Tuesday, 2 August 2022

Bills

Mental Health and Wellbeing Bill 2022

Second reading

Debate resumed.

Ms WILLIAMS (Dandenong—Minister for Mental Health, Minister for Treaty and First Peoples) (18:01): It is my pleasure to rise in support of the Mental Health and Wellbeing Bill 2022 and indeed to now be in the role of the Minister for Mental Health, in which I now have carriage of this bill through the Parliament after a significant amount of work from my predecessor in getting it to this point. I will have, hopefully, more to say about that later on in my contribution.

I just want to recap on the journey so far, and that really takes us back to 2018 when we committed as a government to have the Royal Commission into Victoria’s Mental Health System. We saw some 18 months ago that final report being handed down with great ceremony, and rightly so, and what it represented and the vision that it articulated for a compassionate, caring and expert mental health and wellbeing system, one where people could get the treatment and support they need and deserve close to home. From the outset the government very proudly—and still to this day it is very proud of this—committed to delivering on every single one of the royal commission’s recommendations, knowing that transformation was what was required. In keeping that promise to the Victorian community we have taken on some very, very significant challenges, which has been well acknowledged, I think, in this debate so far. Chief among those challenges was the delivery of a brand new mental health and wellbeing bill within a very short 15 months of the final report being delivered.

This bill lays a new statutory foundation on which we will build Victoria’s mental health and wellbeing system from the ground up. Sometimes we may as politicians be accused of saying things like that lightly, but I think this really does represent transformational reform—a very different way of doing things and a way that is more inclusive of voices that may have previously been largely excluded from important discussions about care ultimately.

This bill delivers in full on recommendation 42 of the royal commission’s final report, which called on us to, just quoting that recommendation:

repeal the Mental Health Act 2014 … and enact a new Mental Health and Wellbeing Act, preferably by the end of 2021 and no later than mid-2022 …

It was to do a number of things, including:

promote good mental health and wellbeing;

reset the legislative foundations underpinning the mental health and wellbeing system; and

support the delivery of services that are responsive to the needs and preferences of Victorians.

Look, it has been—and I would be the first to say it, and I am sure my predecessor would in fact join me in this—a very significant challenge to do all of that in little over a year, but what has been drafted in this time I think surely reflects the ambitions set for us by the royal commission in their final report and does a great job in breathing life into the vision that was given to us in that report.

This bill creates several new governance and accountability entities, it modernises our approach to crisis care and it establishes an opt-out, non-legal advocacy system for the very first time. It puts people with lived and living experience of mental illness and their families, carers and supporters at the centre of this rebuilt mental health and wellbeing system, and I think we cannot underestimate the significance of that. The bill better reflects also the diversity of services that will be needed in our future system. It better defines community expectations of the quality and safety of our services, and it recognises the absolutely critical role of clinical and community mental health workforces who make all of this possible, and I will have a little bit more to say about those workforces later on as well.

Of course, with another hat on as the Minister for Treaty and First Peoples, I am also very proud that the Mental Health and Wellbeing Bill incorporates a statement of recognition and an acknowledgement of the treaty process, which is hugely important, because we know that with that process, with treaty, we are ultimately talking about putting control of Aboriginal affairs back into the hands of Aboriginal people, where we can drive better outcomes. This system is no exception in that broader piece of work, so making sure that we put that placeholder in, that we allow that space for that work to take place, is critical to that other path that is being pursued with my other hat on. Indeed the opportunity to bring together mental health and the portfolio of treaty and First Peoples is enormous. It is certainly not lost on me. The impact of intergenerational trauma on our very proud First Nations communities cannot be understated, and I think we should all be able to recognise in this place that we can do better. It seems fitting to acknowledge that today after we lost the wonderful Uncle Archie Roach over the weekend, a man who had dedicated much of his life to telling the story of that trauma but also to painting a vision of hope and of a future where we could rectify that and truly walk together, as the First Peoples’ Assembly of Victoria co-chair Marcus Stewart said in this very place not all that long ago. So the royal commission’s focus on Aboriginal social and emotional wellbeing as a necessary part of building a culturally safe service system was very welcome, and the fact that the new Mental Health and Wellbeing Bill becomes one of the first pieces of legislation to carry this statement of recognition forward is very fitting.

Now, while this bill is a significant achievement, we know that legislation alone cannot fix the broken system that was laid bare by very frank and brave testimony from thousands of Victorians whose lives have been shaped by this system and who very bravely gave of themselves in the royal commission process so that we might build a system that better meets their needs and those of many others like them in the future.

