Sue Boyce (Queensland, Liberal Party) Share this | Link to this | Hansard source

I intend to make a small attempt tonight to overcome a major omission from the recent Community Affairs References Committee report into mental health in Australia. I would like to add that I take a very large degree of responsibility for that omission. I am referring to the fact that, although the terms of reference of the inquiry included the mental health needs of people with disability, this was not covered in any way in the main report. There were some reasons for that, but I hope that I can overcome that to some extent tonight by speaking on the topic.

Before I do speak on the issue of the mental health needs of people with disability, particularly of people with intellectual disability, I would like to look at the overall situation for people with disability in Australia. I think it is time we had a rethink on the separation of government disability agencies from government mainstream policy and service delivery. I think it is time we assessed whether the development of separate disability focused government agencies has really worked for people with a disability. In every area, from health to education to outside school hours care and violence against women, services available to people with disabilities continue to lag very badly behind those available in the mainstream, and the needs of people with a disability are almost absent from mainstream policy areas.

I was among the thousands and thousands of people who lobbied in the past for the establishment of separate disability services and policy delivery so that at least attention could be properly focused on the needs of people with a disability. The thinking then was that the needs of people with a disability were getting lost in the mainstream and needed a special focus. But I would argue now that this separation has not led to genuinely better outcomes. I cannot think of one area where people with a disability have similarly positive outcomes to those of people without a disability.

In health, people with disabilities have a much higher unmet need for both general health and mental health services. Whilst the outside school hours care of children without disability is met, there is very limited outside school hours care for teenage students with disabilities provided through the FaHCSIA rather than the department of education program. This limitation seriously curtails the employment opportunities for their parents.

In transport, people with a disability have to wait for an accessible bus or train to go past and have to accept a quota system for using planes while the rest of the population travel as and when they wish. In the area of domestic violence, the needs of women with a disability are completely ignored by the mainstream women's programs, even though women with a disability experience violence and abuse at more than double the rate of women without disabilities.

The Australian organisation Women With Disabilities Australia have orchestrated a global campaign to end torture in health care through the forced and coerced sterilisation of women with a disability, and they deserve huge congratulations for this. But their campaign has not even registered with the organisers of White Ribbon Day. You cannot find the WWDA campaign on the White Ribbon website at all, and the White Ribbon resources page does not even mention organisations like WWILD, in Queensland, which assists women with an intellectual disability who have experienced violence or abuse. The disability sector had hoped that the separation of disability from other policy areas would lead to overall improvement. Instead, it has meant in many cases that disability issues are simply excluded from and ignored by the mainstream. Departments and governments can duck and weave, claiming that disability issues are handled in a special place and are not their problem. I quote from the recently released World report on disability, put together by the World Health Organisation and the World Bank, which supports the argument that I am putting. The report says that inadequate policies and standards are the leading barrier to people with disabilities taking their place in mainstream society. It says:

Policy design does not always take into account the needs of people with disabilities, or existing policies and standards are not enforced. Examples include a lack of clear policy of inclusive education, a lack of enforceable access standards in physical environments, and the low priority accorded to rehabilitation.

It points out that people with disabilities:

… experience greater vulnerability to preventable secondary conditions and co-morbidities, untreated mental health conditions, poor oral health, higher rates of HIV infection, higher rates of obesity, and premature mortality.

One of the strongest recommendations the report makes is that the needs of people with disabilities 'should be met in mainstream programs and services'. It makes the point that people with disabilities have ordinary needs as well as specific needs. It says:

Mainstreaming not only fulfils the human rights of persons with disabilities, it is also more effective.

Mainstreaming is the process by which governments and other stakeholders ensure that persons with disabilities participate equally with others in any activity and service intended for the general public, such as education, health, employment, and social services. Barriers to participation need to be identified and removed, possibly requiring changes to laws, policies, institutions, and environments.

The report suggests that there is a need for investment in specific programs and services for people with disabilities, but that is secondary to giving people with disabilities access to the mainstream.

I will now go to the very good submissions made to the mental health inquiry by the National Council on Intellectual Disability and other groups. There were only about three submissions that actually focused on the topic of intellectual disability and mental health. This is not for lack of interest in the subject; this is for lack of expertise in Australia. Unlike the UK, we only have one very limited program at the University of New South Wales which looks at the area of intellectual disability and mental health. There is no full-time, specialist program in Australia. If you like to think about what the effect of that is on people with intellectual disability and mental health issues, I think you can see for yourself that it would be extremely severe and that it leads to huge amounts of unmet need.

The New South Wales Council for Intellectual Disability in fact point out that they have been working for many, many years for recognition and action on the very high rates of mental illness experienced by people with intellectual disability and their poor access to mental health services. They say:

There has been only a small amount of progress on this problem since it was highlighted by the Burdekin report in 1993.

It is a shame that we have not been able to work to assist people.

And yet, when we look at the figures, there are about 408,000 Australians who have an intellectual disability, and they are estimated to have mental disorders at 2½ times the rate of the general population. This leaves a huge number of people who need assistance, and yet, over a 14-year period, only 10 per cent of those people with an intellectual disability and a mental disorder received mental health intervention. By contrast, in the general population, 35 per cent of people with a mental health disorder received treatment in a 12-month period.

Mr President, I would like to say more, but I am about to run out of time. But I will follow up this issue further.