BRIDGET ARCHER, TASMANIAN MINISTER FOR HEALTH, MENTAL HEALTH AND WELLBEING: Look, it's a really exciting day to be here today, a very important milestone, with work commencing behind me, as you can see, on the mental health precinct here at St Johns Park. We've already seen some work underway, construction underway on the intensive residential parenting unit on this site, which we think will be constructed by the end of this year.
This marks the start of these works on residential in-patient beds here, 15 in-patient residential beds, as well as 12 eating disorder beds here at St Johns Park. The facility here will be much like the Peacock Centre as well in terms of having a recovery college here and Safe Haven as well. It has taken some time to get to the start of this work so we're really excited to be here today and see them kicking off, and we hope that construction will be completed on this project by 2028.
It is jointly funded by the Australian and Tasmanian Governments, a $47 million project which we think will deliver a really wonderful precinct here at St Johns Park as part of the St Johns Park Masterplan, where this campus will become a satellite for the Royal Hobart Hospital dealing with mental health here in this really wonderful setting as well.
And I might hand over to Assistant Minister White to say a few more words.
REBECCA WHITE, ASSISTANT MINISTER FOR HEALTH AND AGEING: I think a lot of Tasmanians have been waiting for this moment for a long time, especially Tasmanians who are living with eating disorders. This is a really important day to see the construction commence here that will provide opportunities for Tasmanians in the south of the state to access residential in-patient care in a really beautiful setting and supported by high quality staff, especially those Tasmanians who have been struggling with eating disorders who really haven't had these services until the construction that we started today.
This is a joint Australian and State Government commitment, and I'm going to hand across to Assistant Minister McBride, who's the Assistant Minister for Mental Health who can speak in more details about our contribution.
ASSISTANT MINISTER EMMA MCBRIDE: Thank you so much, Rebecca. It's a real privilege to be here today on behalf of the Albanese Labor Government, in partnership with Minister Archer from the Tasmanian Government, as construction starts on this vital precinct at St Johns Park.
We know that in Australia today, one in five Australians struggle with their mental ill health, and for young Australians, that's doubled. Which is why our government has made the largest commitment of any Commonwealth government into mental health and well-being – a $1.1 billion investment in mental health and well-being.
I want to speak today particularly about eating disorders. In Australia today, currently 1.1 million Australians are living with an eating disorder. That's about 4.5 per cent of the population. That's your family member, that's your colleague, that's your friend, that's your classmate. We know that for Australians, one in 10 at some point in their life will experience an eating disorder. That's affecting at the moment, estimated by the Butterfly Foundation, to be 20,000 Tasmanians. And for too long, services haven't been available close to home. People have had to wait for vital support that can make such a significant difference to their recovery.
This centre, jointly funded by the Commonwealth, is part of our $63 million national commitment to provide more support for people living with eating disorders. We know that eating disorders typically or most commonly affect young people aged 12 to 25, often women. But we've also seen an increase and eating disorders affecting young men and boys, which is why it's so important that community-based services that can catch people sooner are so important.
This centre, when it opens, will have 12 in-patient beds, providing wraparound care that's the most evidence-based tailored to individuals’ needs. And I've had the chance to be at the openings of these centres in the ACT, in New South Wales, and I've seen already the profound impact that support sooner in the community has made.
Thank you.
JOURNALIST: Can I ask you a question? What's your advice to young Tasmanians who are struggling with eating disorders, particularly in the internet environment where there’s discussion about Ariana Grande, looksmaxxing, and that kind of thing?
MCBRIDE: We know that in Australia today, many young people are struggling with their mental health, including with eating disorders, and social media can have an impact amplifying that. What we've done as a government is introduce world-leading social media age restrictions to make sure that young Australians, particularly the most vulnerable, don't have predatory algorithms like metrics that are then leading into and amplifying eating disorders.
