Report of Conf on Human Rights and Mental Health

The Third National Conference on Human Rights and Mental Health, Federal Parliament House, Canberra, 8 & 9 September 2005

Conference Report

Key Findings:

- The cultural prejudice that exists in Australia in the 21st Century, expressed institutionally through our governmental, penal, legal and health care systems, in respect of those Australians who, through no fault or personal choice, experience difference in respect of their mental health, race, skin colour, sexuality, sexual formation or refugee status can so degrade, shame and punish the lives of such Australians, from childhood to grave, so as to adversely impact the mental health of such people; including inducing or exacerbating states of chronic low self-esteem, institutional and drug dependence, self harm and self destruction. Australian culture as a whole, and especially that of our young, is needlessly degraded by the experience and observation of such treatment. People fear it for themselves. The result is a growing malaise in our culture, and especially our youth, characterised by increased drug use to escape an unacceptable reality and an epidemic of depressive illness. Thus, cultural illness and prejudice leads to more of the same. Australians, as a culture, need to accept our responsibilities to those amongst us who are less well off and less able to care for themselves.

- A further crisis exists in the way Australia in the 21st Century manages and conducts its health care systems, formal penal institutions and detention centres, that results either in a failure to adequately care for the mental health care needs of Australians obliged to use those institutions or, worse still, creates the present propensity of those Australian institutions to actually induce or increase mental ill-health amongst those Australians obliged to use those facilities. At the Conference, both psychiatrist and psychologist representatives, as well as patients, uniformly made three pertinent points: 1) That mental health systems throughout Australia remained vastly under-resourced notwithstanding numerous enquiries and reports to that effect; 2) That health bureaucracies were intent upon defending their own position rather than recognising all the meeting the crisis in mental health; and 3) That many of the problems associated with the crisis in Australian mental health practice could be considerably and promptly alleviated by the increased and Medicare funded use of the vastly underutilised non-drug orientated treatment services of psychologists.

- The principles and policies espoused by all levels of government in the Commonwealth of Australia, and especially by the Commonwealth Government, its members of parliament and its administration in respect of people who experience difference in their state of mental health, race, skin colour, sexuality and sexual formation have a direct affect upon this national crisis. What purposes justifies so degrading and harming the lives and human rights of our fellow Australians and other brothers and sisters living with us in this wonderful nation?

- Our conference raised distressing examples of Australian inhumanity to fellow Australians and others. We heard of the fact that the average life expectancy of indigenous Australians in central western New South Wales is approximately 30 years. We heard of a Judge of the Family Court of Australia reduced to tears at a legal conference as he tried to describe the permanent harm suffered by children in Australian migration detention centres. Those who experience mental ill-health, for whatever reason, and people who experience difference generally, are treated like second-class citizens.

- In this way out conference morally challenged us. We were obliged to accept the simple and powerful moral proposition that our fellow Australians, and others who come to Australia of all ages, of all races, of any nationality, and no matter what difference in sexuality or sexual formation they may experience, have a right to call on us for help in their need; rather than being treated in a manner that Australians would not consider humane. Destructive mental health practices destroy human dignity. Mental health is advanced by a sense of social inclusion and freedom from discrimination.

- Our profound failure as a nation expressed above in relation to people of difference, including those who suffer mental ill-health, was witnessed at our convention by experts in mental health, including administrators as well as practitioners, religious and social health and welfare experts, lawyers and members of State and Federal Parliament as well as people who told us their stories of how they have experienced difference and/or mental ill-health at the hands of contemporary Australian culture.

- It is time to stop pointless suffering in Australia due primarily to our own cultural prejudice and the political imperative which seeks to take advantage of that prejudice. All Australians will benefit when Australians experience themselves as the best people they are capable of being. Our parliamentary representatives have both the power and the responsibility to help those least able to help themselves because of mental illness or other difference. Specifically, our parliamentary representatives are responsible for the conduct of the bureaucratic institutions which are presently failing in fulfilling their responsibilities and obligations in the areas of health, migration and prisons. It is our parliamentary representatives, both State and federal, who have the power to undertake law reform to alleviate the present suffering of people who experience difference in our culture. Our conference earnestly urges our State and federal parliamentary representatives to take up this challenge and opportunity. Each individual parliamentarian, in meeting the challenges posed by this conference and in this report has the chance to really achieve true success and to know that because of their own life, and what they did with it, others, perhaps less fortunate than themselves, breathed a bit easier in theirs.

Detailed Conference Resolutions:

Torture in the present day

- DIMIAs practices compound peoples experience of torture- eg holding people in management cells, indefinite detention. Very things people require to help them heal are denied by government practice.

- Abolish TPV once someone is found to be a refugee they must be offered permanent protection.

- Full work for people on bridging visas.

