Emily Hamilton | Parliamentary Grievance| Community Based Mental Health

09 May 2024

Emily Hamilton | Parliamentary Grievance| Community Based Mental Health

MS E.L. HAMILTON (Joondalup) [9.38 am]: My grievance today is to the Minister for Mental Health and concerns the need for investment into community-based mental health services for young people in the northern suburbs. I am passionate about the mental health of our community and I am proud of the work this government has undertaken and is delivering for Western Australians who face mental health challenges. WA has seen record investment in health and mental health, with an unprecedented $10 billion in new funding over the last three years. In 2023–24, there was a record $2.7 billion of additional investment in health, including a $420 million boost to mental health services. Since 2017, our investment in the Mental Health Commission’s budget has grown by 57 per cent. We know that one in five Western Australians will be impacted by a mental health issue at some point in their lives. It affects people across all demographics and at all stages of life. We know that in a crisis, quick support makes all the difference. We need to keep investing in health services to ensure that people can receive the care they need close to home. For some people, this may not include presenting to an emergency department; rather, what we need to see is community-based mental health support, particularly for our young people.

Upon taking office in 2017, mental health was an area of concern for my Joondalup community. It was raised with me at doors, on the phone and at community meetings. At that time over seven years ago, I began advocating for additional mental health infrastructure and support in the region. This is a matter that I have raised with the minister on a number of occasions.

Joondalup, as Perth’s second CBD, is home to the Joondalup Health Campus, which is set to become WA’s largest hospital. We have seen continued investment at our hospital and we are currently midway through its $269.4 million upgrade and expansion. The hospital services one of the fastest growing regions in Australia.

At the beginning of 2018, as part of those upgrades, we saw the opening of the mental health observation area. It is a dedicated 10-bed ward. As an extension to the emergency department, the MHOA is a more appropriate setting for mental health patients. It is a quieter, safer environment, away from general accident and emergency patients who present 24 hours a day, seven days a week, which could be confronting for someone experiencing a mental health episode.

In November 2021, we saw the opening of the behavioural assessment urgent care clinic, which was designed and appropriately staffed to safely care for patients who are affected behaviourally, including those who are affected by drugs and alcohol, away from other patients who are within the main emergency department. Last August, we saw the opening of the new state-of-the-art mental health unit. It is one of WA’s most advanced mental health facilities and doubles the capacity previously available. The new 102-bed dedicated unit improves access to mental
health services for northern suburbs residents and includes a specialised area for young people aged 16 to 25, as well as older adults.

The unit was designed to be recovery-focused, with natural light, enclosed landscaped courtyards, terraces and activity areas. Over the years, I have advocated strongly to ensure that this new facility was able to support our young people. Mental health challenges for young people are all too prevalent, with numbers growing year on year. Primary school principals tell me about children as young as nine who are concerningly presenting as suicidal. I hear of families who are unable to receive the support that they and their children need locally and they have to travel to Perth Children’s Hospital for specialist care. I hear of individuals who have received inpatient hospital support and are discharged and readmitted numerous times in a short period. Their family explained to me that their family member has to continually present to the ED because they cannot access any other support outside of a hospital setting, but would do so if they could.

I commend the Minister for Health; Mental Health for the delivery of the mental health unit. It was much needed. I am thankful that we are now able to provide inpatient care for youth in Joondalup, the first time that this has been available. However, inpatient care should be a last resort. We need community-based mental health support for our young people. It is desirable to have a service that is targeted to young people, addresses the issue of repeat
hospital admissions and provides wraparound support.

In any health system we need hospital beds, for sure, but there needs to be a focus on ensuring that community services and support are in place to keep people well and out of our emergency departments and hospitals. For anyone who needs an acute hospital setting, we have invested and are delivering this care locally. We now need to see longer term reform and growth of non-acute support. I know my community and the broader region want to see that.

The Final report: Ministerial Taskforce into Public Mental Health Services for Infants, Children and Adolescents aged 0–18 years in WA, which I will refer to as the ICA, states —

Mental health is arguably the biggest challenge facing children, families, and carers in WA … More children are being referred to community services; more children are being admitted to hospital for mental ill-health conditions; and more children are presenting to emergency departments when facing a crisis, including many that self-harm or seek to take their own lives.

It goes on to state —

The vision of the future ICA mental health system is that all children, families and carers are empowered to achieve and maintain their best possible mental health and wellbeing. To achieve this, the purpose of the ICA mental health system is to ensure that all children, families and carers in WA have timely, enduring and equal access to holistic, integrated and high-quality public mental health care…

The report notes the need for access to timely, quality care that is tailored to their needs and available close to where they live.

I acknowledge, as the ICA did, that a generational change is needed. When a young person presents with mental health challenges, it is often too late. We need to ensure investment much earlier in a child’s life, providing early intervention and investment in prevention to ensure that we positively change outcomes for young people in coming generations.