What I would encourage young Tasmanians to do, to visit a headspace centre. headspace centres across Tasmania are there to support young Tasmanians aged 12 to 25 to seek support. Our Government has also boosted the funding of the Butterfly Foundation, Australia's leading national charity to support people living with or at risk of eating disorders, by another $9.2 million to provide more support. We're also introducing a national network of Medicare Mental Health Centres that can see people from age 18 and upwards.
So, what we're trying to provide is online support, face-to-face support, wraparound support tailored to that individual wherever they need it. And this centre right here will make such a big boost in a community-based residential centre, the first in Tasmania, to support young Tasmanians or any Tasmanian experiencing an eating disorder.
JOURNALIST: Is this specific centre 50/50 split with the State Government in funding?
MCBRIDE: The funding nationally for our eating disorders residential program is $63 million. The Commonwealth’s funding to Tasmania is $10 million and $7.5 million to this site. But as Minister Archer has said, these are significant commitments as part of our National Mental Health and Suicide Prevention Agreement and bilaterals with each state and territory to make sure that states and territories have the resources they need to provide vital services within their local communities.
JOURNALIST: Can you give a bit of an overview of, I guess, what sort of care and what sort of treatment someone that has been suffering an eating disorder will receive once they arrive at the centre?
MCBRIDE: We do have Anita, who can provide some more detail to this. But what we will see is compassionate care, care that is also informed by people with their own lived experience, alongside clinical support, dieticians, psychologists, psychiatrists, to make sure that there is that wraparound support. Because we know that multidisciplinary support is the most effective kind of care and that care in the community is the right kind of care.
I worked as a clinician in mental health in-patient units for many years, and I saw people whose distress increased to crisis simply because there wasn't support in the community. We're changing that. And very soon, right here at St Johns Park and for all of Tasmania, there'll be better support closer to home in the community.
But I might hand over to Anita to add more comments if she would like to.
ANITA REIMANN, TASMANIAN EATING DISORDER SERVICE MANAGER: Good morning everyone. The program that will be rolled out here as part of the residential recovery program, as part of the Tasmanian Eating Disorder Service, will be an intensive treatment program. It will be for people who are medically and psychiatrically well and able to engage in, excuse me, full-time therapy. So the program will run up to 12 weeks, and there will be 12 participants in the program. It’ll be staffed by a comprehensive clinical multidisciplinary team and also supported by medical staff as well to ensure people remain well and safe while they're admitted. So there'll be good programs, they’ll include intensive psychotherapies. There will also be arts programs and programs that really support an adjustment to a healthy relationship with food, which is the crux of what eating disorder issues are about.
JOURNALIST: Is it 12 beds?
REIMANN: Twelve beds.
JOURNALIST: Right. And how many staff do you expect it’ll need?
REIMANN: In terms of staff, it will be about 27 staff on this unit, remembering that we also have a community-based intensive treatment program that will be co-located on this site, and they'll be in reaching into the residential program as well.
JOURNALIST: Is that going to be existing staff members filling the roles here, or will these be new roles?
REIMANN: They’ll be new positions within the Tasmanian Health Service.
JOURNALIST: Have you mirrored it off some of the other centres that we've seen across Australia?
REIMANN: Yeah, I've had the opportunity to visit most of the new sites because this is a new area, we're breaking new ground in terms of evidence-based practice in this area for eating disorders. And so I'd like to think we'll have a blended model that fits the needs of the local Tasmanian community.
JOURNALIST: Do you have any idea what the average stay might be and how many people you might be able to see per year?
REIMANN: Yeah so I'm hoping that the stay will be between 8 and 12 weeks. And within some of the deliberations we're having around the model of care, we're looking to try and have some capacity to bring people back in for a brief admission should they have a bit of a slip, and need just a little period of time to regain and stabilise again, ready to return to the community.
JOURNALIST: You mentioned that 12-week sort of program aiming for people- sorry, aiming for people to stay around the 12-week, how do you make sure that they get care that's actually suited to each individual rather than an overviewing 12-week program that's not suitable for absolutely everyone?
REIMANN: Sure. So everyone will have an individual care plan that will be worked up as part of their triage and assessment into the program, and so there will be individual therapy that individual members of the program are having as well as joint group therapies as well. So it will be very tailored to the individual.