In the second-reading speech my predecessor and colleague the member for Monbulk highlighted three core foundations necessary to see the royal commission’s vision succeed: a strong and diverse workforce, a modern legislative framework, and sustainable ongoing funding to match the scale of the challenge at hand. Whilst we are only at the start of that 10-year journey, just over a year into it in fact, what I can say is that this government is delivering on all three of those fronts. Over $600 million has been invested into priority workforce initiatives since the interim report was released in November 2019, and with the most recent budget investment we are on track to deliver 2500 more mental health workers into the system. I know our workforces are strained, they are fatigued, they are weary due to the pandemic, and I do want to take this opportunity to thank every single mental health nurse, psychologist, social worker, psychiatrist and peer worker, among others, for their dedication and for their commitment to the challenge of this reform, because as much as we do in this place, they will be doing more to make this work on the ground for the benefit of all Victorians. It takes a lot of strength to push on. It takes a lot of strength to work in a flawed system while also holding out hope for the future that we are all building together and to have confidence that what we are working towards is worth it—is worth the challenge, is worth the hard work, is worth the sweat and tears.

We have also legislated the mental health levy to provide an ongoing dedicated funding stream for mental health services, ensuring that the days of mental health funding being the health system’s poor cousin are at an end. And that does need to come to an end, and I know that is a sentiment that has been articulated by many in this debate. In the last two budgets alone we have invested over $5 billion into this reform and the creation of the system that Victorians truly deserve. None of this would be possible without that levy and the leadership also that it took to establish a sustainable funding source for years to come—and ‘sustainability’ is the key word when we talk about that funding model.

Since the introduction of the bill before the winter break I note that there has been some commentary around certain ambitious aspects of this bill, and I want to address that. I know we have seen some public reflections on the inclusion of an up-front goal to reduce and ultimately eliminate seclusion and restraint within mental health services over the next decade. This was a direct recommendation of the royal commission, reflecting that for many people the use of those practices, those interventions, has had really lasting traumatic impact with little to no therapeutic benefit. This 10-year goal is undoubtedly ambitious and must be approached with much patience, it must be said, and nuance as well.

However, the rates of seclusion and restraint we currently see are themselves, I think it is worth noting, the symptoms of a broken mental health system that we are dealing with. As we build a new and hopefully much stronger mental health system, the need for these interventions should decrease. With every modern facility that we build, with every local service that we open, the hope grows as we are moving towards a system where these restrictive practices are ultimately not needed.

However—I want to say this, and I know I have not got much time left—we cannot hope to eliminate these practices if our clinicians and professionals are not safe. These two things come hand in hand. I want to be really clear on this: the safety, security and support of mental health staff is absolutely critical and will never be a second-order priority in these reforms. This is the government of worker rights and workplace safety. We have a very strong track record in this area. Whether it be nurse-to-patient ratios or industrial manslaughter or wage theft laws, we firmly believe that there can be no meaningful system change without supporting, resourcing and empowering our workforce, and we commit to doing that and working in partnership with both consumers and clinicians as a part of this work. In closing I just want to commend my predecessor for all of his work in bringing the bill to this place and commend the bill to the house.

Dr READ (Brunswick) (18:11): The Victorian mental health system has been undergoing some major changes in the last few years. It has had to, because it was failing badly to meet the needs of Victorians struggling with mental illness. The much-awaited Mental Health and Wellbeing Bill 2022 is the next step in that journey. It includes a lot of promising words. At this point I just want to acknowledge the comments of the new minister; I am very pleased to hear a commitment to a solid investment in providing a well-trained mental health workforce.

In an attempt to move away from a system which focused largely on medication and compulsory treatment, the bill talks about people’s experiences and their rights. It includes a principle on the rights and dignity of people with mental illness. It talks about people’s right to make informed decisions about their own treatment. It acknowledges First Nations people and their right to be supported in a way that is culturally safe. It talks about treaty. It writes into legislation the value that people with lived experience of mental illness bring to the mental health system. It embraces diversity, and it compels mental health services to comply with these principles when they can. These are all welcome words.

However, the shift from focusing on medication and compulsory treatment will depend on more than these words. Much of it will depend on how the act deals with seclusion—in other words, locking someone in a room by themselves—and how it deals with restraint and with compulsory treatment. The hard decisions on these issues have been handed to a review which will recommend future amendments to the bill. We would love to see good legislation passed in this area, but we do appreciate the time needed to do it properly, because some of these are really hard questions. The bill does, however, legislate the Royal Commission into Victoria’s Mental Health System’s aim of an end to seclusion and restraint within 10 years.

There is a near consensus that restraining people and locking them away rarely helps them recover and can make them worse, adding trauma to what should be a recovery process. There are countless stories of harrowing experiences with seclusion and restraint, including triggering people’s experiences of past trauma or just abandoning people when they most need support. Indigo Daya told the royal commission about attempting suicide as an inpatient:

When the staff found me, I was forcibly walked straight to a seclusion room and locked in by myself. This was a terrifying and deeply shaming experience. There was nothing whatsoever to distract me from the overwhelming emotions, and I concluded that I must indeed be a terrible person, because they were punishing me. I remember hitting myself in the head, over and over … I wish that those staff had instead been able to sit with me in a quiet room, show some compassion and empathy, and just asked me what had led me to feel this way.

