HON ALISON XAMON (North Metropolitan) [6.39 pm]: I rise to make some more comments about the State Coroner’s report “Inquest into the deaths of: Thirteen Children and Young Persons in the Kimberley Region, Western Australia”. Tonight I will specifically focus on the coroner’s findings on the provision of mental health services. As I have highlighted previously, many of the young people who died had grown up in circumstances in which they were constantly exposed to domestic violence, had insecure living arrangements and had siblings or relatives who had died by suicide. Almost all had grown up in homes where there were high levels of alcohol use, and a number had themselves, despite being only children, used alcohol and other drugs from a young age. Many of these young people had expressed suicidal ideation, and despite having several contacts with health agencies for preventable health conditions, only one had had contact with a mental health service. It is an absolute tragedy that despite the presence of many risk factors and warning signs, and contact with health agencies, for a number of reasons our existing mental health services were not used to support these young people and their families.
The coroner states that the majority of these children and young people had not been given a mental health assessment so it is not known whether they had mental health conditions that may have responded to treatment, using either conventional medical treatment or traditional cultural methods, or potentially a combination or both. However, it is clear from the fact alone that eight of the coroner’s recommendations relate specifically to improving how existing mental health services are delivered and accessed, as well as the need for more services, that inadequate mental health service provision is, of course, considered an important factor in these young people’s untimely deaths.
Difficulty in arranging an urgent mental health assessment was a factor in at least one of the deaths. There simply are not enough mental health services to cover the region. I recognise that service delivery in the Kimberley is particularly challenging, not least because of the large geographic distances. However, having said that, there is only one child and adolescent mental health psychiatrist in the Kimberley region and it is completely unrealistic to expect one person to be able to service the population’s needs, even without travel considerations. It is already too large a population. Accordingly, the coroner recommended the need for both a mental health facility in the East Kimberley and a mental health clinician to be based in Halls Creek. Long delays in being able to respond to a person who is already in acute distress will clearly compromise their care.
In addition to the need for more services in situ, the coroner has recommended that immediate consideration be given to setting up 24-hour access to a consultant psychiatrist via video conferencing to remote areas. Although the facilities are already there, any access to them, if at all, is currently only during office hours. As we all know, and as I am sure many members have heard from their constituents, crises do not occur only between the hours of 9.00 am and 5.00 pm. The expansion of services to reflect that reality needs to be absolutely supported. Further, if we are going to make any headway in disrupting the cycle of intergenerational trauma and its effects, we must also look at investing in services that intervene very early in a baby or child’s life, such as perinatal and infant health services. There are currently no specific infant mental health services in Western Australia, and there is no perinatal or specific mental health services or indeed any specific mental health services for children under the age of 14 years in the Kimberley region. We need to think seriously about how we might address this.
Importantly, the coroner also made recommendations about the way services should be delivered. Because large numbers of Aboriginal people in the Kimberley have experienced the direct and indirect effects of trauma, it is clearly imperative that service providers take into account the need for trauma-informed models of care. The coroner has recommended that all service providers undertake training in trauma-informed care. Quite frankly, in 2019, I am in disbelief that that still has not occurred. Her recommendations also highlight the need to recognise the importance of traditional cultural healing and for incorporating traditional healing practices into mental health treatment plans. In order to achieve this the coroner recommends that the government should fund more cultural healing projects in the Kimberley region. Other reports into Aboriginal suicide have made similar recommendations in the past but it is an area in which we have been slow to act. It is also necessitates meaningfully partnering with Aboriginal communities. Aboriginal-led solutions must be at the heart of what we do.
In talking about mental health services in the Kimberley I would also like to take a moment to acknowledge some of the programs that are working well, because just as it is important to identify the gaps, we have to make sure we preserve the services that need to be retained. Although the Statewide Specialist Aboriginal Mental Health Service is, as its name suggests, a statewide service, I have been reliably informed by clinicians from the Kimberley who work with Aboriginal clients and their families that it is a critically important part of the way they deliver their services. One of the important things that SSAMHS does is build up the workforce in mental health service provision. It is a very important resource and I was pleased to see in the last budget that the government committed funding to it until at least 2020–21. I will be looking for further funding commitments in the forward estimates when the next budget is handed down. We need to be building the capacity of these services so that more people can benefit from them. Overall, however, it is clear that access to mental health services in the Kimberley is woefully inadequate. Investing in culturally appropriate, accessible and timely service provision is urgently needed if the government is serious about stemming the tide of suicide in the Kimberley.