Radio interview with Assistant Minister McBride and Tom Oriti, ABC NewsRadio - 10 October 2023

Read the transcript of Assistant Minister McBride and Tom Oriti on World Mental Health Day; National Mental Health Workforce Strategy; Voice to Parliament.

The Hon Emma McBride MP
Assistant Minister for Mental Health and Suicide Prevention
Assistant Minister Rural and Regional Health

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TOM ORITI, HOST: Well, today's World Mental Health Day and according to the Australian Bureau of Statistics, more than two out of five Australians will experience a mental health issue at some point in their life. Yet time after time, we hear that people are not getting the basic mental health support they need, due to a lack of services and funding at a grassroots level. Emma McBride is the Assistant Minister for Mental Health and Suicide Prevention and joins us now. Good morning. Thank you for your time.

EMMA MCBRIDE, ASSISTANT MINISTER: Good morning, Tom. Good to be with you.

ORITI: According to the Institute of Health and Welfare in Australia, governments across the country are spending $11.6 billion a year on addressing mental health yet it does seem as though the mental health of Australians is getting worse. I mean, is that the case based on where you're sitting? Or are we just perhaps more aware of the issues nowadays?

MCBRIDE: As you mentioned from the recent national survey, we know that, consistent with the figures in 2007, one in two Australians in their lifetime, almost half of Australians in their lifetime will experience a mental health condition and one in five in the previous 12 months. Those figures have remained fairly stable but there has been an increase in distress, some part of that could be attributed to the COVID-19 pandemic. And we're seeing that distress particularly experienced by younger people and earlier in life, which is why that is a particular priority, of not just the Commonwealth Government, but the states and territories. One of the things that was necessary was really looking at workforce, we know one of the biggest barriers to access and availability of care is having the right workforce in the right place. That's why today I'm really pleased to launch the National Mental Health Workforce Strategy, under the National Mental Health Suicide Prevention Agreement, that the Commonwealth, States, and Territories made workforce a national priority. This strategy is now being launched today to give us a clear pathway to be able to grow the mental health workforce to attract it to retain it and having the right places where people need it.

ORITI: Because part of the issue here is that the health system in general is overwhelmed by this. So mental health experts say fundings being directed towards expensive to run, desperately overstretched, emergency services at the bottom of the cliff rather than community services that prevent people from reaching that crisis point. So this 10 year Mental Health Workforce Strategy, you've just mentioned there what's in that plan, that perhaps provides more resources for that grassroots and community preventative care?

MCBRIDE: What we know at the moment, based on the 2019 targets, we're about 32 per cent short of our workforce, and the current settings without any reform, that is expected to grow to 42 per cent by 2030. So we have to work to address the current shortages now and make sure that we've got a workforce that is future ready. One of the things that we're doing is really looking at that earlier intervention and prevention. And that's where community based services can make a real difference. I'm going to be visiting today the Aboriginal Medical Service in Orange who have a psychiatrist and a psychologist, but also a community based program. We know that often community-based solutions are the most effective solutions. We know that giving them more flexibility and to be able to respond in a culturally safe way to the needs of their community is what's very effective. And that's what I've seen in places like Orange and right around the country.

ORITI: Orange, Central West New South Wales, talk about a regional centre there as well. I mean, is it a particularly acute problem there in terms of apart from anything else, attracting staff at the grassroots level?

MCBRIDE: One of one of the biggest challenges we see is being able to attract and to train and retain staff. And we know that part of that is still the stigma that persists about working in mental health. As a former mental health worker myself, I know that stigma persists within health workforces. So there's a cultural shift that needs to occur. We also need to look at where that workforce are distributed. We know that there's an uneven distribution, by sectors, by settings, and by location and that's something that we're really determined working with the states and territories, but particularly through the Primary Health Networks that have that regional footprint. And do those community needs assessments to understand where the gaps are, and where we can best recruit to retain to meet those needs now and into the future.

ORITI: I mean, some concerning stories coming out patients with severe mental illnesses having to sleep on the floor or couches inside Queensland's largest hospital. That's one that's coming out due to chronic bed shortages there. And a nurse has turned whistle-blower she said one woman had to wait eight days for a bed, others being placed in alternative wards, adults in the adolescent ward, adult patients in the drug and alcohol ward, for example. I mean, how is that happening?

MCBRIDE: Well, many health workforces are stretched, mental health and more broadly, this is something that's happening globally. But it is also affecting us in Australia and we see it more amplified, the further you are from a capital city. So what we're doing, and particularly working through the Primary Health Network and very closely with the states and territories, including through this National Mental Health Workforce Strategy, is to make sure that we can attract and train the right workforce. Part of this is an investment in our psychology pipeline. We know that there is an acute shortage of psychologists and there's bottlenecks along the way. So, through the budget, invested $91.3 million in creating 500 new postgraduate psychology places, funding 501 new internship programs for provisional psychologists, and providing 2000 fully subsidised supervisory training places because we know that the right supervision and equality placement mean that someone is much more likely to either be open to a career in mental health or continue to work in a career in mental health.

ORITI: I've got to ask about training as well. We're all shocked to hear the recent story about you know, a teenage girl raped by a fellow patient while in a mental health care ward in Perth Children's Hospital and a court hearing raised concerns over the staff on duty, failing to detect the incident because they gathered at an office out of fear of the perpetrator, who displayed concerning behaviour earlier in the day, they didn't call security for support. Does that concern you? What's been done to make sure something like that never happens again, because that sounds like that does come down to staff training very much.