The strategy has eight key actions with 32 associated recommendations to guide the implementation of the vision. I am pleased that the Cook Labor government has supported all the ICA recommendations. Is the minister able to provide an update on any work being done to address the mental health needs of our young people in the northern suburbs? Thank you

MS A. SANDERSON (Morley — Minister for Mental Health) [9.45 am]: I thank the member for Joondalupfor her grievance on this issue. I thank both lower and upper house members, particularly in the northern corridor, for their ongoing advocacy around mental health. We have seen the most significant increase in investment and reform in mental health services under the Labor government since 2017.

The member asked specifically about the infant, child and adolescent mental health services taskforce and I am happy to update the house on progress on the implementation of those recommendations. Around the world, services are dealing with a huge increase in children and young people experiencing mental illness. Referrals to specialist public mental health services for children in particular are up by 70 per cent since 2014—that is seven-zero per cent.

The ICA taskforce final report made 32 recommendations. The government accepted those recommendations and is in a phased implementation process. This is a 10-year reform process. The recommendations will fundamentally reshape the system. They focus not only on infrastructure and funding, but also different models of care to do things differently for children and young people and, importantly, their families. They focus on more intensive community-based services and treatments for kids in crisis, keeping children out of hospital environments; better support for families; a more inclusive approach between families and clinicians in treatment decisions; better coordination and information sharing between government agencies and services, such as health, child protection and justice; and increasing the number of peer workers and Aboriginal mental health workers. We know that young people and children do not always want or need to see a psychiatrist or a school psychologist. Sometimes peer workers can provide the kind of support and guidance that they require. The recommendations focus on improved access for regional children and their families and outline a comprehensive workforce development strategy.

Since 2022, the Cook Labor government has invested over $80 million to implement reform, with a further $47 million in this year’s budget. In the 2022–23 budget, it funded $47 million of measures to address immediate gaps, including developing new models of care to meet children and families where they are and developing new workforce pipelines to deliver professions we will need in the future. We are expanding the lived-experience workforce. Children and kids do not want to talk to clinicians who look like their parents, quite frankly. The government invested $35 million in the 2023–24 budget to continue that work. In this budget, we have already announced a significant investment in the acute care response teams. The centrepiece of our investment in the infant, child and adolescent implementation is the expansion of the acute care and response teams. They will be rolled out in the north and south metropolitan and great southern health catchments in the first tranche of the rollout.

We have seen the expansion of the east metropolitan rollout. That has already commenced. Essentially, they are specialised teams that provide mobile outreach and crisis support to children and teenagers experiencing mental health crises. This will work alongside CAMHS Crisis Connect, which has diverted many kids from emergency departments already. It will complement and augment that service. We know that crises do not happen in business hours. Community-based mental health services need to be available out of business hours. Units needs to be
mobile and they need to meet people where they are. The units will provide an invaluable connection between inpatient units, community services and emergency departments. That has formed part of our significant commitment in this budget.

We also see in this budget the mental health co-response. This is a reform of that co-response, which was primarily a healthcare and police-led response. This will become primarily a health-led response, and it is targeted at a range of people of all ages. When a patient or family member is concerned that they or their loved one are at high risk of self-harm or harming others due to a mental health crisis, they can call 000, they will be dispatched through to the WA virtual emergency department and they will be offered a health-led response. There will be an authorised
mental health clinician available on the phone, and the clinician can also be dispatched with a mental health emergency response–trained paramedic alongside them. The patient may be transported to an inpatient environment or referred to an early appointment with a community-based service.

This is all part of our very strong commitment to doing things differently in mental health. We know that emergency departments are not the right place for someone who is experiencing extended and repeated mental health crises. We know that those patients tend to spend longer in emergency departments and often come back repeatedly. We also know that there are better models of care, and that is what we are investing in in this state. It is about not just expanding the workforce—we are doing that—but also doing things differently with the workforce we have.

I want to touch on the Joondalup Health Campus redevelopment. There has been an incredible transformation of that health campus under this government. Since 2017, we have opened a 102-bed mental health unit. That is a doubling of capacity of inpatient mental health services in Joondalup for that northern corridor. As the member for Joondalup has rightly pointed out, for the first time, we will be able to support youth mental health inpatient beds. When we speak about youth in this context, we mean 16 to 25-year-olds. We are very committed to providing that
service and support close to home. We know that families need to be involved in the recovery of young people, and it is very hard for them to engage and be involved when they have to truck down the freeway to the Bentley service in the east or to Perth Children’s Hospital. We know there are always more things to do in this space, but we are absolutely committed to providing more supports closer to home in a more appropriate environment with better, modern models of care for our young people so that we have a strong and healthy generation who have a strong sense of connection and wellbeing in our community and can live really positive lives.