Mental Health

 

JENNY BROCKIE: Welcome, everybody.  Good to have you all here.  John Mendoza, I'd like to start with you -you were the Government's senior adviser on mental health. You resigned in frustration earlier this year when Kevin Rudd was prime minister - your reaction to today's announcement by Julia Gillard first?

 

PROFESSOR JOHN MENDOZA, FORMER GOVERNMENT ADVISOR: Well, Jenny, the contrast between the announcements by Tony Abbott just before the election began and the announcement today - the contrast is big, the difference is big and it starts with a big number difference. One proposal ends with a B and the other one ends with an M. And we need more Bs in terms of the investments the Government is prepared to make in mental health. We need to grow the investment that really began with John Howard and Morris Iemma leading COAG in 2006. We need to build on that investment substantially.

 

The second difference is that one plan - the Coalition's plan - is very much targeted at building a whole new service structure for that group of Australians who virtually get no service at all at the moment and for that group of Australians who have the highest incidence of mental health problems and who have the longest consequences of not getting access to services - and of course I'm talking about young people, so their proposal is about building a whole new service system.

 

The Government, on the other hand, today, has really taken a scattergun approach, not really laying out a clear vision or direction for their proposal but really cherry-picking a number of fairly easy targets in regards of suicide prevention investments. Many of them are not big enough to make a difference - we may talk about that later but that is the big differences I see in what has been outlined here.

 

JENNY BROCKIE: You sound like you're clearing favouring the Opposition policy?

 

PROFESSOR JOHN MENDOZA:  Look, its streets ahead. It's literally comparing an old clunker to a brand new motor vehicle in terms of differences. What the Government has today is a clunker with a new muffler, a paint job on one side and changed the steering wheel. What the Opposition is offering is a modest small car to take us forward.

 

JENNY BROCKIE: Mark Butler, a clunker – government policy a clunker?

 

MARK BUTLER, PARLIAMENTARY SECRETARY FOR HEALTH: No, I don't agree it's a clunker. There are some very significant differences between the Coalition's approach to this and the Government's and what the Government has done which the Coalition would abolish if it were elected in a few weeks' time is to put a significant amount into building our general primary care infrastructure. We don't have any health system for example in Australia in 2010, while pretty much every other sector on the community and every other industry is working electronically, we continue to work with paper. About $0.5 billion – we think is important to build any health system for Australia, which will obviously have benefits for people with mental health as well, so those things – building primary health infrastructure – would all go to pay for the $1.5 billion into Headspace…

 

JENNY BROCKIE: You're suggesting it's an either/or scenario. That's what the Opposition has decided - does it have to be either/or for the Government?

 

MARK BUTLER: Well, we think there is a real importance across the community to build primary care infrastructure, to build after-hours GP services, to build a new health network and on top of that, build additional investments into, for example, Headspace, which will be doubling over the next three years, expanding the EPPIC program that operates in Victoria and, as we've seen today, very significant investments into the prevention of suicide. Now, I don't agree there are easy targets for suicide - there are about five or six Australians who commit suicide every day. A significant additional number attempt suicide and we've not seen a significant improvement in those numbers for years. We think a package today, while targeting a broader population than is targeted by Headspace and EPPIC, targets a very specific area of need for the community.

 

JENNY BROCKIE: Headspace of course is the operation, Pat McGorry, that you're involved with as well. I just wonder as Australian of the Year, what your reaction is to the Government policy? We'll get on to the Opposition in a moment, but you've been pretty scathing today.

 

PROFESSOR PATRICK McGORRY, PSYCHIATRIST: Well, I think what they've announced today, the Government, is a suicide prevention policy with a few additional issues covered. It's not really a mental health reform policy. That's what Australia needs. It's one brick in the wall and that's very welcome. I certainly wouldn't say that that's not a positive move, but the big issue is a building a 21st-century model of care for Australia. The best insurance policy to reduce suicide is making stigma-free accessible mental health services for all stages of life and particularly, as I think Mark and John have emphasised, for young people. Headspace is one building block - it's very successful but it's struggling at the moment because of a lack of investment. The new investment announced earlier this year will help to strengthen it, but not if we, if we, if we, um, try to do 30 sites with that amount of money. It just won't work. So we need a much more substantial commitment, which Headspace asked the Government for in February.

 

JENNY BROCKIE: That's just Headspace, though. There's a lot more to mental health than just intervention for young people. It's a much bigger issue than that. Julia Gillard has said she'll make mental health a priority for the second term. You don't believe her?

 

PROFESSOR PATRICK McGORRY:  Look, I think the Prime Minister is sincere on this but for this to happen, there has to be money allocated in the forward estimates, because otherwise, there won't be the financing for that reform. So I do believe, you know, that she does understand and is committed to mental health, but I just don't understand how it will happen without the B figures rather than the M figures.

 

JENNY BROCKIE: The billion figures?

 

PROFESSOR PATRICK McGORRY: Absolutely.

 

JENNY BROCKIE: No billions, Mark Butler.

MARK BUTLER: The important thing about mental health - and I agree with Patrick - that our announcement today targets a particular area of need and the Coalition's announcement targets a particular area of need, but our view and the view of COAG, the premiers and the prime minister, when they met in April is that we need to do a fair amount of work to get the different State arrangements into some kind of line if we are to have an overall national policy. There is an amazing variety of different efforts going on State by State. There's about a 30% to 40% gap in the expenditure by States, who do most of the heavy lifting in the area of severe mental illness. So we've got a fair bit of work to do, which is to be reported back to the premiers and the prime minister, whoever the prime minister happens to be, next year. It is identified as a work priority, Julia Gillard, who's got a significant background of interest in mental health, whose father was a mental health nurse, has indicated that if she's re-elected, this would be a significant second term agenda along with aged care.

