerable minor through the National Disability Insurance Scheme process, and, in this instance, I am talking about a minor who has a diagnosis that is 100 per cent confirmed; the pathway of the inevitably of disability is known, and the minor already has significant functional capacity. I can tell members that as someone who is white, educated, a lawyer, in this place, understands the NDIS and was engaged in trying to help to pull together the NDIS processes when I was outside of Parliament, even I am struggling to navigate through those processes. At this point, I will inevitably have to go through the Administrative Appeals Tribunal process. Thank goodness my husband and I are both lawyers, so we are in a position to be able to do that, but other people cannot. But if I am having that much difficulty, what must it be like for people who are living in private psychiatric hostels and who have severe psychosocial disability?

The report points out that the failure to appropriately hook these people into services means that the state is picking up the cost, because a disproportionate number of them are ending up in our emergency departments. This would not be particularly shocking to a lot of members in this place as we are very familiar with the stories about what is happening in our emergency departments, but it goes to the absolute failure of the NDIS to address this issue and the fact that these people are being left incredibly vulnerable. I am eternally frustrated that the NDIS is not working in the way that so many people fought for it to work. I am absolutely appalled at the way that people are falling through the cracks.

This report is very important in highlighting the many systemic ways in which people with severe and chronic psychosocial disability are, effectively, not having their needs met within the system. This is one area in which the problem should be capable of being rectified but has not been.

There are many more elements of this issue that I want to talk about and I will talk about at a future time, because I think that this cohort of people is very often left to fall between the cracks. I can tell members now that there are no votes in this. In fact, when I have spoken about this cohort of people in the past, I have received more criticism than I have bouquets. But I think it is really important that we remember that we need to be able to support those most vulnerable people within our community, because if we are not speaking out for them, nobody else will. At the moment, as outlined by this report and the other reports that I know will back this up, these people are being failed.

 

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