The Hon. EMILY SUVAAL (21:02): I seek leave to amend private members' business item No. 1436 by omitting in paragraph (3) "further notes that the Government".

Leave granted.

The Hon. EMILY SUVAAL: Accordingly, I move:

(1)That this House acknowledges that:

(a)October is Mental Health Awareness Month; and

(b)Mental Health Awareness Month is an international day for global health education and awareness for those struggling with mental ill health.

(2)That this House recognises that two in five Australians aged 16 to 85 are estimated to have experienced mental ill health at some point in their lives.

(3)That this House acknowledges the lived experiences and lives of people who have experienced mental ill health and is committed to providing dignity and genuine health care to those in need.

October marks Mental Health Awareness Month, and it is an important time to reflect on the impacts of mental ill health on our community. This year the theme of Mental Health Awareness Month is "Let's talk about it"—a theme that highlights the importance of having open, honest discussions about mental health at any time of the year. When thinking about the theme, I wanted to acknowledge that while talking about mental health is becoming more and more normalised, which is great, there is still more that we can do to improve. Some mental illnesses are talked about more than others. While a lot of us now have a good understanding of anxiety and depression symptoms, some mental illnesses are still the subject of quite a lot of stigma. They need to be talked about more and better understood.

I have talked a lot in this place about eating disorders, but tonight I talk about schizophrenia. It is a mental health condition that can impact a person's perception of reality and their behaviour. According to ReachOut, schizophrenia is estimated to affect one in every 100 people across Australia. It is slightly more common in men than in women. People living with schizophrenia often report the following symptoms: having unusual ideas or beliefs about themselves or the world, some of which may be frightening; hearing sounds or voices other people cannot hear or seeing images that others cannot see; having the feeling that others might be in control of their body or their thoughts; having trouble with thoughts getting jumbled, so that it may be hard to make sense of what people are saying or to express themselves clearly to other people; and exhibiting behaviour that seems odd or that other people might find strange.

I have chosen to speak about schizophrenia today as it is a deeply misunderstood mental health condition that unfortunately is often met with a lot of stigma and even fear in the community, even today. However, the condition can be managed, just like any other mental illness. The first step to managing schizophrenia is talking about it and raising awareness. I lived in supported accommodation for two years with someone who lived with schizophrenia. She was in her late thirties. She worked in temp roles as admin support. She enjoyed shopping, watching movies and singing, and she was very neat and tidy. In fact, I credit my pet hate of leaving crumbs on the bench to her. She was caring and kind, she was a devout Catholic and she also shared with me that her voices were as real as my voice. Sometimes she ignored them; sometimes she spoke with them; sometimes she told them to shut up. Sometimes she experienced being tickled and would laugh out loud.

My housemate had monthly clozapine injections as part of her treatment, which she hated. The side effects of the depot injection were deeply undesirable. Among the common side effects of clozapine, 50 per cent of people experience weight gain, up to 50 per cent experience hyperlipidaemia, over 50 per cent experience hypersalivation, or excessive drooling, and 50 per cent experience tiredness. But she knew it was the only medication that had been shown to work and keep her well, so she took it. She was a good housemate and a good person. I think of her often. That is why I wanted to talk about schizophrenia today, if only briefly, as we debate this motion in the House.

I acknowledge the great work WayAhead does in promoting Mental Health Awareness Month every year in New South Wales. I am happy to inform the house that WayAhead will be here again next Thursday for Mental Health Awareness Month. We need to ensure that our health system and our mental health care are consumer centred, recovery oriented, trauma informed, culturally responsive and built with and for our community. I commend the work of the Minister for Mental Health. I extend my thanks to her staff, who I know are deeply committed and do a lot of work in that space. I also acknowledge the record $2.9 billion commitment in the budget this year and the funding initiated for the Single Front Door for mental health. That will deeply improve people's engagement with mental health in our system. The Government is committed to improvements in the mental health system and the health system more broadly. It is committed to continuing the conversation and recognising people's lived experience. I commend the motion to the House. Let's talk about it.

The Hon. AILEEN MacDONALD (21:07): I speak in support of this important motion acknowledging Mental Health Awareness Month. Mental health is a challenge that affects too many Australians. As the motion highlights, two in five Australians aged 16 to 85 have experienced mental ill health at some point in their lives. Those are not just statistics; they represent people we know—our family members, friends and colleagues. By recognising October as Mental Health Awareness Month, we take an important step towards breaking the stigma surrounding mental health issues. Public campaigns like Mental Health Awareness Month educate and empower, reminding us that mental health is just as important as physical health and encouraging those in need to seek help.