Compassion and empathy are usually not enough, but they are a very good starting point. While seclusion and restraint can be damaging to the mentally ill person, we are also very conscious of the need to protect the safety of healthcare workers as well as mentally ill people’s own physical safety. Mental health workers, like all of us, have the right to be safe at work. We also share the concerns raised by health workers that some people with acute mental illness are so disturbed that it may not be possible to offer treatment at all without some form of restrictive intervention. Restraint can be traumatic, and so can untreated severe mental illness, and untreated mental illness can cost sufferers their relationship, their job or their housing. This is the dilemma that the review will have to grapple with: how to enable such individuals to receive treatment without subjecting them to further trauma. The Greens are heartened by approaches in other jurisdictions which are reducing the use of seclusion, restraint and compulsory treatment without reducing safety.

We also understand that it is much harder to sit with someone in a quiet room when you are desperately understaffed. We sincerely hope that the extra funding working its way through the system means that staff will have more choices which make seclusion, restraint and compulsory treatment much less necessary. Thus far our mental health system has been so starved of funding and so understaffed that clinicians simply do not have the time to offer more. The new stream of funding for mental health care will fix some of this, but it will take time which we do not have. We are not training enough mental health nurses and allied health professionals to fill the many gaps, and there are bottlenecks in determining the diagnosis and appropriate care of patients in our mental health clinics due to the lack of psychiatrists. Many psychiatrists work in private practice, where they are unaffordable for a large section of our population, including those on benefits, who are often chronically ill. While the shortage of nursing and allied health staff may be numerically greater, their work will be hampered if there are not sufficient psychiatrists to make the treatment decisions that their work depends on. So workforce training and planning and funding will be the key to determining whether the human rights and other aspirations of this bill are realised, and that is where the minister’s comments just now are very welcome.

Other than funding and staff, one other important factor may be increasing the use of restraint and seclusion, and that is that every day people are released from prison and some go straight into hospital mental health units because they have been suffering untreated or undertreated mental illness while in prison. This problem is multidimensional and complex, and it varies with the severity and type of mental illness as well as the offending that led to imprisonment, but certain features stand out. Some individuals with psychosis remain untreated in prison because they lack the insight to consent to treatment and because compulsory treatment is not allowed in prison and there are often no forensic mental health beds available—that is, there are no beds in Thomas Embling Hospital. More beds are being built, but we also need staff to care for those patients, and that is a challenge right now. Meanwhile, these patients are discharged via ambulance into hospital, where they are more likely to be violent when they are held in hospital for necessary but compulsory treatment, and this can be a particular problem at hospitals near prisons, such as Sunshine. Possible solutions include more comprehensive mental health assessment upon admission to prison and more resources for mental health care in prison, including considering how to encourage prisoners to take advantage of the treatment on offer.

But we should also be looking at what can be done to keep mentally ill people out of prison in the first place. Changes to the Bail Act 1977 in the last few years have made it more difficult to get bail and have led to large numbers of low-level offenders from vulnerable populations, including those suffering mental illness and homelessness or both, serving weeks or months in prison on remand, and when they finally appear before a magistrate many are immediately released and likely would not have been imprisoned at all if they had received bail. Bail reform and public housing for offenders and for those with chronic mental illness would keep many out of prison and prevent this problem.

Besides principles and restrictive interventions, the bill makes a series of other changes, some of which I will touch on briefly now. People receiving compulsory treatment have a right to advocacy, and the bill takes this from an opt-in model, which lots of people do not know about, to an opt-out one. We welcome this, although we note that the Victorian Mental Illness Awareness Council would like the service to also be provided to people on assessment orders. The bill legislates a definition of ‘chemical restraint’. Again, we welcome this, although we will be interested to see what it means in practice. The bill allows some health professionals to take people against their will to be examined as the first stage of compulsory treatment. This follows on from the royal commission’s recommendation that responses to mental health crises be led by health professionals, not police, and while we applaud the sentiment behind this, we note that the Health and Community Services Union are concerned about the practicalities of this with an already exhausted workforce. Other health workers and the Victorian Aboriginal Legal Service have also raised concerns.

Despite these concerns the Mental Health and Wellbeing Bill 2022 has many promising words in it. It is worth noting, though, that the Mental Health Act 2014 has some of these words too, including on least restrictive treatment and supporting people to make their own decisions. And while the words in the bill matter, what also matters is implementation. Part of that is culture and part is funding. The Greens are heartened by the significant investment the Victorian government has made in mental health in the last couple of years and believe that this is a real cause for hope. However, we also hear again and again that all that funding has not made a real difference on the ground yet, particularly with the problems compounded by the pandemic. We are still optimistic, though, that it will. It is essential that it does.

Ms THEOPHANOUS (Northcote) (18:21): I consider it an honour to contribute to the debate on this significant bill, a bill which represents real transformational change in its own right but also represents a process of truth, investment and reform which will improve the lives of countless Victorians. Victoria’s mental health system is broken. We know this. For years the system has been overburdened, overly complicated and under-resourced. For Victorians experiencing mental ill health, the realities of this system are distressing. It has meant barrier after barrier to seeking care and convoluted pathways that are almost impossible to navigate. It has meant people in need being turned away because their conditions are too severe or not severe enough. For our heroic mental health workforce it has meant impossible case loads, workforce exhaustion and an overwhelming sense of disempowerment.

