R U OK with South Australia's Legislative Approach to Mental Health?
A discussion on South Australia’s human rights protection in respect to its current mental health plan
On Thursday 10 December 2020 the Rights Resource Network SA held a landmark discussion on the role that human rights currently plays in our society at its digital conference, ‘Time for a Human Rights Framework for South Australia?’. The ideas of reasonableness and proportionality featured heavily in the discussions on the day – as did the idea that we need a clearer, more consistent way to balance different interests and perspectives when making laws and policies in this state.
The issue of mental health was a focus of one of the interactive workshops held as part of the conference. Participants at the workshop considered the rights implications of South Australia’s current Mental Health Services Plan (available here), which includes a forthcoming Urgent Mental Health Care Centre (information available here and here). Many were of the view that while the Plan will deliver some results to improve the lives of some South Australians, the human rights aspirations of those needing mental health care required a deep, careful, rights focused review.
At the conference, Geoff Harris (Executive Director, Mental Health Coalition) and Ellie Hodges (Executive Director, LELAN) discussed the need to reframe the legislative models currently in place to support a shift identified in the UN Convention on the Rights of Persons with Disability from a medical to a social approach when developing a mental health care policy.
Ultimately, participants agreed that a human rights approach to mental health service planning and policy development would be beneficial to ensure that every new initiative is assessed against a set of specific standards that are focused on the needs and rights of all South Australians, with particular consideration for people with lived experienced of mental distress, social issues or injustice. Participants discussed whether a new and adapted policy framework that works independently from legislation may also provide a pathway forward to improved mental health outcomes. However, it was recognized that both of these solutions require advocacy, raised awareness and direct input from those who have lived experience.
The Urgent Mental Health Centre has been a surprisingly controversial element of South Australia’s mental health care plan. The Centre will provide that assistance in a quiet and calming environment as an alternative to the current busy Emergency Department. The Centre’s workforce will comprise at least 50% workers with lived experience as well as clinicians.
Harris and Hodges concurred that whilst the Centre is a great leap forward in providing a much more tranquil environment for recovery, the issue remains that people most in need of support may still be left without appropriate and responsive care. Statistics by the Mental Health Coalition of SA demonstrated that Commonwealth mental health programs and the National Disability Insurance Scheme have places for only 20% of people who need psychosocial support. This clearly evinces the large gap in psychosocial support in Australia, given that 80% of the need is not being met.
The psychosocial rehabilitation gap is of great human rights concern, as it is an important source of support for people to re-integrate and re-adapt to everyday life in society.
The challenge of funding is ever-present in the mental health space, with clear tension arising between funds needed to support acute care in hospitals and the funding required to implement evidenced-based preventative or community-based mental health care.
A rights-based approach could result in better uptake of a ‘care not treatment’ (LELAN 2020) attitude, whereby individuals and their families are supported to manage emotional distress and recover in a way that suits their needs and lifestyles. These changes can only occur if those with lived-experience are engaged in discussion, and a ‘by me, for me’ tactic is favoured.
To achieve positive change in mental health policy and ensure that human rights are not neglected, we must prioritize the views of those with lived experience at every stage of the process and bring the South Australian community along with us. To accomplish this, mindsets must be shifted and stigma must be eradicated. It is a work in progress. However, if we can turn R U OK Day into an R We OK lifestyle, culture can be driven, and change will occur.
Isabella Candeloro is a Bachelor of Laws (Honours), Bachelor of Journalism and Professional Writing student at the University of South Australia. She is a member of the Rights Resource Network SA and Golden Key International Honour Society.