To highlight the scale of the issue, approximately 20 per cent of Australians experience a mental health disorder each year, and 45 per cent of Australians will experience a mental health disorder in their lifetime. Youth mental health demands urgent attention. One in seven young Australians experiences a mental health condition each year, and suicide remains the leading cause of death for Australians aged 15 to 44. That stark reality underscores the importance of early intervention and access to appropriate mental health services. However, despite the growing awareness, nearly half of Australians with a mental health condition do not access the help they need. That is especially concerning for those in rural and regional areas, where access to services remains a significant challenge. The New South Wales Government's commitment to expanding mental health services is a step in the right direction; however, there is still more to do.

The human and economic costs of untreated mental health conditions are simply too great. They are estimated at $70 billion annually. Beyond the financial costs, the impact on lives, families and communities is immeasurable. By supporting this motion, we reaffirm our commitment to breaking the stigma and ensuring that every Australian has access to the mental health care they deserve. This is about creating a society where mental health is prioritised and every individual is given the opportunity to lead a life of dignity and wellbeing.

Dr AMANDA COHN (21:09): The Greens support the motion. Mental Health Month is an annual event dedicated to raising awareness and fostering open conversations about mental health. The theme this year is "Let's talk about it", so let's talk about it. This is the second time in a month that the Government has introduced a motion to acknowledge a day of significance relating to mental health. The mover of this motion and the Minister both say a lot of the right things. In general, I do not disagree with many of their comments both tonight and in previous discussions.

The Minns Labor Government has now been in government for over 18 months. My support for this motion would be more enthusiastic if those words were accompanied by action and a meaningful increase in resourcing. The Government has committed to a range of reforms, including suicide prevention legislation, a functional peer workforce framework and reform of crisis responses to mental health emergencies toward a health-led response. Those commitments are welcome, but I would rather be debating the implementation of the reforms than another motion acknowledging the Government's stated commitments to do those things at some stage. Mental health care is health care, but it is not yet treated that way.

As this House has already noted, last year the Australian Institute of Health and Welfare found that mental health issues represent 15 per cent of the total burden of disease in New South Wales, but only 6.5 per cent of the State's health budget was spent on mental health. The budget is a pretty revealing look at the genuine priorities of the Government. For a number of people, recent announcements feel like rearranging deckchairs on the Titanic. Mental health is health, and we must transform our health system to reflect that. All people deserve free and universal access to timely, public and culturally safe consultations, assessments, diagnoses and medications in their communities.

Our health system desperately needs prevention; health promotion and early intervention mental health services that are fully funded and that genuinely address the social determinants of health, including mental health; and a mental health workforce that is reliable, capable, empowered and fairly remunerated. People with lived experience must be able to equally participate in the workforce, including the mental health workforce, where their experiences are so valuable. The Greens look forward to seeing announcements from this Government that would meaningfully acknowledge the lived experiences and lives of people who have experienced mental ill health, and to working with the Government to deliver on its stated commitment to providing dignity and genuine health care to those in need.

The Hon. ROSE JACKSON (Minister for Water, Minister for Housing, Minister for Homelessness, Minister for Mental Health, Minister for Youth, and Minister for the North Coast) (21:12): I speak in support of the motion. I thank my dear friend and co-convenor of the NSW Parliamentary Friends of Mental Health, the Hon. Emily Suvaal, for once again using her time and space in this Chamber to raise this issue. It is an incredibly powerful thing that she does. Motions can be moved about anything on a Wednesday, and we debate a lot of different things in this Chamber. It is a fabulous part of our democracy. This member repeatedly chooses to use her opportunities to move motions about mental health. She does this to provide a regular platform for us to talk about the issue. It is a deliberate choice that she makes as an advocate for this issue, and one that should be acknowledged by this House.

The theme of Mental Health Month this year is "Let's talk about it". That talk needs to be inclusive. It needs to be a discussion which is conducted in various ways so we can meet people where they are at. What does "it" mean? I think there is a deliberate choice to say "it" and not to use a label like mental health. It is deliberate that the theme is not "Let's talk about mental health". "It" can mean anything to anyone who wants to participate in a conversation about mental wellbeing. This ensures that the conversations we are having are inclusive and that we are destigmatising rather than labelling people. The best way to start such conversations is by ensuring that we are having open conversations that meet people where they are at, and that we are not labelling them or forcing them to pathologise their experience. It also suggests a conversation that can be initiated by either party.

This is not the type of message that says, "Raise your hand if you need help." While those messages are important, we have moved beyond the idea that, if people just put their hand up and identified that they needed a little bit of support, there would be services wrapped around them. Firstly, we know that is unfortunately not true. Secondly, putting your hand up is actually very difficult. "Let's talk about it" encourages the idea that a person might initiate a conversation by reaching in and saying, "How are you going?" I acknowledge that the theme "Let's talk about it" is incredibly important for our community and for marginalised groups, who find it particularly difficult to talk about mental health. For the Government, however, the theme is inadequate. It is not just about talk for us; it is about action. I agree with many of the things that Dr Amanda Cohn has put forward as a call to action for the Government. I use my time provided by the mover of this motion to both talk about mental health and recommit the Government not just to talk but also to take action. We will have more to say.

