HON ALISON XAMON (North Metropolitan) [9.54 pm]: I am continuing to go through the annual reports and I want to draw members’ attention to the Mental Health Advocacy Service annual report, which was tabled last week. As members should know, the service performs an incredibly important role in oversight of and individual advocacy for people who are under involuntary treatment orders, as well as psychiatric hospital residents, people who have been referred for psychiatric assessment, people who are subject to custody orders and some voluntary patients. The service is, of course, a statutory body. The report identifies continued serious gaps and shortages across our mental health system and paints a very dire picture of the state of our mental health system at the moment.
The single biggest issue identified was access to appropriate care. It was identified as being a problem particularly for children and young people, for people in prison, for people who have eating disorders, for people who self-harm or experience suicidal ideation and for those who have severe mental health issues or intellectual impairment and challenging behaviours.
This report details unacceptable wait times, including many people who are left waiting for several days in emergency departments. The service reported one case of a person who waited six days for a bed. As members should know if they do not already, emergency departments are terrible environments for people who are seriously mentally unwell. They are one of the worst places for them to be. About a quarter of hospital beds are taken by people who could be discharged if only there was somewhere for them to go, which means that over 160 people could be discharged if there were appropriate community care facilities for them, but there continues to not be.
The section of the annual report about children and young people is titled “Children and young people—tragic gaps” and it reveals that the number of children under involuntary orders has increased by over 32 per cent this year, and children presenting at our EDs after self-harming increased 319 per cent in the last nine years. The report also documents ongoing gaps, particularly for 16 and 17-year-olds. Support services in the community are failing children and their families, not because of poor quality, but because they just are not there. We are talking about long delays of over six weeks in referrals to public community mental health services. We know that the headspace programs are great services, but they do not deal with more serious mental health issues, which means that EDs are often the only place left, and, as the report notes, sometimes, tragically, children are dying.
Children in regional areas are particularly vulnerable and the report found that they can wait in regional EDs and hospitals for days. There are continued, significant discharge delays, which are experienced by young people who have complex matters, particularly conditions such as autism and foetal alcohol spectrum disorder; people who struggle to get on to the National Disability Insurance Scheme—I have spoken in the past about the problems with that—and others who are left to languish on acute wards as battles are fought with mental health and child protection and disability. It is just not working.
The report contains the following quote —
The mental health service says the child needs to be discharged somewhere safe with high levels of care and staying on an acute ward is not conducive to recovery. Child protection services say that they can’t provide the level of care/supervision required and it is the responsibility of mental health services. In some cases, there are family members available to help but they need support, and that support has been denied to them by child protection services because they are a family member.
We are talking about vulnerable Western Australian children. The situation is terrible. It is completely unacceptable. The report also details that First Nations people are being detained under mental health orders at more than twice the rate of other Western Australians. Although the Mental Health Act 2014 clearly articulates their right to cultural support and collaboration during their assessment, examination and treatment, along with the recognition of family culture and community and any healing process, these rights are not being observed. This is prescribed within the act. This is something that people are entitled to by law. The report also notes that the Mental Health Act is regularly breached, with families and carers not notified when their loved one has been made an involuntary patient. It is horrifying to see that in black and white in this report. It is unsurprising to me because I hear their stories over and again.
The Mental Health Advocacy Service also raises the ongoing forensic mental health crisis. I will have plenty to say about that at a future date. Although the report details a worsening situation across the mental health services, none of the problems or the gaps are new. As the Chief Mental Health Advocate, Debora Colvin, acknowledges in the report’s foreword, the facts are well known and proven; what is missing is the funding to make changes. Deb Colvin is stepping down at the end of the year. I want to take the opportunity to acknowledge the incredibly valuable role that she has played as the Chief Mental Health Advocate for the past five years and prior to that as the head of the Council of Official Visitors since 2008. She has been an excellent advocate for some of our most vulnerable and has undertaken a very challenging role with strength, determination and compassion. I am proud to have been able to work with her since 2009 but specifically for the four years that I worked in the mental health sector. She is a marvellous woman.
More broadly, the Mental Health Advocacy Service is really important. It has experienced a dramatic increase in people wanting and needing support, including a fourfold increase in the number of voluntary children or their families and guardians seeking help. I note that it is continuing to not receive the level of funding that it requires. It is impossible to think that the service will continue under such severe budgetary constraints. Again, I say that this is a statutory body prescribed within the act that has a very clear role and that needs to be funded accordingly. I urge members to read the annual report so they can get a more balanced view than what is coming out from the regular press releases of this government about the state of WA’s mental health services. Our Chief Mental Health Advocate is not a political operator. She has no reason to put a spin on anything. She is describing a situation that continues to be desperately underfunded and that is in crisis, where people, including children, are losing their lives.