 

 

JENNY BROCKIE:  That's very non-specific in terms of actual dollars, isn't it?

 

MARK BUTLER:  Well, well, well, we've taken the view, as we did in the general health system, that you need to get some of the foundational elements right before you move to new investment. Now in the meantime, we've made additional investments in the area of youth, as I've said with Healthspace and EPPIC that was announced some months ago. Today, some significant additional investments in the area of suicide, but that is that we've said, Julia Gillard's said, Nicola Roxon has said, there is more to be done in mental health and if elected in a few weeks' time, Julia Gillard and Nicola Roxon have said that we will do more.

 

JENNY BROCKIE: OK, quick response, Pat, because I want to go on to Peter Dutton.

 

PROFESSOR PATRICK McGORRY:  John Mendoza and I and David Crosby from the Mental health Council presented a very clear plan that points out what the Commonwealth can move on now and rapidly upscale, including Headspace and EPPIC which is actually a trillion investment so far in EPPIC. There's a whole series of things the Government could do right now without worrying about the machinations of COAG and State governments. That plan has been presented and it's in the hands of the Government

 

JENNY BROCKIE:  Peter Dutton, I want to involve you here because the Opposition's laid a lot more money on the table. What are you going to do with that money?

 

PETER DUTTON, SHADOW MINISTER FOR HEALTH: Well, we're going to roll out a national scheme based on advice by people like John Mendoza, Pat McGorry, Ian Hickey, David Crosby and others. These are the experts that have been working in the space for a long time - they're world-renowned experts. But also it was a key recommendation of Mr Rudd's own review, the national health and hospitals recommendation talked about mental health as being a priority and Tony Abbott and I took a decision that we needed to bite the bullet when it came to mental health. So we talked about rolling out an additional extra 60 Headspace sites – funding properly the….

 

JENNY BROCKIE: This is early intervention for young people.

 

PETER DUTTON:  Yeah, so targeted across the program, targeting young people between the ages of 12 to 25. All of the evidence that was produced to us showed that if you were able to have that early intervention, you could provide most assistance to those young people, turn their lives around where possible, and we don't need the same promises at this election that Kevin Rudd made at the last election. I think the evidence is on the table. In addition to the 60 Headspace sites, we talked about another 20 EPPIC centre centres, the Early Psychosis Prevention and Intervention Centres and on top of that 800 acute and sub-acute beds helping approximately about 100,000 young Australians each year.

JENNY BROCKIE: So where will those beds go? And who are they for?

 

 

PETER DUTTON:  Well, around the country, in major capital cities, but also in regional and remote areas as well. It is about establishing that network that people have been working on for years. With all due respect to - Mark is here tonight because Nicola Roxon doesn't want to be. The reality is that the architecture has been set up for us - we met with these gentlemen and many others. We listened to mental health nurses, to people working in the sector around the country. This is the architecture that you need to adopt, there is no need to stall it any longer.

 

JENNY BROCKIE: OK - Can I just get you to be a little bit more specific about the architecture? Where are those beds, will they be in hospitals, where are they going to be?

 

PETER DUTTON: The 20 EPPIC centres ….

 

JENNY BROCKIE:  No, the 800 beds you talked about.

 

PETER DUTTON: With each of the 20 centre, there would be 40 beds, 20 acute and 20 sub-acute on average and that's the model that's been shown to work. It's a step-up process, if you like. Young people in particular receive advice and information from the Headspace centres but to give you a practical example, it might be that a family with a teenage child who's attempted suicide at the moment has very little by way of options for that family, could make contact with the Headspace site of the EPPIC centre. There may be a need for admission. It also reduces a lot of pressure on our emergency departments –

 

JENNY BROCKIE: So it's primarily - I'm sorry. We have a lot of people here who want to talk. I want to make clear it's primarily for young people, those beds. It's not for the broader community that have mental health problems? It's focused mostly on young people?

 

PETER DUTTON: It is - two points, Jenny. One is that the early intervention is proven without any doubt to work. Secondly, if we can try and have that targeted assistance, I think we free up space in the rest of the health space, mental health space, to provide that assistance to people above that age.

 

JENNY BROCKIE: OK. What about the fact that your money is at the expense of other things? Like GP Superclinics, electronic health records. There are other things that people aren't going to get as a result of this money.

 

PETER DUTTON: Yeah, well, the most important point to recognise here is that we haven't announced yet our policy on health more broadly and we'll do that before the election. We strongly believe in e-health. We set up e-health when Tony Abbott was the health minister. In our country we spent about $5 billion on e-health over the last ten years and we still don't have systems that talk across streets to each other, let alone across States. I want to make sure that money that's been spent in e-health and there is funding already going out to 2012 in e-health - that it's spent appropriately. This is not an either/or argument. We strongly support after-hours and primary care. We'll have things to say about those measures and many others. In our mind it's not an either/or option but that's the way the Government wants to spin it.

 

JENNY BROCKIE: That's the way you've said you're going to fund it.

 

PETER DUTTON:  We said there are measures that the Government has announced like the GP Superclinics, where they promised 36. In the years since that promise was made, three out of 36 are fully operational. The other point about GP Superclinics, Jenny, and very importantly, is that some doctor practices which are operating now in competition with the Government model are on the brink of closure. That's why we see savings in that particular area.