The Hon. JOHN RUDDICK (21:15): The Libertarian Party has concerns about this motion. I know this will be unpopular, but I believe that we have an important message to say. I raise the possibility that an escalating society-wide focus on mental health is exacerbating mental health issues. When one feels a little down and gloomy, it is most often nature's way of telling us that we need to make an abrupt and positive change in our lifestyle, diet and general outlook. I am concerned that the medical industrial complex has a propensity to prescribe overcoming a little gloom with a subscription service of antidepressant drugs, which seem to be the most addictive of all drugs. It is certainly a booming industry and it underpins so much of the pharmaceutical industrial complex's profits. I note a paper cited in April last year in The Lancet titled "Are mental health awareness efforts contributing to the rise in reported mental health problems? A call to test the prevalence inflation hypothesis". I quote at length from the abstract of that paper:

In the past decade, there have been extensive efforts in the Western world to raise public awareness about mental health problems, with the goal of reducing or preventing these symptoms across the population. Despite these efforts, reported rates of mental health problems have increased in these countries over the same period.

…

We term this the prevalence inflation hypothesis.

…

…we propose that awareness efforts are leading some individuals to interpret and report milder forms of distress as mental health problems. We propose that this then leads some individuals to experience a genuine increase in symptoms, because labelling distress as a mental health problem can affect an individual's self-concept and behaviour in a way that is ultimately self-fulfilling. For example, interpreting low levels of anxiety as symptomatic of an anxiety disorder might lead to behavioural avoidance, which can further exacerbate anxiety symptoms.

The paper concluded:

Lastly, the prevalence inflation hypothesis states that the relationship between mental health awareness efforts and increasing rates of mental health problems is cyclical and escalating.

Psychologists have long known that the number one symptom of depression is rumination, which is the pathological obsessing over your pain. There is a rich tapestry of life, and part of that complex but beautiful experience is some pain and mental distress along the way. The Hon. Rose Jackson urged us to talk about it more. I think that if we talk about it less there will be less. I urge a return of good old-fashioned stoicism and rugged individualism, and for the Government and the media to stop over-hyping mental health issues.

The Hon. SUSAN CARTER (21:18): I am happy to support the motion recognising October as Mental Health Awareness Month, and I thank the honourable member for bringing the motion to the House. The Hon. John Ruddick is right: We talk a lot about mental health in this place, and this is good. We should be doing this every October. Talking about it is part of the education in which we all need to be engaged. But perhaps it is time to recast the narrative a little. When we talk about our physical health, we are usually not talking about disease or illness but about how we can make our healthy selves even healthier, through sensible eating and regular exercise. Sadly, mental health has almost become a cipher for the opposite—for mental ill health. This October let us start to reclaim the concept of mental health and focus on how we can make our mentally healthy selves even healthier. Let us talk about mental fitness as well as mental health. We know that mental ill health is a major community problem. It is important to normalise the experience of mental ill health and recognise how widespread it is, with at least two in five Australians having experienced mental ill health at some point during their lives.

But in normalising it, let us not just accept it. It is time to change the narrative. Mental Health Awareness Month should be about, among other things, fostering resilience, developing a toolkit to foster mental fitness. Mental resilience is the ability to cope with life's challenges and bounce back from adversity. It is a crucial component of mental health, enabling individuals to manage stress, overcome obstacles and maintain a positive outlook. By promoting mental resilience, we can help individuals build the strength and the skills we all need to navigate the complexities of life. Like our physical health, mental health must be nurtured, and it is incumbent on all of us to nurture the health of our whole community.

Supporting mental health and resilience requires a multifaceted approach. It involves increasing access to mental health services, reducing stigma and promoting education. It also means creating environments that support mental wellbeing, whether in schools, workplaces or communities. By addressing these areas, we can create a society where mental health is prioritised and individuals feel empowered to seek help when needed. We obviously focus a lot on government in this place, but it is not the role of government to legislate for mental health. This is not an "only government" issue; it is an "and government" issue, with everyone in the community and government working together.

The Hon. Dr SARAH KAINE (21:21): I speak in support of the motion. I join the Minister for Mental Health in thanking the Hon. Emily Suvaal for her commitment to mental health issues and for bringing the motion to the House. I have some prepared notes, but I will instead respond to a few of the comments members have made and the characterisation of mental health issues in a particular way. I am presuming the Hon. John Ruddick was speaking about depression when he said, "We shouldn't confuse it with being a little down and gloomy. We shouldn't think there is something wrong with that. That is a natural and healthy thing." Yes, being a little down and gloomy is natural—spending a long Wednesday in here does not do much to help that!