- Need for specific services for both adults and children who have experiences torture

- Australian Government complicit with other Governments practices of torture,

- Treatment of Falun Gung practitioners. Support their right to protest.

Human Trafficking

- That the victims be seen as such and not just as witnesses, this leads to depression form not knowing what is going to happen to them.

- That the BVF be not reduced because they need time to reflect what is happening to them – they have already been traumatised by their experiences.

- That interviews by AFP/DIMIA are done at an appropriate time not immediately after they are picked up and they are scared confused and disorientated.

- That Commonwealth Anti-Trafficking Laws be re-focussed on support for victims of trafficking and not have as its emphasis law enforcement and prosecution of traffickers.

Mental illness and the Prison System

The growing incarceration rates in Australia and the gross over representation of inmates with mental illness is part of a worldwide trend to re-institutionalisation and jails are becoming the new mental hospitals,

- MH Strategy must address the steadily increasing prison population (increase 50% in the last 10 years in New South Wales, that houses half the prison population of Australia) & adopt strategies/ policies calculated to reduce inmate numbers. Victorian is being modest in successes in this – the only State.

- Develop much more court diversity options eg. MH assessment, increase drug court parameters to include overtly dual diagnosis, the largest group in the jail population.

- Prison substantially needs more community-based options - particularly in remote/rural areas to enable offenders to be supported much more in the community.

- Abolish jail sentences of less than 6 months, as these short sentences are very counter-productive in reducing recidivism and often lead to loss of employment potential.

- Provide real Mental Health services in jails so that inmates can access them. Currently many short-term inmates are denied mental health treatment and are often withdrawn from medication ‘cold turkey’ – also dual diagnosis suddenly withdrawn form treatment, medications and substances, therefore placing them at higher risk of self-harm and suicide.

- Establish human rights mental Health methodology to oversee jail conditions and ensure that community-based supervision observes mental health charter conditions.

- Provide whole-of-government correctional/ mental Health and forensic psychiatry services with massive funding increase for forensic hospital beds in a secure settings.

- Ensure that people with mental illness are provided with high-need interventions with through care frameworks that recognise the special needs for supported housing, interagency liaison and closer work with mental health teams.

- Ensure that inmates with mental health issues are NEVER placed in inappropriate cells, eg. ‘Supermax’ (NSW) and segregation.

- Ensure that they are provided with mental health case workers for their special needs
o Provide that parole legislation does not discriminate against mental heath parolees by ensuring they have special assistance with pre-planning for parole conditions and case work, also that be given authentic right of review, which is now not available in any of the states (being abolished in NSW)

- The current restructuring plans in NSW (already having trailed in other States – QLD and WA, provide for no discrimination of funding for community supervision and an emphasis on the value of probation and parole/ community corrections with appropriate representation in the senior chain of command.

Industrial relations

- Whatever policy government develops with regard to industrial relations legislation, human right must be given priority and Occupational Health and Safety recommendations must be strengthened.

- If AWA are to be expanded in use, employers should be made responsible for the impact of work related illness.

- Negative ‘down stream’ consequences of Industrial Relations Reform must be considered – increased mental health issues, with increased risk of bullying practices.

- The Government both State and Federal, should take a role in reining in the market forces that on sustainability of Australian Workforce.

- The needs of non-residential parents to have contact with their children should be included with the industrial relations reforms.

Young People

Young people are unique and are a great asset to our community. Unfortunately young people are also amongst the most vulnerable to be affected by mental health issues, and are the least likely to access support services. Young people need to be involved in the solutions to their own issues, including things like increasing peer and mentor support, easier access to information and help in places where young people go.

- Increase inclusion of young people in decision-making processes.
o Facilitate their participation in conference such as this via grants and subsidies
o Acknowledge young people’s strengths, vitality and contribution
o Give young people a voice

- Increase recognition of at-risk groups
o Culturally and Linguistically diverse populations
o Young people in juvenile justice
o Young people exposed to violence, abuse, neglect and poverty
o Young people caring for those with a mental illness

- Increase awareness of and normalise mental health issues and difference amongst young people. So that peers are better able to share their concerns with each other; support each other & encourage each other to seek further help.

- Expand generalist support in schools to enhance young people’s sense of connection with each other
o Instil a culture of talking about personal issues amongst school students, say form year 7, once a week in a dedicated class time.
o Increase peer support mechanisms (partnerships)
o Support Organisations that support young people/students such as student unions.

- Early and effective (empathetic, sensitive& respectful) intervention essential to prevent continuation of mental health issue into adult hood.

- Reduce pressures on young people, academic pressures, role models (via the media), pressures to get good grades and secure jobs in the workforce and feel socially connected

Sexuality, Gender Expression and Sexual Formation

- The human rights of people of all ages of diverse sexuality and sexual formation are fundamentally linked to the human rights of all.