 

JENNY BROCKIE: OK. John Brogden, I want to bring you in at this point because you're in a very interesting position here. You're a member of the Liberal Party. You're a former Liberal lead you're the director of Lifeline which has been promised $18 million today by the Government. You were at the Labor launch. Which side has the best mental health policy?

 

JOHN BROGDEN, LIFELINE: Look, listen, I'm not in politics any more so I'm not interested in the politics of it. I'm very happy with the $18 million that Lifeline will get because that will go to allow us to answer more calls. It will go to allow us to answer about 700,000 phone calls in three years' time. We're doing 450,000 at the moment. It will also help us - we've got about 25% of people who ring on mobile phones and that will only increase so that will be the cost of a local call.

 

JENNY BROCKIE: So you're backing the Government on this?

 

JOHN BROGDEN:  I think Pat got it right. On the specific area of suicide prevention, I think it's a good policy. I think it will make a difference and I'd be very happy to endorse any political party that supports Lifeline. So these days –

 

JENNY BROCKIE: That's where your loyalty lies?

 

JOHN BROGDEN: Absolutely and unashamedly.

 

JENNY BROCKIE: OK. Alexandra Rivers, I'd like to bring you in because you're with the NSW Schizophrenia Fellowship. You're a carer for your 38-year-old son who has schizophrenia. What do you make of this debate and the policies both sides are offering?

 

ALEXANDRA RIVERS, SCHIZOPHRENIA FELLOWSHIP, NSW:  I'm very disappointed because nobody's tackling the pointy end. It's the adults with schizophrenia what are suffering and have been suffering for years. There are at least 40,000, the missing 40,000. Where is the money for the missing 40,000? At the moment, about 10,000 adults get money for community services and they're supported and they're helped, but there are over 40,000 who get nothing. If you're going to tackle stigma, these people are the face of mental illness to the community. They're the homeless, they are the prisoners, the people in rags, the people making trouble in your shop, the neighbours who are a nuisance. If the Government doesn't provide any services for those people, any community support for those people, then it's pointless giving massages to carers, pointless giving anti-stigma programs out in the community. Until they do some work for these suffering people, they're not going to help carers and they're not going to help mental health.

 

JENNY BROCKIE:  OK. Kate Riddell, you're one of our panel of swinging voters. You live in the King Lake Ranges, which was devastated by the bushfires. Now, you raised mental health here last week just as we were finishing the show and, quite unexpectedly I might add. What do you need on the ground where you live?

 

KATE RIDDELL, ELECTORATE OF McEWEN, VIC:  Sure. Um, whilst I've appreciated hearing about psychotic disorders, they actually represent under 1% of the population. Much higher on the list are people suffering from anxiety and depression and certainly our community, we're seeing a lot more of anxiety and depression. And what I'm really interested in is not so much the GPs and the hospital funding, but what's being done in the way of preventative and holistic medicine? What's being done in terms of early intervention and follow-up support for those people suffering?

 

JENNY BROCKIE:  OK. Who would like to take that up? Early intervention for anyone regardless of their age presumedly.

 

KATE RIDDELL: We've heard about youth, but there's a whole heap - we understand a lot of mental illnesses present themselves early on. So I really congratulate both parties on their youth initiatives. But there's a whole heap of adults out there suffering from a whole heap of mental illnesses that perhaps are flying under the radar.

 

MARK BUTLER: There are a range of programs in place for early intervention and prevention. We've been trialling some, particularly for children, because we know that by early 20s about two-thirds of those sorts of disorders have already onset

 

JENNY BROCKIE: But Kate's saying aside from youth. This is the big issue here. Because there's a lot of focus on youth but there are a lot of people with mental illnesses who aren't young.

 

MARK BUTLER: If I can just say Headspace and EPPIC are focused on teenagers to early 20’s. We are also trying to focus some initiatives at primary school level through the Kids Matter program which is significantly expanded to promote mental health and resilience there. We've got some programs that are expanded through today's announcement, for example operated by Beyond Blue now out in the workplace particularly targeting men, who are hard to reach, who are resistant to accessing support and treatment. There are a range of announcements today about trying to expand the type of service that you can use, whether it's the telephone service that Lifeline uses or online counselling as well. We need to expand the options and we also need to do some work at reducing stigma, particularly for groups like men, about seeking treatment as well as early as possible.

 

JENNY BROCKIE: Kate, just quickly.

 

KATE RIDDELL: Sure, there seems to be a real focus on talk therapies and for a whole heap of people out there, that just doesn't work and I'm really interested in the support for other programs that approach things in a really different way. We've seen a few of those in our communities. We've got Horses for Hope. We've got people who have done EFT work. We've got a whole range of other community initiatives that don't revolve around someone sitting down for a chat with someone who is a psych.

 

JENNY BROCKIE:  Sam, I want to bring you in because you're from the advocacy group GetUp!. You've made mental health one of your four top issues for this election. It hasn't been playing like that until today. Certainly in the campaign - it wasn't even mentioned in the leaders' debate the other night, I don't think. How do you rate the major parties' policy now they're on the table?