JOURNALIST: And then after the 12 weeks?
REIMANN: After the 12 weeks, they'll do a step-down care. They'll transition to our community-based intensive treatment program who hopefully will have done the initial assessment and supported them in the entry, or step up into care and the care will continue from there.
JOURNALIST: Have you seen the demand for a centre like this grow, say, over the last decade?
REIMANN: Absolutely, there's been an increase- since COVID, in fact, we've seen an increase internationally and nationally in terms of presentations of people with eating disorders, and we're not sure whether that's related to a general impact of COVID and isolation that occurred with some of the lockdowns related to mental health issues such as anxiety and depression, which are also comorbid medical disorders associated with eating disorders.
JOURNALIST: And you expect this to be finished- is it 2028, by the end of 2028?
REIMANN: Yes.
JOURNALIST: As it was mentioned, there's thousands of Tasmanians that are struggling. Where can they turn to right now?
REIMANN: Absolutely. So people are very welcome to call the Access Mental Health number which is staffed by mental health professionals across the state 24 hours a day. There'll be an initial triage and then there'll be a warm handover to the Tasmanian Eating Disorder Services hub, navigation hub, where they'll speak to an eating disorder specialist and we'll do a more thorough assessment and either enter them into service or look at putting together the appropriate care pathway that meets their needs.
JOURNALIST: We’ll talk to the Minister if that’s alright.
JOURNALIST: Yeah, might just get you quickly to spell your name Anita, and your title.
REIMANN: Yep. Anita, A-N-I-T-A, Reimann, R-E-I-M-A-N-N, manager of the Tasmanian Eating Disorder Service.
JOURNALIST: [Inaudible]… You mentioned the Peacock Centre, do you think there'll be- I mean, it's open in 2028, that's still a while away. How much do you expect demand to grow between now and then?
ARCHER: Yeah, look, as we've heard, we know that demand has grown and continues to grow. And as we have tried to respond as that demand has grown and changed over time. And we've seen in Tasmania in the last decade substantial investments in our mental health system, including into facilities such as the Peacock Centre. And as we heard from Minister McBride, an integration of both Commonwealth and state programs and funding on the wide spectrum of mental health presentations. There is a range of supports available for Tasmanians. I think that's the most important message.
As Anita said, you can call Access Mental Health to get that guidance for your particular presentation or your particular needs. But there are a range of other services as well, whether those are headspace centres, walk-in Medicare mental health centres as well, and a range of other treatments depending on people's clinical presentations.
JOURNALIST: Is it nice to actually see construction start? Because was it delayed or it's just been sort of a lengthy process to get to this point?
ARCHER: It has been a lengthy process to get to this point. It is very exciting to see work commence on this. There has been some delays as we've worked through the approvals processes. This is a really significant site. There are some significant heritage values here, both colonial heritage values but also Aboriginal heritage values. That is part of what makes this a beautiful and unique site for this purpose, but it also adds to the complexity of ensuring that that heritage is respected and preserved as this site is redeveloped as well.
JOURNALIST: I have some on something slightly different… a report came out just on the future hiring in the health department. I'll probably ask Dale about this before he walks away at some point. But in terms of, with future hiring not offering out jobs that are for experienced doctors, it's my understanding- you might have to break this down for me, but instead hiring junior doctors to cut costs. Is that your understanding and has that been happening for a while now?
ARCHER: I think what you're probably referring to is in relation to allied health and I can get Dale to speak more to it. These issues were consulted on as part of the recent bargaining process with HACSU. So it is somewhat surprising to see them raising these issues in this way now. It's also really important for kind of workforce development to be able to have that pipeline for younger people, new graduates coming into the system as well. So it is a part of a workforce development approach as well. It is undertaken on a case by case basis, but Dale might like to add some more.
JOURNALIST: Can I just ask you on HACSU then, because I spoke to them this morning and they said that patient care would decrease because of this. You're saying that they were consulted, they already knew about it?
