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Child and Youth Mental Health

Cassy O'Connor MP  -  Thursday, 30 May 2019

Tags: Children and Young People, Young People, Mental Health, Coronial Inquest

Ms O'CONNOR (Clark - Leader of the Greens) - Mr Deputy Speaker, that was the clearest statement we have had from the Minister for Health on the situation in the child and adolescent mental health area of public policy. It is clearer than what we heard from the minister this morning during question time when he said that some of the new beds in the Royal Hobart Hospital will be mental health beds - some of them. I took note when you said that because we, through our questions, were seeking clarity. On page 104 of Budget Paper No 2, Volume 1, it says -

These new beds will be progressively rolled out from 2020-21, including 10 new intensive care unit beds and a dedicated 16-bed adolescent unit. Clinicians will determine the final mix of services and beds.

We asked about that and you said, 'Some of those beds will be mental health beds'.

Mr Ferguson - If I said that, that was clearly an error on my part or a misunderstanding on yours. A 16-bed adolescent unit. I have clarified them all

Ms O'CONNOR - Thank you, minister. That is an enormous relief to us. It is a different issue from the matters that are raised in the Auditor-General's report. I have a terrible sense of déjà vu when we discuss in this place child and adolescent mental health. Lin Thorp in the Labor government at the time promised an adolescent mental health unit at the Royal Hobart Hospital. That never came to bear. Now it seems there is an investment in a dedicated mental health unit. Boy, do we need it.

As we have discussed in this place, young people are under enormous pressures that I do not think we were when we were their age. There is a fragility among our young people now which we need to recognise. There is increasing drug use among young people. It was raised this morning in the media by paediatrician, Dr Anagha Jayakar, who said -

We have a huge problem with substance abuse in young people … and we have no safe, secure place for them to be able to detox, and the ward is not the right place and neither is Ashley [Youth Detention Centre].

This is an issue the minister is going to have to grapple with in this term of the Parliament - the increasing complexity of the mental health challenges for children and young people are facing, the risks that are ever-present for children and young people and particularly adolescents who engage in risk-taking behaviour. We have all been there but adolescent mental health is a different picture now than it was even only a few years ago.

One of Coroner Olivia McTaggart's most powerful investigations was into the death by suicide of six young people in 2012. She talks about the underfunding of the Child and Adolescent Mental Health Service and I would like the minister to detail the level of funding that is going into CAHMS. As Dr Woodruff detailed, we know that the waiting lists for young people to get into CAMHS is long and any time we have someone in a state of mental distress on a waiting list or waiting in the emergency department for hours and days, it is increasing the risks of harm to that person.

One of the key recommendations of Coroner McTaggart in this profoundly important and moving report is the recommendation that there be a dedicated inpatient unit for adolescents or young persons between the ages of 12 and 25, designed around the needs of that cohort, including for the treatment of those suffering from an acute state of mental illness or suicidality. Coroner McTaggart recommends that: CAMHS be staffed to the equivalent of best practice for such an organisation so as to provide an adequate service for children and adolescents with mental health issues to ensure there is no freeze in accepting referrals; eliminate a wait list for referrals; provide for clinical directorship of this service; allow access to a wider group of adolescents suffering mental health issues; develop a comprehensive early intervention program for the 0 to 3 age group and their families, including to identify those children at high risk and focusing on early intervention in the infant attachment period; and develop a school-based multi-systemic approach to developing mental health disorders for the 5 to 12 years age group.

There is a body of work here for the ministers for Health and Education and Training to do together, to make sure we have the psychologists and counsellors in our schools who are able to identify emerging problems in students, to work with those students and their families, to protect them from mental ill-health and to provide support where it is needed. We are concerned there is not enough resilience being taught to young people in our schools and we would like to see the two ministers work more closely together on that.