MCBRIDE: I've worked in acute adult inpatient units, in high dependency units where people have been bought in by ambulance, or by police in distress and in crisis. We need to make sure that the staff within those units have the right training, but also have the right support. Sometimes staff are working back to back shifts, sometimes staff are working beyond what they should reasonably be doing within their scope of practice. So this is something that again, we need an overall workforce strategy to pull this all together. I mean, it's absolutely unacceptable, what happened in that hospital, and we are determined to make sure that something like that doesn't happen to someone, again, in a place where they should be safe, and where they should be getting the right treatment, care and support. And that also relates to the staff as well, we need to make sure that they've got the right training, that they've got the right accreditation, that they've got the right supervision, to give them the right resources to give them every chance to be able to provide that care and support that, I have to say is mostly what happens. But you're right, these incidents have occurred, and we need to make sure that they don't happen in the future.

ORITI: It's before the courts, and allegedly raped was what I should have said there, by a fellow patient in that case. It's also a broader issue outside clinics, right. I mean, we're vastly less likely to be part of a sporting club or church or another community group compared with Australians in recent years, according to research conducted by well now, your Federal Minister for Charities, former economist Andrew Leigh, the average Australian, this interested me, has four to five fewer friends, knows two to three fewer of their neighbours than they did in the mid-1980s. I mean, how can we help people to connect again, because feeling a part of a community is one of the strongest ways to improve mental health, right?

MCBRIDE: It is social isolation, and it's something that was exacerbated through the COVID-19 pandemic, but social isolation, a disconnection or lack of belonging is one of the drivers of distress. And we need to help to boost those protective factors. When I visited local communities, and seen some of those local grassroots initiatives, where we really see strong success, where people then feel connected. I'm from the Central Coast, and there are 15 local surf clubs, and I was on patrol over the weekend. And that kind of connection when people are part of the club, and whether they're with people that share their values and people from their community. So as a government, I'm working very closely with Dr. Andrew Lee and also Dr. Michelle Lim, and the government has invested through the medical research Future Fund, through the Million Minds Round in understanding better how people can be better connected, what are the barriers to that, and how we can make sure that is improved in Australia, particularly for older people, but also younger people who felt the social isolation and disconnection through COVID particularly acutely.

ORITI: I've got to ask you, well, I've got you there, given you're with the government, of course, a few days out now from the Voice to Parliament Referendum. Yesterday on the program, we spoke with Michael Mansell, who calls himself part of the progressive no campaign, he's from Tasmania. And he made several arguments, can I just play you a tiny bit of audio, because I'm keen to hear your thoughts. I'm just going to play it now.

MICHAEL MANSELL: The normal way to advance the cause of Aboriginal people is through legislation. If you want to shore up Native Title, then you legislate, if you want to overcome discrimination you get the parliament to enact anti-discrimination laws. It was always going to be a tough ask, to in instead of going through the normal challenges of legislating, which is a pretty direct way of getting a response from the politicians, whether they're going to give land back or give housing to Aboriginal people. But instead of going that direct way, this idea of putting a sort of a plebiscite or a referendum to the Australian people, about a plan for the advancement of Aboriginal people was always going to be a tough ask. I thought it was very poorly thought out. And you can see that polls on that.

ORITI: Michael Mansell calls himself part of the progressive no campaign. I'm just keen to hear your thoughts on that. I mean, do you feel as though the Prime Minister and the government perhaps missed an opportunity or, or made an error in terms of going down the referendum path rather than introducing legislation because it does seem to be an argument we're hearing time and time again, from the no side.

MCBRIDE: The Uluru Statement from the Heart is a very generous offer, from First Nations people to all Australians. It's not an offer to politicians or members of parliament. And so the referendum process is something that the Prime Minister committed to when he was as an Opposition Leader, which he has, and we have now passed the enabling legislation to facilitate and we're really determined to get over the line. In Orange last night, I was in a room close to 80 Yes supporters who are in their community volunteering on pre poll having conversations and encouraging other Australians to be big hearted, to accept this really generous offer towards unity. And in my role as Assistant Minister for Rural and Regional health, I have seen firsthand whether it's First Nations women and their elders talking about birthing on country in Alice Springs, or the COVID-19 vaccination immunisation rates in Yarrabah in Far North Queensland, or what I saw in Wagga just last week about a program for infant and maternal health. When First Nations people have a say, a direct say in the policies, and programs and impact them, we can close the gap. And those examples, those pockets of success through a referendum and through a voice of the Constitution, we'll be able to see scaled up and rolled out right around Australia. So in the five days left, I will continue adding my voice to this campaign because I believe it's a way that we can close the gap. We can't have a society with First Nations people who are twice as likely to die by suicide as a non-Indigenous person, where a young Indigenous man is more likely to go to jail than university, where the gap in life expectancy is eight years. This is a chance, one in a generation chance to accept this very generous offer. And I'll keep campaigning optimistically and hopefully until referendum day.

ORITI: Minister McBride, thank you for joining us. Appreciate your time.

MCBRIDE: Good to be with you, Tom.

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