All this was brought to light by the Andrews Labor government’s Royal Commission into Victoria’s Mental Health System. This was a confronting process, but it was a necessary one, because the result of this royal commission was a clear and unequivocal blueprint for a complete rebuild of the system into one that puts people first. It delivers hope and a direction for the future. And as we have done time and again on issues from family violence to treaty to climate action, Labor has not shied away from the challenge. We have committed to delivering real change. We commit to delivering on every single recommendation of the royal commission. We said, ‘Yes, our state, Victorians, deserve better’, and we got to work.

Across the state budgets since the release of the royal commission’s interim report we have already seen a record $6 billion directly invested into mental health reform in Victoria. New services are already opening their doors, new workers are being recruited and new voices are being heard in the design of programs and services—but there is more to do. The complete transformation of our mental health system will not happen overnight; it is a decade-long reform. But significant change is already underway.

Coming into this Parliament in 2018 I knew that mental health was a priority for me and my community. The past three years have only reinforced my commitment to achieving greater investment and fairer access to services in the inner north. Indeed making a submission to the Royal Commission into Victoria’s Mental Health System was one of the earliest steps I took to outline the needs of my community. As I have raised before in this place, the inner north of Melbourne faces a significant service gap when it comes to health and mental health infrastructure. That means that every day I am having conversations with residents, schools, local businesses, community organisations and clubs, and while the conversations are as diverse as our community the one issue that has consistently and insistently been raised with me is mental health. Whether that is a principal concerned about the mental health and wellbeing of their students, a small business owner trying to support their staff through tough times, parents persevering with perinatal anxiety and depression or an older resident coming up for a talk on the street feeling isolated and alone, the experience of mental health issues and concerns around access to services permeate the conversations I have with my community.

The recent 2021 census for the first time recorded long-term mental health conditions, and the results were confronting but not surprising to me. Over 8000 locals, or 12.5 per cent of residents of Northcote, reported a long-term mental health condition. This is compared to 8.8 per cent across Victoria and Australia more broadly. This tracks strongly with my discussions with residents and stakeholders like Headspace, the Fitzroy community legal centre and Women’s Health in the North and providers like Your Community Health and PANDA.

Recently I have also been seeking direct feedback from my community through an electorate-wide mental health survey. I invited residents to share their priorities for and experiences of our mental health system, and the response was overwhelming. Hundreds of locals have now shared their thoughts and priorities with me, and I am hearing loud and clear that the inner north needs investment in more public mental health services. Many responses were from healthcare workers themselves, who spoke about seeing too many people who cannot get the care they need. There was a huge amount of support needed for infant, child, youth and family services both in community and in school settings. And as a proudly diverse community with strong multicultural, First Nations and LGBTIQ networks, there were many responses which called for culturally appropriate and affirming services. The stories people shared with me through this survey, emails, phone calls, forums and conversations on the street paint a picture of a real local need that is not being met by local services, but there was also real hope and real excitement about the Andrews Labor government’s reform agenda.

One example is the massive investment already underway to support better mental health outcomes for young people through our schools. We know that the vast majority of mental health conditions occur before the age of 25, so investing in our young people is critical. Labor has now rolled out mental health practitioners in every single state secondary school across the state, including Northcote High, Thornbury High and Preston High. From next year our state primary schools will have their own mental health practitioners supporting our children through this important time in their lives. Thornbury Primary has been one of the trial schools participating in the early rollout of this program, and the feedback has been absolutely heartening. In coming years Northcote schools will also see the full rollout of the Schools Mental Health Fund, which will deliver a suite of evidence-based programs and supports that schools can tailor to their students’ needs.

In Parkville earlier this year I was thrilled to see the opening of Victoria’s fourth youth prevention and recovery units, or YPARC. Totalling 50 new beds, this service will provide short-term residential care in a homelike setting for 200 young people per year stepping up from community care or down from hospital care. These investments are already delivering real change, but as I said, there is more to do.

One of the flagship recommendations of the royal commission is building the missing middle of our system, with 60 adult health services as well as 13 for infants, children and young people. The first six of the 60 will be up and running in 2022, and 21 more locations have already been identified. As I have said many times before, I will not stop working to ensure that the inner north benefits from the rollout of these local services. Northcote needs access to mental health supports close to home, not further afield. We know that the mental health of parents is critical to long-term outcomes for children, and for those following on the journey you will know that I am determined to keep raising awareness of the need for more support for infants and families in Northcote as well. Supporting women and supporting families means supporting our next generation of kids and young people too. That is why the royal commission intrinsically linked infant, child and family mental health and why the Victorian government is investing in initiatives like our three new hubs and expanding our network of early parenting centres.

The people of Northcote understand the need for this reform in a very personal way. They understand the importance of what this government is achieving, and they are backing it in. I have been stunned by the generous openness of locals willing to talk about their own lived experience as carers, as people impacted by mental ill health and as mental health workers, and I have been spurred by the incredible support I have received from locals backing in my work to boost services locally.