ARCHER: Yes, and I would absolutely reject that there would be any reduction in patient service. This is part of workforce development planning for the future, but also you can see in the data that is presented the number of presentations that are currently dealt with by different categories of clinicians. This is consistent with that approach and also, as I've said, is undertaken on a case-by-case basis as well.
Did you want to add-
JOURNALIST: [Interrupts] Can I ask you, Dale? You were shaking your head. Can you break it down for me?
DALE: Yeah, so as part of our recent enterprise bargaining arrangements with HACSU, we looked at the fact that our workforce had become heavily weighted towards senior allied health professionals, so the pathway for graduates had become quite difficult because they would need to apply for a job that where they required experience. So we worked on how do we actually structure our work- our agreement so that we have a mix of skills, so graduates will come into level 1 which they always have, but we have a level 2 which is an experienced level, that level beyond graduates. And then we have the level 3s which are the- if you like, the senior allied health professionals.
At the moment we have an over representation of that senior level and that means that we're not recruiting enough graduates, we're not changing every job from the senior level to the graduate level. It's important that we have the right mix. But what we are doing is looking at as every level 3 or level 4 gets advertised- gets ready for advertising, is that a job that could actually be used as a graduate role or a level 2 experience- you know, someone that's experienced but not yet at the senior level. It is a way of making sure we have the workforce for the future. But secondly, that we have allied health professional graduates staying in Tasmania because if they can only apply for experienced jobs or senior jobs, they're going to have to leave the state to get that experience and they probably won't come back. So this is a really serious effort to make sure we've got allied health professionals for the future of Tasmania.
JOURNALIST: Would it mean that level 3s and level 4 don't need to do more supervision?
DALE: No, it won't. Firstly, I emphasise that level 2s is an experienced level. Someone at level 2 is probably five or six years into their career. A level 1 is a graduate level. So what we'll be seeing is a balance of the workforce. And it doesn't mean that the workload of threes and fours goes up. What it means is that people will be able to have a career in the Tasmanian Health Service without having to leave the state at the graduate level.
JOURNALIST: How much of an impact do you think this will have on the $700 million that you have to find in savings?
DALE: This has no impact at all on that $700 million. This is unrelated to operational efficiencies. This is related to a serious workforce issue that we have, that's why we put it into the enterprise bargaining process. It's why we've redone the structure so we can do this. This is all about making sure we have a workforce for the future of the Tasmania Health Service.
JOURNALIST: Will it be an added benefit that it helps save on costs?
DALE: No, it won't because I will go back to where this isn't a cost saving. This is about the workforce balance. So yes, it may mean that we we're saving money on threes and fours, but that will be reinvested in making sure that we're growing the graduates.
JOURNALIST: What would you say to HACSU then that say that patient care will be influenced?
DALE: Look, your- unions say these statements because they're representing their members, but what I would emphasise is that we're doing this carefully job by job. It's not a universal suddenly we're taking out our level 3s and saying we don't want you anymore, we're going to create level 1s or level 2s. We're doing this on a job by job basis as they become vacant, to do an analysis of what's needed for the patients and for the future workforce. The worst thing for our patients will be not having a workforce in five or ten years’ time.
JOURNALIST: Back to the minister, can I ask a couple questions about the racism inquiry yesterday?
ARCHER: Yes.
UNIDENTIFIED SPEAKER: We only got five minutes.
JOURNALIST: Yeah, no worries. We heard from yourself and some other state government representatives yesterday that structural racism does still exist here in Tasmania. Can you give some examples of how that exists?
ARCHER: Look, I think what I stepped through yesterday with the racism inquiry, which I welcome and I think all Australians would welcome an inquiry into this issue, is that obviously, and I stepped through this yesterday, from the history of colonisation in Tasmania, we have seen structures evolve that have been discriminatory to our Aboriginal Tasmanians. Many of those things have been addressed over time, but there still exists, in our view, work to be done around cultural safety and about out stamping out racism and unconscious bias where it does occur. There has been a significant amount of work in that area right across agencies in Tasmania, which we gave some evidence of yesterday. Some of that has been as a result of the Commission of Inquiry, and that has really I think amplified some of the efforts that we have seen right across government not only for Aboriginal Tasmanians but does include particular actions around Aboriginal Tasmanians, for example.