- Equality before the law in both State and federal jurisdictions, including all forms of familial relationships and parental rights and obligations, is a fundamental civil and human right.

- That transsexualism and other forms of intersex should be removed from the Diagnostic Statistical Manual of the American Psychiatry Association.

- Recognition of the need for specific services for those dealing with sexuality and sexual formation health and welfare issues.

- That specialist Centers of Excellence be established at selected Public Hospitals in each State and Territory for the provision of publicly funded medical treatment and related services such as welfare and educational for people with transsexualism and other intersexual conditions of all ages and their families.

- That such Centres of Excellence address the special needs of people who experience variation in sexual formation and expression and act as teaching centres for the medical profession and the community so as to overcome the anachronistic disorder model of treatment.

- That the Standing Committee of Attorneys-General (SCAG) be requested to promptly act to introduce humane uniform State and Territory legislation recognising the human right of individuals who have experienced transsexualism and all other intersexual conditions to the reassignment of their legal sex so as to bring it into conformity with their lived sex with:
- No condition of being unmarried
- Compassionate provisions where age or health preclude complete sex affirmation treatment

- The need for greater awareness of health issues associated with diversity in sexual formation.

- Homophobia is rife amongst decision makers in control of civil rights & mental health – the problem lies in the ‘culture’

- Mental Health promotion needs to be mainstreamed.

- Increase awareness of and treatment for the higher risk of addictive and mental illness experienced by people who experience difference in sexuality and sexual formation.

- GLBTIQ research and service data collection is required to better understand the mental health needs of these communities.

Refugees and Asylum Seekers

That the Government acknowledges that the National psyche is being damaged through our inhumanity in policies dealing with mandatory detention

- The Burden placed on individuals, organisations and communities to carry the impact (financial, social and emotional) of the policy of Temporary Protection Visa, bridging and removal pending Visa’s and mandatory detention

- End mandatory detention and the related processes – brief detention only for due processing

- DIMIA to be made accountable with full enquiry of practices, adequate training and accountability of staff.

- Absolute inadequate for DIMIA and non-political appointment for members of RRT and also adequate training and support to be provided

- That all Temporary Protection Visa’s be abolished

- Those current holders of Temporary Protection Visa’s are given permanent protection visas.

- That in our negotiations with other countries that human rights consideration showed not to be subjugated and be secondary to trade and economic consideration eg. Falun Gong practitioners in currently being deported to China.

- That officers of foreign countries are not aided in accessing detention centres

- Interpreters be appropriately trained and used – with the possibilities of review of interpretation being given legal status. End spin doctoring and fear generating abuse.

- That DIMIA cease Government investigation of deportation of Falun Gong practitioners and the unmonitored interviews by Chinese Consulate Staff

- Law on dissent – M.O.U. trade must not override human rights

- Separate Border Protection from DIMIA put it back in the hands of Coast Guard

- Stop Government Interference in process of requests for asylum or refugee status

- Following the release of children form detention and steps taken with regard to long-term detainees general community perception is that many of the refugee problems are now okay. This is not true, outstanding is:
o People on bridging visas, home detention and temporary protection visas.
o Long-term detainees still with unresolved status ie. Removal pending visas.

Disabilities and Ageing

The conference organisers regret that this information is not available.

Indigenous

Reconciliation and indigenous affairs be put out back on the national agenda.

Governance and Mental Health

Medicare should be extended to cover the needs of the patient rather than the time of the general practitioner: best practitioner to deliver service.
Divisions of GP should be true Divisions of Practitioner Care, so that people can have immediate access to best practice.
Utilise workforce that already exists instead of bringing in o/s doctors or using untrained medicos.
Train mental health workers from indigenous communities and other cultures.
Integrate silos especially education/health/drug and alcohol prevention/early intervention/housing

And in all these circumstances the Conference earnestly requests the Parliamentarians of Australia-:

1. To take urgent action to reform mandatory detention policy so as to ensure the humane treatment people seeking asylum in Australia

2. To value and respect difference and the contribution that people who experience difference of all kinds make, and have made, to this nation;

3. To take action through policy initiatives and legislative reform so as to help and not harm those who experience difference in mental health, race, sexuality and sexual formation and in so doing to rebuild Australia’s sense of healthy national identity by affirming our generosity of spirit and our fairness.

4. To release to the media a joint communiqué about the recommendations of this conference and publish the recommendations and actions from the plenary session in the nominated websites

5. Call for establish a Human Rights Legal Centre to address some of the key issues relating to mental health and the violation of health and human rights

6. Call for a Parliamentary Support Group on Human Rights and Mental Health to keep parliamentarians informed, involved and active on these issues.

ENDS

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