The investment in our mental health system needs to be sustained and ongoing. It is why we introduced the mental health levy and why it remains beyond disappointing that those opposite continue to flip-flop on this very important issue of sustained funding. There is a choice to make here about the value we put on mental wellbeing in our community and the value we put on the services providing it and the workforce that support people in their times of need. For too long the system has suffered from patchwork investment. The levy brings certainty to this sector and locks in mental health as core business in our public health system. That is as it should be. And of course investment is only one element of our reform.

Another foundational element is people building our workforce. Nothing happens without people, and our mental health workforce have been giving their all with empathy and passion day after day. I am proud to say that Labor has provided over $269 million in dedicated investment in the mental health workforce in the past two years, and over 2500 mental health jobs have been created in Victoria. There are also incredible pathways for those seeking to enter that workforce, with free TAFE programs across mental health and peer support now available. I am looking forward to catching up with some of our local mental health workers and the Health and Community Services Union in a couple of weeks to hear more about how we can best support them through this rapid transition period.

This bill encapsulates our ambitions and our commitment to mental health reform in Victoria, one that puts human rights, lived experience, dignity and autonomy at its core. This bill is about putting people first. It builds on Labor’s extraordinary record of delivering social and economic reform that makes our state fairer and stronger. We are doing the hard yards. We are delivering the mental health system Victorians need and deserve. I commend both the former and current ministers for their work, and I commend the bill to the house.

Mr ANGUS (Forest Hill) (18:31): I am pleased to rise this evening to make a brief contribution in relation to the Mental Health and Wellbeing Bill 2022. Can I say at the outset what an important bill this is for our community because all of us as local members and members of the broader community know what a difficult situation many people have found themselves in as a result of the last couple of very, very difficult years. This bill essentially acts on the recommendations of the Royal Commission into Victoria’s Mental Health System. The outcomes of this bill and the purposes are going to be needed more than ever, particularly as we look and see the result and the evidence that has been heard in other forums of this Parliament in relation to the mental health situation here in the state of Victoria following, as I said, the last two very, very difficult years.

I particularly want to just touch in my introduction on a couple of the matters that were raised in the committee which dealt with that, the Pandemic Declaration Accountability and Oversight Committee, and the report that they tabled recently in relation to some of the mental health issues and the evidence that was led to them, because I think this helps to give us a context as to how difficult and how very significant this issue is for our communities. The committee members on page 6 of the minority report said that there were significant concerns during the public hearings that:

… not one expert witness was requested to provide mental health advice to the Minister for Health or the Chief Health Officer regarding the impacts of pandemic orders before the orders were announced and came into force. This resulted in a systematic whole-of-government failure to recognise mental health stresses within the Victorian community, especially amongst under 25’s.

I say that as the start, because it is all well and good to have an enormous bill like the one we have got and to have all sorts of aspirational goals, but I urge the relevant ministers opposite to ensure they are getting the feedback and getting the expert opinions from those that are indeed experts in their field before they go implementing various strategies and various other approaches to a whole range of public health issues. It is very obvious from the evidence that the committee heard and the evidence that has been distilled in this minority report that that clearly did not happen, and as a result of that there has been a catastrophic impact on the broader Victorian community and the mental health thereof. On page 7 it says:

Despite the Chief Psychiatrist indicating there was not an increase in suicides over the pandemic lockdowns and restrictions, the Coroners Court of Victoria … has reported the highest number of suicides on record in 2020 …

that is, 712.

There remains a number of cases pending for 2020, 2021 and 2022 to date so recent figures cannot be used comparatively.

It goes on to say:

Further, a peer reviewed study into suicides in Victoria investigated by the Victorian Coroner found that almost 10% of all suicides in 2020 were COVID-linked, ‘where COVID-19 and its associated impacts were identified as being a factor in the suicide’.

Like other members in this place my office was certainly inundated with people of all different ages, all different backgrounds, that were having significant mental health issues as a result of the very onerous restrictions that were put on them during the height of the pandemic, over the last two years in particular.

That included people with suicidal ideation. We had young people who were just totally despairing and had lost all hope. We had parents contacting us stating that they had children that would not leave their bedrooms, would not come out and engage in any way and clearly were exhibiting all kinds of mental health issues. The issue there, really, is the fact that the government did not listen, because there were many people saying that that was what was going on in the community. Indeed we certainly mentioned it in here and in other places, but the government just chose to ignore the evidence that was so obvious. Now in hindsight, as the committee has done, they are able to clearly see that that evidence was there and was brought to the attention of the government, but the government fully neglected to do anything about it. That is a disgraceful situation and one that must never be allowed to be repeated.

We can see some of the expert evidence that was given by various organisations, including Beyond Blue. On page 8 of that report it talks about some of Beyond Blue’s experiences, and it says:

Up until the middle of 2021, monthly demand for Beyond Blue’s support services was 20 to 30 per cent above pre-pandemic levels nationally.

It goes on and says:

This includes a total of 128,000 calls and 13,000 webchats between July 2020 and February 2022, from Victorian contacts only.

The next expert witness that attended was representing Mental Health Victoria, and the report says they:

… wrote in December 2021 that “Victoria is in the midst of a mental health … crisis.”

