STEWART BRASH, HOST: Let’s talk about mental health because we've been talking a lot about this with World Suicide Prevention Day. Now, like a majority of our health services, the mental health sector here in the centre faces real challenges when trying to get staff to the centre, and if you're looking to speak with a psychologist you might be waiting a while for a face-to-face and you might maybe need to do telehealth appointment instead. Our bush services are thin on the ground and in some cases non-existent. This morning the federal government is announcing that Alice Springs will soon have a free walk-in mental health support and care centre. A new Medicare Mental Health Centre is set to open. The centre will offer mental health support and care for people in distress without the need for an appointment, referral or mental health treatment plan. Emma McBride is the Federal Assistant Minister for Mental Health and Suicide Prevention and the Assistant Minister for Rural and Regional Health. Good morning, Minister.
ASSISTANT MINISTER EMMA MCBRIDE: Good to be with you, Stewart.
BRASH: Can you just explain what this Medicare Mental Health Centre is?
MCBRIDE: Medicare Mental Health Centres are free, walk-in services that we're providing in the heart of communities to reduce any barriers to access mental health support and care. As you mentioned, Stewart, a person won't need a referral from a GP, they won't need an appointment, and they'll be able to access both clinical and non-clinical support for free, close to home, when they need it most.
BRASH: Yeah. In what sort of circumstances would you expect a person to use this centre?
MCBRIDE: We've opened, now 45 of these centres across the country. What we're seeing is people in distress who need information and advice, some people with ongoing more moderate to severe mental health concerns also getting wrap-around support, and importantly support for family and kin as well because often they need support themselves in supporting their loved one.
BRASH: Okay, if I’m having an acute mental health episode, do my family take me there or do they take me to ED in Alice Springs, which has got Ward 1, which of course is a psychiatric ward here?
MCBRIDE: I’m a mental health clinician myself and I worked in acute inpatient services. Why we're designing these centres and rolling them out is to give earlier support for people so distress doesn't escalate to crisis so that they can have support in their community and close to home. But if someone is in an acute crisis, then the acute service at the hospital would be the most appropriate place for them to attend.
BRASH: Okay, so if I'm having a psychotic episode or a family member is, I would be better off still to go to ED?
MCBRIDE: And this is what we're trying to do is create a whole system of care. Depending on the circumstances of the person at that time, what best meets their needs. So if someone is in early distress and needs some support, perhaps some counselling, some input from a social worker, then a Medicare Mental Health Centre would be the most appropriate place for them. But if someone is experiencing an acute psychotic episode, then yes, the inpatient unit would be the most appropriate and safe service for them.
BRASH: Everyone I can hear on the text line will be asking, where will this be? When will it be open?
MCBRIDE: It'll be opening in the coming months and NT Primary Health Network is commissioning the service with Neami and the Central Australian Aboriginal Congress. And the location will be in Alice Springs and will be determined in co-design with the community to make sure it's accessible, that people can easily access it and that it meets the needs of local people in the community.
BRASH: Okay, so we don't have a location as yet, but you reckon we'll be open within months?
MCBRIDE: Yes, these services, once the commissioning process has started and the providers, in this case, Neami and Congress, have been commissioned, can be up and running very quickly.
BRASH: Okay. We've got an urgent care clinic in the Northside shops. It's probably one of the busiest urgent care clinics in Australia, I'm told. Over 100 people present there every day. Will it be possibly co-located there?
MCBRIDE: I think really this is a decision for Neami and Congress working with the community, but I'm sure that a very convenient and central location will be determined.
BRASH: And this will be for everyone, this clinic? Anyone will be able to use it?
MCBRIDE: Yes, it is. It's open to anybody. As I said, it's free, it’s walk-in. And I know will make a really big difference to access to mental health support and care within Alice Springs.
BRASH: You know, and I'm sure people have told you how hard it is to get staff in the Northern Territory in Central Australia. Where will it be staffed from? Because we know, you know, we have even fly-in, fly-out staff in some cases. So how will you staff it?
MCBRIDE: Staffing and workforce is a challenge that persists across Australia. Workforce shortages and both distribution challenges are ones that services face day to day. As a mental health clinician myself who's worked in the regions, it's something that I've experienced. But we are investing strongly in a pipeline of workforce including, we've announced, 150 First Nations psychology scholarships. You'd be aware that Charles Darwin University will be having a medical program that will be commencing, expected in 2026. And we're also developing a peer workforce. So really looking at people with their own lived and personal experience and how they can bring that to supporting others, particularly within this clinical and non-clinical model of care.
BRASH: Still a lot of answers to be questioned. You mentioned another body. You mentioned Congress. Everyone knows Congress in this town. Who's the other organisation you mentioned there?
MCBRIDE: Neami. Neami are a very experienced provider of mental health support and care and they've been commissioned in other parts of Australia as well to be able to provide Medicare Mental Health Centres in partnership with local service providers.
BRASH: Hours of operation. Now we have, as I said, an urgent care clinic which gives after-hours service. Will this be an after-hours service or will this just be working business hours?
MCBRIDE: They're typically open extended hours and that will be part of the final model of care. But often in other parts of Australia, they're open on Thursday evenings or on Saturdays. Some are open across seven days a week. And so I would expect in Alice Springs that given the funding investment, that this will be open extended hours, including through the weekend.
BRASH: We know in bush communities there is a lack of service. We know in bush communities there is an under reporting of people suffering health episodes. What is this going to do in those circumstances, because reality is this is for Alice Springs. What about in remote communities? What services- what more can be done to ensure people actually have access to services often in places which are hundreds of kilometres away and hours away even by air?
MCBRIDE: The intention of these services is that there is a central service that will be located in Alice Springs with outreach to surrounding communities. There will also be a virtual network of psychologists and psychiatrists that we're setting up nationally to support these centres, so that wherever somebody attends a centre across the country, they’ll be able to get the support and care they need.