And in the health service particularly, this has been a real focus. We recently had an Indigenous roundtable table. We have an Indigenous health advisor now, and that was a really productive day where we had representatives from right across the Tasmanian community, right across the Tasmanian Aboriginal community come together really sincerely and have some really serious and honest conversations about what we can do to break down these sort of structural inequalities that still exist.
JOURNALIST: What are some examples of areas where that unconscious bias you mentioned still exists and needs to be stamped out?
ARCHER: Well, some of the examples that we heard at the Indigenous Health Roundtable, for example, were just those sort of unconscious bias potentially of patients presenting at an emergency room, for example, who if they were identified as Indigenous, that they were more likely to perhaps be thought to be intoxicated, for example, when they presented rather than necessarily viewed on the basis of their symptoms. So that was one example that we heard of throughout the course of that day. And some of that is just around breaking down those unconscious biases that people may hold.
JOURNALIST: Some of the evidence we heard earlier in the day painted a picture of Tasmania's Aboriginal community as potentially quite divided. Do you think that's an issue here in Tasmania?
ARCHER: Look, I think there is no doubt that there has been challenging conversations here in Tasmania over a long period of time. It's really important, I think, and as Aboriginal Affairs Minister, my role is to listen, to listen to all of those views, to sit with uncomfortable conversations. I think it is really important and it is incumbent on all of us to listen to each other and hear sometimes the difficult things that people have to say, and to listen to understand not just to respond. So I think that is really important, that's the work that I'm seeking to do with Tasmania's Aboriginal population as we kind of work together and walk together towards a better future for all Tasmanians.
JOURNALIST: Aboriginal identity was a big topic that came up. Who should have the final say on whether someone's Aboriginal or not?
ARCHER: Aboriginal people are the holders of identity. That is a matter for Aboriginal people to determine and not a matter for governments to determine.
JOURNALIST: Firearms legislation consultation finishes tomorrow. Does that hold much weight given Felix Ellis seems to have already made up his mind?
ARCHER: Look, I think the consultation, as it is with all legislation, is really important and as I've just said, it is really important to listen to the views of Tasmanians. We have worked carefully in coming to bring forward this legislation to balance a range of considerations, but importantly putting public safety at the heart of those deliberations and those considerations. We've put forward a draught proposal and we've put it out for consultation and we look forward to seeing what those submissions say.
JOURNALIST: Are you open to amending the legislation?
ARCHER: I think that is the legislation generally, is that it goes through a process. The government will always endeavour to put out draft legislation that we believe gets the balance right, whether it is on this legislation or any other. We, of course, then consult with stakeholders in the wider community in the formation of the bill that goes into the parliament. And then, of course, the parliament does its work as well. That is a normal process, and it is important to have consultation along the way as a continuum of that process as well.
JOURNALIST: And there's been calls for updated stadium costs, obviously off the back of a motion in Parliament. When is the government going to be able to provide that figure?
ARCHER: Well I think there are two parts to this. One is that these are calls that are coming from the Greens who have made it unmistakable that they oppose this project and that they will do everything that they can both to slow it down and to blow out those costs, and ultimately they want to see that project fail. We do not. We want to see that project progress and succeed. The second part of that is that this project, like all major infrastructure projects, has rigorous assessment processes for contracts and procurements. What the Greens are actually seeking to do here is to circumvent that and to actually, I think, disrupt the integrity of those processes. These are robust regulatory and probity processes related to procurement and they should be allowed to run their course.
JOURNALIST: So they won't be getting an answer anytime soon?
ARCHER: It is part of the process to assess tenders and procurement as it is with all projects that there are procurement guidelines around that, that there are rules around that, and it wouldn't be appropriate to give those kind of- that kind of information on the way through because it actually compromises the integrity of those processes.
JOURNALIST: Thank you.