 

SAM McLEAN, GETUP: It's a huge issue for GetUp! members. It's a huge issue for voters generally. As Pat and John have pointed out, today's announcement is a suicide prevention policy, not a mental health policy. It's a real shame that the government haven't told us their mental health policies yet, before the election because there are a lot of voters who are waiting to hear it and will make up their minds on it. We actually did a poll this month to find how Tony Abbott's announcement played. And Peter will be glad to hear that it's playing well with voters and about 22% of people identifying as soft Labor voters are more likely to vote for the Coalition because of it. I guess if you're in the Government right now you'd be wondering who are we losing by not announcing the policy before the election.

 

JENNY BROCKIE: Rachel, what are the Greens offering?

 

RACHEL SIEWERT, GREENS SENATOR, WA:  I want to correct your opening statement. The Greens actually announced our policy several months ago before both of the majors announced theirs. We have proposed a similar level of funding to the Coalition, who came after us, about $1.5 billion. We believe we need to be funding early intervention, more services, connection of services through GPs, more practitioners - for example, people with expertise on mental health in emergency services. Do you know you can go to an emergency service if you've attempted suicide, you go to emergency services and you won't necessarily get to see somebody with mental health expertise? We need to be fixing that. We need to be ensuring that everybody that leaves an emergency care service or some sort of - having had some sort of mental health intervention, actually has a follow-up plan, has contact afterwards. Not everybody who attempts suicide has that follow-up plan. And the policy that was released today has taken bits out of the Senate committee report which we, um - I was the chair of the community affairs committee that tabled that report. Unfortunately, it was the 24th of June, which was date that Julia Gillard became the prime minister, so it received no attention. What the Government's done has funded - picked bits out of that report which, of course, are good, but they've missed the gaping hole of mental health. Mental health is essential.

 

JENNY BROCKIE: Does that mean you favour the Coalition's policy?

 

RACHEL SIEWERT: We think we need to go further than the Coalition's policy but at the moment from the majors, they have certainly got the better policy on the table.

 

JENNY BROCKIE:  So why are you preferencing the ALP, then?

 

RACHEL SIEWERT: Because we haven't done policy for preferences. There's a whole range of issues of course that we would talk about – if you were doing preferences, would you preference over marine – another passion of mine - over forests, over climate change? Which reminds me - we put off climate change till the next election and now the Government is putting off climate change till after the election until the year whenever and now they've put mental health off for this election.

 

JENNY BROCKIE: But on balance you prefer the Coalition's policy on mental health to the government’s policy?

 

RACHEL SIEWERT:  Certainly from what we've seen from the Coalition's. It's closer to our policy at the moment and very disappointed that the ALP are putting it off until after the election. People want to know about these issues. I was up this morning talking to a community about suicide. They want to know what's on offer. What they said to me is, "You know the simple thing we want? We want a coordinator for our community to help us work out which programs we can access," because they want to deal with youth. They want to deal with men's health. They want to deal with a whole range of issues in their community and they don't know where to start.

 

JENNY BROCKIE: OK, we're going to talk to John Brogden and to others about their own personal stories and we'll look at what needs to change to address the urgent health needs of the community.  I'd like to hear a few people's stories and John Brogden, I'd like to start with you, because you battled depression very publicly. You had a very public fall from grace and then you attempted to take your own life. I'm interested in what you were like behind the scenes at the time that you were suffering in the run-up to that. I mean we saw your public face. What was going on behind the scenes for you?

 

JOHN BROGDEN:  I guess the first point to make, as you said, that I've been battling depression for some period of time. The reality is I didn't know I had depression and, you know, Pat will understand this better than most, that, you know, many people can live an enormous period of time without knowing there's anything wrong. It's a bit like having a bad left leg so you compensate with your right leg, only to discover after 20 years that you've got a bad left leg and you've been ignoring it – you have been compensating for it. For me, I had depression for probably five or ten years, certainly five years in the run-up to hitting a wall with it. What happened increasingly was that I'd be, um, you know, very... You almost put a mask on in public - you do what you've got to do in public.

 

JENNY BROCKIE: Well, you had to have a mask on. You were a politician.

 

JOHN BROGDEN: You do. You do. You literally do. And that's how that worked. And then that's - then in terms of the day-to-day and behind the scenes, I was - my behaviour was increasingly erratic. My, um, my sleeping pattern was erratic. My eating pattern was erratic. And, you know, I was not a pleasant person to be around. When my wife Lucy and I look back at it, we sort of talk about her sitting there in a quiet panic watching it happen.

 

JENNY BROCKIE: You were angry?

 

JOHN BROGDEN: Yeah, very angry and very driven - like driven beyond the normal, the normal, um, um, even the normal expectations of somebody who is driven to whatever physical or mental or professional outcome. I was very, very driven.

 

JENNY BROCKIE: And the closer you thought you were becoming, you were getting to becoming premier, did it get worse as the pressure increased?

 

JOHN BROGDEN: Yeah. One of my reflections looking back is that the better I got and the closer I got, the thinner my skin got and the more, um, the more angry I would get, the more, the more, um, I guess, depressed I would get. So yes, it was an interesting juxtaposition.

 

JENNY BROCKIE: Did you know something was seriously wrong?

 

JOHN BROGDEN: No. I do laugh about it. If somebody had walked up to me and said, "John, I think you've got depression," I of course would have thought it was a conspiratorial political plot but, look, hindsight is a terrible thing because it tells you what you should have known at the time and I look back now and it's, you know, like flashing lights. It's a psychologist or psychiatrist's dream to see it but I wasn't aware.

 

JENNY BROCKIE: In the context of this discussion we're having about policy, what I'm interested in is what could have helped you, do you think?