I think there is little doubt that that is absolutely the case, and we are still seeing many, many legacy issues of that in our communities. That can be exhibited in a range of ways, but it is presenting amongst all our broader communities, with people’s behaviour being changed, with people still not recovered at all and still not reintegrating back into the community, and a lot of that is just attributed, in my view, to the fear that we have been ruled under over the last two years here in Victoria. As a result of that—as a result of the fear, the threatening behaviours and the onerous restrictions that were put on all Victorians—that has resulted in mental health issues for many, many Victorians. That was Mental Health Victoria, as I said. Of Compassionate Friends Victoria the report says:

First contacts with people bereaved by suicide increased from 31 in 2019–20 to 64 in 2020–21. Grief calls to their helpline increased by 25 per cent in the same period.

It goes on and talks about further statistics, which I will not have time to go into in relation to that, but basically it paints a dreadful picture for the community as a result of these circumstances. Yourtown, or Kids Helpline, also gave expert evidence in that hearing, and I quote from that. It says:

In 2021 close to 123 000 attempts were made to connect to our Kids Helpline counsellors from young people in Victoria. This represented a 20 per cent increase in demand from 2019—pre COVID.

So we can see with a whole range of organisations the pressures they were under. It goes on:

Sadly, we could not respond to 62 per cent of these children and young people, or over 76 000 attempted contacts. Of the contacts we were able to respond to in 2021, 38.8 per cent sought help in relation to mental health or emotional wellbeing concerns, 11.5 per cent for suicide-related concerns, 7.7 per cent for child-parent relationships and 6.3 per cent for parents’ wellbeing.

It also goes on:

From the beginning of COVID in March 2020 to December 2021 Kids Helpline provided emergency support to 2408 Victorian children and young people. This included 978 young people who attempted suicide or expressed suicidal ideation and 749 children who reported child abuse.

So we can see, again, more expert evidence. I really commend the minority report to all members, because it does provide an insight not through the rose-coloured glasses that the government would like us to be looking through but through the reality of organisations that have been at the coalface over these last number of extraordinarily difficult years, dealing with the victims of the government’s pronouncements. We can see there is evidence also from the Royal Australian and New Zealand College of Psychiatrists and the Australian Association of Psychologists. They gave more expert evidence, and the report says:

The Committee also heard that—

these organisations—

… directly approached the Andrews Labor Government with solutions to build the mental health workforce, but these requests did not receive funding support, and in some instances, no response was provided by the Minister for Mental Health.

What a shameful condemnation that is of the minister at the time in relation to how they did not respond to that particular situation. We had evidence from the Victorian Mental Illness Awareness Council that talked about their increase in demand, and on and on it goes.

There was even a shadow pandemic group set up through social media. That had 20 000 Victorians involved, and all those people had a story, and they were directly impacted in some way or another. The evidence is there. It is all well and good for the government to bring a bill like this before the house, but it is a matter of not putting Victorians back into that dreadful situation that we all found ourselves in—where they were essentially the cause of many of the mental health issues that Victorians are now facing and still dealing with. Some obviously will never recover, particularly those that have had tragic outcomes. Can I implore the government to ensure that they seek advice from mental health experts before they bring in any more lockdowns or any more constraints on Victorians.

Mr EDBROOKE (Frankston) (18:41): From that I take it that the opposition support the bill and that they thoroughly endorse all the recommendations that the Royal Commission into Victoria’s Mental Health System put out.

Ms McLeish: Correct.

Mr EDBROOKE: Correct? I did not quite get that from that speech. I am not sure anyone else did, but we are here today to make sure that we take the next step in the fundamental reforms that this government committed to.

This bill of course gives effect to the royal commission’s recommendations that we need to start fresh, we need to have a new mental health and wellbeing act and reset the legislative foundations of our system. Throughout my time as an elected member of this place I think that one of the issues that my office hears about the most is mental health. That was prior to COVID; it has not just magically appeared around COVID. We had a broken system before COVID, and this government has been very much at the forefront of saying, ‘Yes, it is broken. It needs fixing’. But instead of being like that person that points out the massive fire, the house on fire up the street, going, ‘Look, there’s a fire! There’s a fire!’, someone actually has to do something about it, and it is this government that is actually doing it.

We heard some statistics from the previous member. I would like to have look into some of those statistics. I very much doubt there is a professional person who could forensically tell this chamber that they attribute COVID to someone’s suicide. That is something that is a fairly decent reach, and I would like to have a look at those facts, maybe a little bit later, and see them for myself.

I do note that there was a joint statement made by some absolute peak bodies in this field. It was put out. I quote from that right now:

… as we respond to this once in a generation opportunity to make the mental health care system better for all who access and work within it today, and in the years ahead.

The passage of the Mental Health and Wellbeing Act 2022 is a crucial first step to enable this vital work to begin. Victorians cannot afford any delays to the vital work of reform.