BRASH: It is World Suicide Prevention Day. What can you say about whether or not this centre will have an impact on reducing our appalling rates of suicide here in the Northern Territory? Because unless we're seeing those drop, is this really playing a role?
MCBRIDE: Well, suicide is complex and it's individual. And typically when someone dies by suicide, there's normally three or four drivers to that distress. It might be financial pressure, relationship breakdown, childhood trauma. In some instances as well, mental health or psychological distress. I think what these services will be able to do by providing information and support earlier to people themselves and to those who are supporting them to be able to reduce distress, to increase the protective factors, and hopefully to play their role in helping to reduce suicide and suicidal distress in Alice Springs and across the country.
BRASH: This isn't necessarily a question for the federal government, but I'm sure they can support. Alice Springs Hospital has one mental health ward. It is mostly for adults, Ward 1. There is no dedicated children's ward or children's beds suffering from mental health issues. And I know many families have suffered episodes with their children who need the kind of care you’d get in a dedicated specialist psychiatric ward for kids or at least some beds. Is that something the federal government can help deliver to Alice Springs? Because there is an undoubted need for it in a place like Alice Springs.
MCBRIDE: And yesterday I visited the new Kids Hub, the Medicare Kids and Family Hub, which started in February but was fully operational in March. And the Kids Hub is designed exactly for that, for children aged 0 to 12, for their families and caregivers, to give them early intervention, better wrap-around support and care. And having visited yesterday and heard from Fi, one of the Aboriginal health workers, there's been a really strong interest in the community, particularly through preschools and local schools. And this service is one of 17 that we are opening across the country. But this one is particularly designed and led by First Nations people through Congress.
BRASH: [Talks over] But Minister, I was talking about psychiatric beds for kids, like for acute care beds, not- I mean, this sounds like a support service. I'm asking about beds. Is there anything the federal government can do to ensure that we do get a service and beds for acute psychiatric episodes for kids, for teenagers?
MCBRIDE: The Commonwealth is working very closely with the Territory Government, including through health and hospitals reform and investment. We also are now going to be rolling out across the country more specialist youth services. But in terms of acute services, as your listeners would be aware, they're directly run by the Territory Government. But as the minister responsible, I'm really pleased to see that the strong investment that is coming through the Commonwealth and then flowing through...
BRASH: [Talks over] But do you acknowledge the absence of those beds has a real impact on the town? We're 1,500 kilometres from Adelaide, 1,500 kilometres from Darwin. What I'm trying to say is, do you believe there is a need to have those sort of acute beds for Alice Springs Hospital?
MCBRIDE: What I understand, having been a mental health worker myself but particularly for children and young people, the earlier intervention that we can provide and the better support we can provide in communities means that young people can be better supported to thrive and are less likely to need those sorts of services…
BRASH: [Talks over] I've got to move it on but I take it we haven't really dealt with that that issue at all.
Can I talk about something which is very front of house and front of mind here in Alice Springs? Now you are the Minister for Rural and Regional Health. We have several GP clinics in our town who are likely to close within the next year. The GPs are retiring, of retiring age. They find it very hard, we understand, to sell their GP clinics. Now the local college, and Sam Heard is the chair of the local college of GPs in the Northern Territory, has called for the federal government to subsidise remote GP practices the same as how pharmacies are subsidised as well. I think it's about $100,000 a year. How- will you look into that as a way to keep GP clinics in our town? Because at the end of the day, GPs are often the front line when it comes to mental health. Will you look at that issue? Will you look at that particular idea from the Royal College of GPs here in the NT?
MCBRIDE: From hearing from GPs locally and across the country, about one in two presentations to GPs often have some mental health concern. We're working very closely with the Royal Australian College of General Practice including the remote and regional, the AMA and others, to make sure that there's the right investment to ensure that GP practices can remain open. We also have …
BRASH: [Talks over] What does that investment look like, though, Minister? And this is the question: will you look at subsidising those GP clinics to stay open? Because it sounds like from the college's point of view, that's what's required.
MCBRIDE: The Commonwealth has made significant investment in general practice, including tripling the bulk billing incentive that will be extended to all patients from 1 November. There are also particular grants and support available to practices in thin markets or in communities where practices are at risk and it's something that we work with the department to do…
BRASH: [Talks over] Would you look at subsidising practices to stay open, Minister? That's the question.
MCBRIDE: Yes. The Commonwealth has through individual grants in thin markets and working through the department has looked at subsidising and other incentives that will make a practice viable.
BRASH: Will that be available here in Alice Springs for those practices who are looking to be sold? Because that's the reality. If you can't find a buyer, that practice closes. Some of these practices have 8,000 patients on their books. So you will look at that?
MCBRIDE: Yes.
BRASH: Okay. I'm going to follow this up with both the Royal College, but also with you, because I think a lot of people listening here will go and see our GPs and we'll say if you close, I've got no primary health care. And to be honest that sounds like the worst case scenario in all ways. So you will look at the issue of maybe subsidising them to $100,000 like the college has asked?
MCBRIDE: There are, through the Commonwealth, and working with the department, there are examples of other investments or subsidies that have been provided to practices in similar situations. And of course our intention is to properly support primary care. As a pharmacist myself and someone who works in a regional community, I'm determined to make sure that every Australian, wherever they live, has access to primary care. And this is on top of our already multi-billion dollar investment in bulk billing, which is improving access in more regional communities…
BRASH: [Talks Over] Minister, we've been there already. I'm going to let you go. I've got to go as well. But thank you for joining us this morning.
MCBRIDE: Good to be with you.
BRASH: That is the Federal Assistant Minister for Mental Health and Suicide Prevention, Emma McBride.