 

JOHN BROGDEN:  Well, there are probably a few things. Um, the first point I want to make generally - and five, ten years ago, this would not be happening. We would not be having a debate about mental illness and there would be a lot of voices in the wilderness. Five years ago, I think we began to break the back of the public ignorance, in a true sense, the lack of understanding, and the stigma associated with that, particularly with depression, you know. My friend Jeff Kennett has done phenomenal work in that space, particularly for a bloke who doesn't have depression. But it's only about a year or two ago, I think, that nobody would be talking about suicide. So I'm personally thrilled that we're talking about suicide. I mean suicide's tough. It's hard. You know, it will never be easy to understand why somebody takes their life.

 

JENNY BROCKIE:  But what could have helped you, do you think, John?

 

JOHN BROGDEN:  Sorry to wander off the point, Jenny. Thank you.

 

JENNY BROCKIE: What would have helped you? Is there anything that could have helped?

 

JOHN BROGDEN:  Let me give you this easy comparison - when I resigned and then when I went to hospital after my suicide attempt, in the month or so that followed that, I got worse, not better. Which I think probably is often the case. You think you're fine and then you're the only person in the room who doesn't realise it's going to get worse. So it got worse. And then I resigned from politics. Now, I don't regret that decision at all. I don't look back and think I should have hung in there. You put Jeff Gallop into the mix, the former Premier of WA. Geoff resigned because he didn’t think he could…I thought there was no way I'd be allowed to recover from what I'd been through and still in the public eye, but Andrew Robb has proven that in five short years - I've been out of politics five years next month - in less than five years, that's changed and my great post-political noble cause, if you like, is that we treat mental illness in exactly the same way we treat physical illness and Pat spoke about this at the Press Club, in funding in all forms, but we think about it very differently. I hope we'll look back in 10 or 20 years and regard this period as the period where we changed our attitude forever on mental illness. I think what's fascinating and once again it's great that all political parties are talking about it and the Greens and the Senate committee was fantastic, Rachel, absolutely fantastic, but the good news is that we'll look back and see this as a great period of change.

 

JENNY BROCKIE: OK. Miles, can I bring you in at this point? You're 43 now. You had a very successful career as an actor. You won a Logie, in fact, I think. You then moved into theatre. Things started to go wrong for you. When did things start to go wrong for you? How old were you? And what happened?

 

MILES BUCHANAN: Well, that's a difficult question to answer because it was all such a very gradual build-up. Um, as you said, I didn't know I was depressed. I didn't know I had an anxiety disorder. Um and it first manifested as alcoholism in my case, because I became very dependent on alcohol and other drugs and was working in theatre and it was that that my career fell apart and I was diagnosed with alcoholism and later on with depression and only years later did approximate become clear that I had bipolar disorder and again I've forgotten what was question was.

 

JENNY BROCKIE: That's quite OK. What's your situation now?

 

MILES BUCHANAN: Well, I've stabilised over the last few years. It took them a long time to find the right medications and also I've had psychotherapy. I had psychotherapy for 3.5 years with a therapist. And I'm doing much better than I've ever been at the moment, yeah.

 

JENNY BROCKIE:  Jo, you're Miles's mother and carer. There's a long history of mental illness in your family, going back some generations, I gather? You also cared for your sister. You cared for your nephew. How much support is there for families? And how much support is there for carers? And how difficult has it been for you?

 

JO BUCHANAN: Well, there really isn't much support at all. I always think of carers as being the invisible people, because people focus on the person who's ill, but they don't realise that when you're caring 24/7, you never get any time off and you're just in it and you're actually grieving because you're actually caring for a stranger in many cases, not the person that you used to know and there's a lot involved for carers, a lot of stress, and really, carers, just in talking tonight, carers need a lot more help.

 

JENNY BROCKIE: How bad has it been for you, though? Can you describe your lowest ebb with all this?

 

JO BUCHANAN: Well, my lowest ebb would be - it happened many times, going quite mad myself. You know, you go through a lot of grief, because I lost my sister and I lost my nephew. My nephew took his life when he was 19. And, so you go through the grief and loss and there really isn't any - I don't think there's any support. I can't say that there is. I didn't get any support. It was hard, but a lot of the time I found that, I would lose it myself, you know? I didn't suffer depression, but I think I went - had moments of madness. But then you don't tell anybody because if you're put into hospital, then who would look after the person you're meant to be caring for.

 

JENNY BROCKIE: Miles, what would have happened if your mum hadn't been there?

 

MILES BUCHANAN:  I don't know. I don't know. I would often disappear from the house. I was sharing a house - I shared a house with mum for 17 years. She was my primary carer. And I would often run away and, if she had to be taken away, then we'd both be, you know, taking up hospital beds, and I don't know, we'd have to find a carer for mum.

 

JENNY BROCKIE: Let's have a look - I'm interested in having a look at what happens to people who don't have family support. Here's Ann Worthington.

GLENN PILLEY’S STORY:

 

REPORTER: Ann Worthington

 

 

 

GLENN PILLEY:  Not your wallet, guys, not your purse. A small piece of your heart, sir. That's all we're looking for. Goes a long way, Sir. It's only a fiver.

 

Glenn Pilley has been selling the 'Big Issue' for nearly two years. He's one of the many mentally ill who fell through the cracks in the system. At 25, he became psychotic after an acid trip. He had no job, no medication and family and friends had deserted him.

 

GLENN PILLEY: Life was hectic. I couldn't, I couldn't, I couldn't live on the, on the money that I was getting from, from Centrelink, and pay my bills and keep the roof over my head, without going, without going without food. And, you know, I think there was six days there that I went without food.

