HON ALISON XAMON (North Metropolitan) [9.47 pm]: I rise tonight because I want to tell the house about a particular issue that one of my constituents has been having in trying to navigate the mental health system. All of us would have been contacted at some point by concerned people having problems trying to access mental health services. I think that this particular issue really illustrates how problematic our system is for some people and how comprehensively it is failing some people. My office has been seeking to assist this particular family for some months. Their experience serves to highlight the failure of our mental health system to support some of the most vulnerable members of our community. The man I will talk about tonight has an advocate with experience of the mental health system and his sister engaged in his care. Even with these two people in his life, they have been unable to secure even the most basic of supports for him. His story demonstrates a cascade of decline and a litany of missed opportunities to intervene and to prevent further deterioration.
In 2017, my constituent was well. He was living in permanent accommodation under the independent living program. He was compliant with his medication and was actively involved in a recovery model of care process. However, in late 2017, after a change in caseworker, this man’s care became compromised. He was no longer receiving his medication or regular welfare checks. As a result, he suffered a psychotic relapse. At this time, his GP, his sister and his advocate raised concerns about what was happening because of this lack of support for him. They lodged formal complaints with the health service that was coordinating his care, the Office of the Chief Psychiatrist, and the Health and Disability Services Complaints Office. Even then, they got no joy. This man did not receive any greater attention and his condition continued to deteriorate. It culminated in him assaulting a police officer while resisting arrest. In my opinion, that police officer was also comprehensively failed. The man was subsequently sentenced to 14 months in prison. Leading up to his release from prison in December last year, his sister and advocate once again began their quest to have supports put in place for him upon his release. However, the mental health service was unable to source appropriate accommodation in time. If it were not for the efforts of his advocate, who managed to secure temporary accommodation, this man, who is known to have a serious mental health issue, would have been released from prison into homelessness. A few days after his release, he suffered from chest pains and was admitted to hospital, where he had to have surgery to have a defibrillator inserted. It was only then that his advocate was informed that his client had suffered a heart attack while in prison and had undergone surgery at that time to have a stent inserted. Prior to his release from prison, this information had not been passed on by prison health services to his advocate, the mental health service in-reach team or his family. It is outrageous that such a major health issue was not reported, particularly when the psychiatric medication that this man is on is known to compromise heart health.
Even now, five months after his release from prison, and despite his sister recently travelling to Western Australia to help arrange a permanent home for him, my constituent remains in temporary accommodation. Their aspirations are entirely reasonable. All they want is for him to have safe and clean accommodation near public transport, where someone can administer this gentleman’s medication and remind him of his medical appointments. This man’s sister is a very articulate and reasonable person. She is trying her best to work in partnership with her brother’s caseworker to achieve the best possible care for him, but poor communication has unfortunately been a constant feature of her experience. After her trip to Perth, she reflected on her experience of trying to navigate our system. Each person she met or spoke to concerning her brother seemed to recommend that she go on to speak to a further two or three people or organisations. When she spoke to those people or organisations, they also told her to speak to further people or organisations. She describes a labyrinth of unconnected people and organisations, which are working completely independently of each other. As a complete outsider trying to navigate her way through this labyrinth, she never knew where she was meant to go or what the clear pathway was for her brother.
With the exception of her brother’s advocate, no one reached out to help her while she was in Perth. She was unable to even arrange an appointment with her brother’s caseworker. As she puts it, whenever there is a plan A for her brother, there always seems to be a reason that he does not meet the program requirements for the model of care. There never seems to be a plan B to facilitate services for this man.
Regardless of these ongoing efforts, this man remains in temporary accommodation with no prospect at the moment of permanent accommodation and support. This man has had a persistent and enduring mental illness for 20 years. He is not new to the system. It is well-established that he is vulnerable and requires ongoing support. The last time that he was not supported to ensure that he took his medication regularly, he ended up in prison. There is no question that providing the relatively low level of support he needs now to prevent another psychotic relapse should be a priority. The benefits are obvious. Most importantly, it will ensure the wellbeing of one of the most vulnerable citizens within our state. But it will also reduce costs for the state, because prison is not the cheap option.
I acknowledge the complexities of supporting a person with a severe mental illness, but my constituent’s experience highlights myriad failings in the mental health system. They include poor communication and liaison with carers; difficulties in system navigation; accommodation issues, which are huge; and siloed service delivery. It is absolutely clear that there is still a long way to go. The problems have been well documented and there is a map for the sorts of services that we need—that is, the 10-year mental health and alcohol and other drug services plan. The need to get system navigation right has been clearly identified front and centre as an area in which we need to get the work done and start to get this right. It is 2019 and we are four years into the plan. I cannot believe that these sorts of situations are still happening. This man is known and should never have ended up in prison. If he had received appropriate services, he most likely would not have ended up there, yet now he is out of prison and still unable to get proper accommodation and the support he needs. It is just not good enough. I will continue to try to assist this man, but this is appalling.