That is signed by Marcelle Mogg, who is the CEO of Mental Health Victoria. It is signed by Marie Piu, who is the CEO of Tandem; Craig Wallace, who is the CEO of the Victorian mental health awareness council; Charlotte Jones, who I met with last week and who is the CEO of the Mental Health Legal Centre; and of course Professor Pat McGorry AO, who is the executive director of Orygen. These are the people who will not tell us that everything is rosy. They made sure and certain that throughout the royal commission people’s voices were heard. There was a huge number of—I think 253—contributions, plus the hearings as well. This today is us, a government that have listened to our community, putting what our community wants in action. As was alluded to by one of the previous speakers, I really fret when I think that the opposition do flip-flop around the levy. We are talking about a $3 billion-plus hole without that levy.

But in my mind—and I am sure that the data supports it—this is a community, in Victoria, that has supported this royal commission. They have voted on it, and they would like to see it rolled out. Can I say thank you to everyone who was involved in the royal commission and also particularly our workforce. I, the member for Carrum and members of the Health and Community Services Union pulled into the Peninsula Health community care unit last week, and we were able to listen to mental health workers talk about the pressures that they are under, what they see as great about this reform and also what is on the horizon with the $1.1 billion Frankston Hospital redevelopment, with more mental health services on the way.

This is about acknowledging those people that have worked through such a difficult time, but they have worked in difficult times before COVID as well. We seem to have a context across the aisle where we bring back all our talk about mental health into the context and the optics of COVID. Well, mental health has been an issue for a long time, and it is this government that put into place and made sure that we were going to act on what the royal commission said—and we have accepted all those recommendations.

Can I also thank the people that came forward and gave their sometimes brutal stories, very hard to hear at times. I know that we heard some of those stories on the day that the royal commission recommendations were made public, and at times there probably was not a dry eye in the house, hearing about people’s lived experience. I think that this bill goes a long way to making sure that there is a balance of that lived experience and the consumer and also the clinicians and mental health workers as well. So far in the last three state budgets this government has invested over $600 million into that workforce, and also we have committed to deliver more than 2500 more mental health professionals across forward estimates, which is exactly what the strategy told us that we needed. As I mentioned before, the levy goes a long way to ensuring that the royal commission’s recommendations in the form of the architecture of this bill can be rolled out.

Why are we doing this? I mean, we have just heard 10 minutes about COVID. We are doing this not just because we have had a one-in-100-year event—which is probably causing many of the same issues in every state and every nation across the globe—we are doing this because the system is broken. But we are not just doing what the royal commission says, we are actually going above and beyond. The bill really reflects the recommendations of the royal commission, and some aspects I think of the hearings reflected that we needed to go beyond those recommendations.

We are going to establish Youth Mental Health and Wellbeing Victoria. This responds to the significant mental health challenges being faced by young people and the fact that the primary focus of the Victorian Collaborative Centre for Mental Health and Wellbeing will be on adults and older adults. We are rolling out the inclusion of specific decision-making principles in relation to compulsory assessment and treatment and restrictive interventions, and although this is not a direct recommendation, the royal commission did state that the bill should include principles that reflect concepts of autonomy, supported decision-making, recovery-orientated practice, the protection and promotion of human rights and the use of compulsory treatment as a last resort.

I am sure 99 per cent of the time those kinds of treatments are the last resort at the moment, but as we will get to in a second, over a 10-year plan a lot needs to change—and this bill is unashamedly aspirational, as it should be. We have reduced the maximum duration of community treatment orders from 12 months to six months, and in line with recommendation 10 we are changing the support to a health-led response for mental health crises as well, which is something that I have heard the opposition speak about today—and I was nodding my head in agreement with what was said.

We have heard a little bit of chatter about the bill’s limitations on the use of restrictive interventions possibly putting workers and people using mental health services at risk—so, other clients. While this bill does not actually ban the use of restrictive interventions, seclusion or restraint, chemical or physical, this bill seeks to envision a time that these might still be used, but not as much. That is I think in every mental health worker’s mind. Everyone who works in the mental health area does not want to do this. Often it is for the safety of the client, often it is for the safety of other consumers and the staff themselves. So the bill continues to permit the use of restrictive interventions to prevent imminent and serious harm to that person or another person or, in the case of bodily restraint, to administer treatment or medical treatment to the person. Essentially the worst-case scenario, the last resort, is to do this, and we have got 10 years to actually get to that point.

I am absolutely proud, and probably one of my proudest moments in the last seven or eight years has been to stand up here and finally see this bill tabled. The recommendations of the royal commission were not pulling any punches, and they were the result of people opening their hearts and their minds and reliving some horrible, horrible stories. So thank you to the workforce and thank you to everyone that worked on the royal commission and of course the previous minister and the current minister. I commend the bill to the house.