 

Glenn had his first taste of jail after an assault charge. It wasn't his last. Five years later, still unmedicated and in denial about his illness, Glenn attacked his flat-mate.

 

GLENN PILLEY: And I went up to my room to go to bed and it seemed as though someone had gone into my room and I had some money in there and the money had gone or I thought the money had gone missing. And subsequently, I attacked him with a claw hammer, so.

 

REPORTER: And you nearly killed him?

 

GLENN PILLEY: I tried to.

 

REPORTER:  Was that your intention at that point?

 

GLENN PILLEY:  Yeah. Yeah. Yeah.

 

Glenn was sentenced to 3.5 years for grievous bodily harm with intent.

 

GLENN PILLEY: Spent 10 months in a, in a maximum security and I was assessed by a doctor and, and, found to be mentally ill and they sent me to Long Bay prison hospital which is D ward.

 

Finally, behind bars, Glenn received medication for the first time. He was released in 2002, but with no job and no support, he became homeless. He slept inside the Sydney Casino until security moved him on. Then he would sleep rough outside on this park bench.

 

GLENN PILLEY: I was doing volunteer work at the same time in the Salvation Army and they talked me into taking some accommodation up with, with, Matthew Talbot.

 

It was here that Glenn came into contact with the 'Big Issue' and started piecing his life together again.

 

GLENN PILLEY:  I'm not in the best job in the world, you know? But, um, I'm moving ahead, you know? I'm moving ahead. I'm not going backwards any more. I'm finally finding - there's a smile on my face these days rather than a frown.

 

 

 

 

JENNY BROCKIE:   Thanks for joining us, Glenn. What did you need? You've listened to all the politicians talking about policy and what they're going to do. What did you need?

 

GLENN PILLEY:  Work opportunity. Work opportunities are non-existent. I guess you could say that moral care, moral treatment, a work program, a program to sort of reintroduce you back into the community. Once your psychosis is broken, you're expected to rejoin the community without any introduction back into the community. And it doesn't come natural to you any more.

 

JENNY BROCKIE: Elaine, you're a carer for your 24-year-old son who has schizophrenia. You also live in the electorate of Macquarie, one of Labor's most marginal seats, held by just 0.3%, I think. What do you make of what you've heard? And what do you need? And what does your son need?

 

ELAINE GODDARD: Well, I listened with interest to the various politicians talking about what is on offer. But as a parent, what I'm looking at is practical support for our son, who needs accommodation. I mean he needs supported accommodation and currently he's living at home with us. He doesn't want to live with his ageing parents but unfortunately there are no other resources out there for him. I'm talking about supportive accommodation that is not based on a medical model, that he could have some type of mentor there who would assist him on a daily basis with practical things.

 

JENNY BROCKIE: Like a halfway house kind of arrangement?

 

ELAINE GODDARD: Something similar to that. What's on offer - we've been told there's a 12-year waiting list for him to have any type of supported accommodation and that is not a favourable option for him, so currently we're supporting him at home and he doesn't want to be at home.

 

JENNY BROCKIE: OK. What are the major parties offering in terms of supported accommodation - Peter Dutton?

 

PETER DUTTON: A couple of points. When we talk about a $1.5 billion package now, those numbers don't mean much to people but when you talk about it providing help to 100,000, I think it starts to sharpen the focus. But it's the next step. I mean there are - Alex raised a point about providing help to people with a particular condition, housing, employment, all of those things meld into it.

 

JENNY BROCKIE:  Yeah, but is there anything specific around this? Because this has come up a lot - supported accommodation has come up a lot with the people we've spoken to, are you offering anything specific on that?

 

PETER DUTTON:  Well, there are programs both in the employment field with disability support services, in particular, that try and intervene in cases like we were just talking about where they can refer people off to get assistance. The problem is that yes, there are services, but they are massively oversubscribed. The waiting lists that we talk about aren't appropriate and there is a disparity between the States and the services that they offer. Again, there's a difficulty and a tension between the Commonwealth and the States in relation to it.

 

JENNY BROCKIE: What I'm getting at is whether you've got any plans to fix it?

 

PETER DUTTON:  Well by putting more money into programs that work is the first step but I think there will continue to be a need until we start to address some of the fundamental problems and also break down many of the community barriers that are opposed to, if you like, more money being spent in these areas. So we have to do what John Brogden was talking about before - break down the stigma and I think that is a bigger way forward to putting more investment into these sorts of issues.

 

JENNY BROCKIE:   Elaine, does that answer your concerns?

 

ELAINE GODDARD: Not really, no. As a parent I feel we save the Government a lot of money by providing support for our son because there's no other support out there. I think we need to have some options to look forward to so our son can have a decent quality of life.

 

JENNY BROCKIE: Mark, what's the Government offering in terms of support?

 

MARK BUTLER:  Supported accommodation is one of the areas that I've talked about as being largely in the province of State governments now which we need to talk to them about a future Commonwealth role. There is significant social housing construction going on as part of our economic stimulus plan in the wake of the global financial crisis and significant amounts of that new accommodation, the biggest social housing bill since World War II, will be available to people with mental health issues. Now it won't be supported accommodation, but it will be affordable accommodation for those who are at least able to live independently.

 

 

JENNY BROCKIE:  Pat and John Mendoza both want to have a go at this. Which one of you? John, you go first.

 

PROFESSOR JOHN MENDOZA: Can I say Tanya Plibersek met with colleagues of mine on this issue because when the Government announced that program to build nearly 20,000 public houses, we saw a great opportunity to build the sort of infrastructure that Alex was saying is needed. Supported accommodation works. There's good evidence about it. The scarcity of it is the problem at the moment. In NSW alone there is about 1,000 places available in a very good program here but it's like winning the Lottery to get into it.

So we need to scale these programs up massively. Now the Government, the Federal Government, said, "Oh, yes, we're interested in that, but it's a State problem." Tanya Plibersek, "I'm not the Health Minister. I can't do that.” It got flicked to Health. Health said, "It's a housing problem. Talk to them." Or, "It's a State problem." It got lost and unfortunately, Mark, the opportunity is almost gone to just simply find $100 million to provide an extra 2,000 places for supported accommodation. We need leadership. We need some intelligence to the policy framework around this. I am tired of the opportunities being lost that continue to arise in government and its policy laziness by the governments that we don't see these things coming through. And we leave families under crushing sort of responsibilities to care for their loved ones. They are taken out of the workplace. The impact across the community is enormous. And I think the Government has to step up to the plate and deal with this issue.

 

JENNY BROCKIE: Are you getting this from either side, though? Are you getting it this from the Opposition policy either?

 

PROFESSOR JOHN MENDOZA:  We had more of it under the Howard government. Howard did lead COAG in this area. His leadership and Morris Iemma's leadership as NSW premier, really resulted in the biggest ever injection of funding into mental health. The announcement that the Coalition's already made for this election is the second biggest announcement on mental health. So we've had 18 years of so-called national health priority on mental health but we've never seen any big investments other than those two and the governments have got to come up to I think face the fact that it is a crippling shortage of funds that is behind the tragedies that we see playing out every day.

 

JENNY BROCKIE:  Patrick McGorry?

 

PROFESSOR PATRICK McGORRY:  I want to pick up on Glenn and Elaine's story too. Those are the absolutely doable things right now - Vocational recovery programs - the best evidence based recovery program you can put on deck, like Glenn actually said – there is great evidence for that - that's a federal capacity to do that. It's a federal possibility to develop the supportive housing too because I saw in Canberra, I saw in Queanbeyan about three or four weeks ago a spectacular program which Father Peter Day had initiated in Queanbeyan - 700 people in the Queanbeyan community getting behind it - 22 new purpose-built units for people with serious mental illness who had been homeless - in a home of their own for the rest of their lives. That can be done, cost $3 million, rolled out across the country to soak up this huge, huge problem.

 

JENNY BROCKIE:  Johnny Luu, our online reporter, I'm interested to on what you're getting on Facebook and Twitter about this – what are people saying?

 

JOHNNY LUU, ONLINE REPORTER:  Jenny, initially there's been a lot of talk of personal experiences. There's a lot of consensus there that there is an issue. But as the policies have been announced, the talk has turned to political, particularly what people want and what people need. There's talk for example - Kathy Heinz on Facebook, talks about more money for rural health. There's other people talking about aged care. Benjamin Bryson for example talks about needing some subsidies for medications when it comes to mental illness. So lots of people talking about things they need. I know on Twitter, 5Sprocket talks about and asks what about financial assistance to people who can't work because of mental health issues? So lots of people telling their stories and asking about what they want.

 

Interestingly enough, on feedback about the politics and about the announcement today, you know, generally positive and people are saying that, you know, it's good to talk about mental health and try to reduce the stigma. But however, there is - there are some people who are talking about, you know, about who is missing out. On Facebook, Elissa Champion talks about mental health developing at any age and she feels that there has been a focus on early intervention and she feels the focus of this announcement - and I know there's been a similar sentiment when Tony Abbott announced his policy - that there's so much focus on early intervention. So she says there may be a number of older Australians that have mental illnesses since childhood but haven't sought help due to social stigma. She feels the focus is too narrow.

 

JENNY BROCKIE:   We are talking about mental health and votes. And Vicki, you had bipolar from the age of 19. You're now 40. You came from a Greek background. What did you need?

 

VICKI: Basically what I needed was - stigma is very, very different in multicultural communities so while John Brogden is talking about yes, so much has been done for stigma, in multicultural communities, when I was sick and depressed and withdrawing and watching TV all day and was just totally depressed, my father didn't want to go to a service, didn't want to tell anybody. We needed bilingual mental health workers. We needed trans-cultural mental health workers in every State and Territory, which is non-existent at the moment. In both these policies, there is no mention of multicultural communities, migrants. There is mention of specific indigenous youth but from always these speakers today, nothing about the multicultural

 

JENNY BROCKIE: And very specific needs. Your father used to bless the house when were sick. Is that right?

 

VICKI: That's right. People from different multicultural communities interpret mental illness in a different way so they need someone from their cultural, a bilingual worker, to speak to them. They need translated information in their language. These things don't exist in every State.

 

JENNY BROCKIE:  Lisa, you're on our panel of swinging voters and you're from Bennelong. You're nodding your head there. Is that the case for your community as well?

 

LISA YEN, ELECTORATE OF BENNELONG, NSW: Absolutely. She's right in terms of the stigma. It's an unspoken thing, very invisible. It takes a lot of courage to admit it. Also in the older generation, they don't speak to the language, so who are they going to go to and if they are suicidal they're taken to hospital, but what happens? They can’t speak the language, no one knows what is happening - they don't understand what's happening. In the seat of Bennelong, we've got the right hospital but as far as I'm aware, there are no bilingual health care workers there.