Ms McLEISH (Eildon) (18:51): I rise to make some comments on the Mental Health and Wellbeing Bill 2022 that has taken all our time today. I want to set the framework around this. Yes, the Royal Commission into Victoria’s Mental Health System delivered its final report in March 2021, and this has come out of that, but it also builds on the work that was done between 2010 and 2014 by then Minister Wooldridge, who took on this space and did an enormous amount of hard work and heavy lifting in this space. Whilst it is very easy for the government members to read off prepared notes and look at everything through rose-coloured glasses, this is an area that they have certainly neglected in the last almost eight years. Having the royal commission was a very positive outcome for Victoria, but that did not mean that everything should have stood still for the four years leading up to that and now for the 3½ years to this point. So we have had such a long period of inaction by the Labor government in mental health support services, and they cannot see through their own rose-coloured glasses that they have an absolute crisis in mental health out there at the minute.

Now, I am confident to say that every member in this chamber would have spoken to people over the last number of years about that crisis and what that crisis means to them. I represent a number of small communities, and it is very difficult for them to get the mental health support that they deserve and that they need. We find people in the towns of Yea and Alexandra—even Kinglake—for example, that end up at Goulburn Valley Health in Shepparton quite some distance away, quite a considerable period away. Due to the limited capacity of the hospital to actually admit people, and by the time they get through the assessment, we find that people that have had mental health episodes are being discharged at 2.00 am and 3.00 am, and they have to get home. I have had a lot of people speak to me about having to get home, because now the standard way of doing that is unless you can ring somebody who will drive that 2 hours to pick you up another 2 hours home, you get a taxi. The bills that have been given to me, that I have seen, from Goulburn Valley Health and the number of taxi vouchers that have been provided to those with mental health episodes are really quite alarming. I know Kinglake residents would like to see that they can access mental health services in the north of Melbourne rather than being directed, too often, to Shepparton, which is quite a long way away. If people are admitted into hospital, they are very disconnected in terms of family and friends being able to visit them, whereas they could scoot down for half an hour into the suburbs and be treated.

I do want to also mention the ongoing failures of the Labor government in mental health and mental health and wellbeing support. They have been no more evident than during the pandemic we have had in the last couple of years. I know that people that I spoke to during that time did suffer enormously. I saw small business owners suffer big time. I saw children and I saw parents equally suffering, and for families that were living in fractured situations those situations were exacerbated by having everybody under the one roof where people could not go out. And if you had a family that was under a lot of stress, the access during COVID was very, very limited and very difficult for these families.

I note that we had the review of the pandemic orders handed down in July 2022, and I am going to actually quote from a couple of the points in the minority report which really do point out some of the failings of the government, because we know that there are many people now who have said that the impact of children being locked up to do homeschooling for as long as they did actually had a lot of negative consequences. Whilst it may have helped with the spread of the pandemic, on the other hand you had the absolute increase in need for support services, which was not happening. I want to read from page 16 of the minority report—some of the findings about mental health during that time.

The Australian Association of Psychologists wrote to the Minister for Mental Health on six occasions—

six occasions—

over two years requesting funding support for provisional psychologists to boost workforce capacity …

We know there was a lack of support workers in the mental health space, and this was a solution. This was a good solution, but the report states:

… the Minister did not respond to any of these letters.

Six times. Do you reckon the Australian Association of Psychologists was pretty happy about that? Well, no, they were not. There was a huge demand in calls to support services, and this included Beyond Blue, Kids Helpline, Compassionate Friends Victoria, Mental Health Legal Centre, Victorian Mental Illness Awareness Council and Tandem, as well as clinical support services for alcohol and other drug treatment and support. There was a significant increase in demand, and this was noted through the inquiry.

Very sadly, there were a number of suicides that could be attributed to COVID. The report states:

A peer reviewed study into suicides in Victoria investigated by the Victorian Coroner found that almost 10% of … suicides in 2020 were COVID-linked.

I think that is devastating, and all the more devastating when there were calls by the association of psychologists with a solution for how to increase the number of provisional psychologists and counsellors who were on the ground and could have helped in this situation. The report states:

The impact of school closures—

I mentioned that—

had a profound impact on child and youth mental health, and increased mental health support has been slow to be enacted by the … Labor Government.

We know that through the lockdown kids did not see their friends and did not get active, and they ended up not being able to be involved in any meaningful sport. Sport is good for their mental health, whether that is through community sport on the weekends or weeknights, whether it is through PE classes or whether it is that informal kick-to-kick in the street or that kick-to-kick in the schoolyard or throwing a ball where kids get active. We know that kids were not active, and we know that being away from their friends socially was very detrimental.

I want to outline a couple of the recommendations that were also put forward, and these are on page 17 of the minority report.

That the Coroner’s Court of Victoria undertake a special inquiry into COVID-19 related stressors present in suicides in Victoria, and this report be tabled in Parliament.

I think that that is such a serious issue, and the government really should give some thought to doing that and how they may do that. Also:

That the Department of Health undertake a special inquiry into suicide and suicidal behaviour due to COVID-19 related stressors, especially for Victorians under 25, and this report—

also—

be tabled in Parliament.

Early interventions are what work, and we have lost the opportunity for early interventions with the number of suicides attributable to COVID but also with the rise in all these calls for help. And the later it is, the longer it is between the—

The DEPUTY SPEAKER: I am required under sessional orders to interrupt business now. The member may continue their speech when the matter is next before the house.

Business interrupted under sessional orders.