 

JENNY BROCKIE:  Unfortunately, there's so much to cover here - we'll keep talking about this online because this is very important territory, I think. Glenn Williams, what do indigenous communities need? We're talking generically here about mental health as though one size fits all. But what do indigenous communities need?

 

GLENN WILLIAMS, PSYCHOLOGIST:  Well, for a population that are really overrepresented in the mental health system, I think they need greater access to mental health services. But as was stated before, culturally appropriate mental health services and also workforce capacity needs to be built behind them with culturally appropriate mental health workers who can work in indigenous communities. A lot of community members can't leave their communities and therefore they can't access any service.

 

JENNY BROCKIE: What do you think of the policies an offer so far?

 

GLENN WILLIAMS: I think they're a bit of a shopping list to grab votes in the upcoming election.

 

JENNY BROCKIE:  A shopping list.

 

GLENN WILLIAMS: Yeah.

JENNY BROCKIE: So you don't think they're addressing what you need for your communities?

 

GLENN WILLIAMS:  Aboriginal people fall into a lot of the - some of the items that have been identified in the budgets but for me there's nothing specific for indigenous people across Australia.

 

JENNY BROCKIE: Abd, are your needs being met from the multicultural health council with these policy proposals?

 

PROFESSOR ABD MALAK, MULTICULTURAL MENTAL HEALTH AUSTRALIA: Unfortunately, Jenny, people migrant has been missing from most political party. Unfortunately, 20% of the population has been missing from both policies. We're talking about approximately $50 million a year to be able to deal with a significant misdiagnosis. We overdrug people. We actually are currently spending more than $300 million wasting resources. If we have this $50 million targeted, we can have significant saving.

 

JENNY BROCKIE: OK, quick whip-around about votes. Alexandra, who will get your vote?

 

ALEXANDRA RIVERS:  I think I'm going to look at the Greens policy. There is nothing for there for older people. I had early intervention for my son, it was wonderful - three years and then 20 years of nothing.

 

JENNY BROCKIE:  John, who will get your vote?

 

PROFESSOR JOHN MENDOZA: I want to see a party, Jenny, who says that for the cost of one Freddo Frog for each Australian every day, that's what it will cost us to deliver good mental health care. I've brought a Freddo Frog for everyone here tonight. It's a pretty small price to pay to have the benefit of accessible, quality mental health services

 

JENNY BROCKIE: OK. Who else is going to give us an indication of which way their vote will go? Kate?

 

KATE RIDDELL:  Living in a rural area, access to mental health services is really, really tough and I don't think either party has gone far enough in addressing that.

 

JENNY BROCKIE: Is it enough on its own to affect your vote?

 

KATE RIDDELL: Absolutely. I had three years battling with postnatal depression and the impact that that had on my family and on myself, it's a deal-breaker for me!

 

JENNY BROCKIE: Jason, you're on our panel of swinging voters. What do you think having heard all this tonight?

 

JASON MOLE, ELECTORATE OF BOWMAN, QLD At the moment, I'm probably leaning more towards the Coalition, with regards to what they're putting on the table with $1.5 billion. It speaks volumes. I have people around me who are suffering quite severely with, um, with mental illness. And to see the impact of what happens to the immediate families and the practical support that doesn't go with that while their loved ones are being treated is what I get to see personally on a day-to-day basis and it's that practical help. It's not talking to people and getting a lot of treatment all and lot of the time. It's just people getting alongside other people and helping them through what they are dealing with.

 

JENNY BROCKIE: Lisa, is it enough to affect your vote, this one issue? Or are there more important things you're going to vote on?

 

LISA YEN: It will affect it. But there are other big issues to talk about. But it's important to remember that - it's not too late but what about this coming term? Let's talk about now, what can you put on the table now? Patrick talked about things you can do now. Let's talk about now, not four years' time.

 

JENNY BROCKIE:  Pat McGorry, who will get your vote, just quickly?

 

PROFESSOR PATRICK McGORRY:  We're all fighting over scraps from a table. There are so many - this discussion has shown how much the need is. We're so far off the pace in terms of scale.

 

JENNY BROCKIE:  But who will get your vote?

 

PROFESSOR PATRICK McGORRY:  I think it's not over yet, we have got to see some more action on that front.

 

JENNY BROCKIE: Glenn, how about you?

 

GLENN PILLEY:  I'm sitting on the fence.

 

JENNY BROCKIE: Sitting on the fence. OK. We've got a few weeks to go.

 

WOMAN: I now have to see an educational program for migrant families. My recovery - I come from Argentina - and my recovery did not stop on discharge. After discharge, the social support we needed was minimal because the family was elsewhere. So all my support fell on just my husband, at the moment, and I didn't have any other people to lean on.

 

JENNY BROCKIE:  I think that's a point that's been made by quite a few other people here tonight as well, the importance of other support services. Look, we can keep going, there's so much more to talk about here. I'd like you to jump online now and continue this discussion with some of our guests. We have a number of our guests. Peter Dutton is going to be online, I think, to talk with us. Mark, you're going to be online as well and we also have someone from Beyond Blue and we're also going to be having John Mendoza online. So go to our website, click on the live chat for that. You'll also find what our panel of swinging voters is thinking about the broader campaign. They have made video diaries so you'll find out a little bit more about how they're reacting to the broader campaign. Have a look at that. And a letter too that John Mendoza and Patrick McGorry have written to Julia Gillard is online for you to read.