I am making light, but the comment forced me to reflect on when a member of my family in my household was "a little down and gloomy"—or so I thought. I treated that person as if they were just a little down and gloomy. Let me tell you, it is quite dangerous to dismiss a serious mental condition or depression as a transient experience. Sometimes it is, because we do have feelings. Feelings are transient and we can live through those. But if we dismiss actual illnesses they will get worse and if we do not treat them, particularly in the mental health area, they can be terminal. I suggest that we be very, very careful about how we talk about mental health. We need to be cognisant of the realities of life and we need to guide our young people—one of whom I was talking about—through its ups and downs.

We need to make them resilient and help them understand that they will get through difficult times. But we cannot dismiss when those feelings are more than that, when they are something that does need to be treated. So I caution us to, as always, be very careful about how we talk about things in this place because that also matters. Yes, we do need to keep a focus on mental health and, yes, we need to model and teach resilience. But mental health is not just about resilience. It is about making sure that people get appropriate treatment, that they are not stigmatised when they do and that we provide support for the people who need it most. I commend the member for moving this motion.

The Hon. WES FANG (21:24): I make a brief contribution. I thank the Hon. Emily Suvaal for moving the motion and commend the previous speakers. I will address some of the comments made. Although there are times when I agree with the Hon. John Ruddick, this is not one of them. I think there is nothing wrong with discussing mental health and normalising it. I do not think it encourages more people to feel down; I think it encourages people to seek help if they are struggling. I often joke that all of us in this place are experts in mental health because no‑one gets into politics unless there is something a little bit wrong with them. I make light of it, but the reality is that this is a pressure‑cooker environment. All members recognise the pressures of this 24/7 job—engaging with different colleagues, the community, the media—and know that it impacts people differently.

People will express that in different ways. The way it is expressed can either help somebody or hinder them. But expressing it is the first step in acknowledging, as the Hon. Dr Sarah Kaine said, that it is a health problem and seeking a way to address it. Ultimately, mental ill health is something that can be hidden very well. It can also be quite apparent. But addressing it is the most important thing, and it does not necessarily always have to be by way of medication. Cognitive behaviour therapy, exposure therapy or simple counselling might be what alleviates someone's pressure. But people cannot address their mental health unless they acknowledge and talk about it. I commend the member for bringing the motion. I commend the Minister for Mental Health for saying that we need to talk more about our mental health, because if we do not talk about it then nothing will change.

The Hon. CAMERON MURPHY (21:27): I speak in support of the motion and in response to what the Hon. John Ruddick said about mental health. I need to call him out. Quite often his contributions start in one area, take a quick turn and end somewhere else. I do not know whether that was his intention in relation to this matter, but I found it offensive for him to say words to the effect that if you talked less about it, there would be less of it, because mental health is a serious issue. It is something that we all need to come to grips with as a community, as a Parliament and as a government. Talking about it is the first step to fixing it, so that we are aware of it, we know about it, and we can put the resources and the effort into making people's lives better.

If that is what the report stated—I thought the 4Chan economics was weird—that is really not the sort of thing that we should be relying on. I urge the Hon. John Ruddick to read less of that. Imagine if people took that attitude towards domestic violence: that somehow it would disappear if we spoke less about it, and that we would not have a problem. We know that is not true. In many ways mental health is the same. It must be taken seriously. It should be out in the open and talked about so it can be dealt with properly.

The Hon. SCOTT FARLOW (21:29): I support the motion moved by the Hon. Emily Suvaal and commend her and the Hon. Susan Carter for their work as the co‑chairs of the Parliamentary Friends of Mental Health. I had the role of the chair for nearly eight years. I remember moving many similar motions in this House. It was always quite good for my own mental health because it was when everyone said nice things about me and commended me for moving the motion, and that was refreshing. But talking about mental health takes its toll. I have some sympathy with comments made by the Hon. John Ruddick in that respect because sometimes we need other factors as well as resilience. I commend the mover of the motion, particularly for her comments on matters such as schizophrenia. Rob Ramjan is a former head of the Schizophrenia Fellowship, and he always used to talk about how there were acceptable forms and unacceptable forms of mental health issues.

In a sense, we need to shine a light on mental health conditions that are more complex and are not just conditions that people can relate to in their everyday lives—things that are a little bit more frustrating for those who have to deal with it and their families and carers. Talking about significant conditions like schizophrenia during a month like this month, which can at times take on some fairly complex manifestations for those who have the condition and for those who care for them, is perhaps a little different to what some of us might think of when we talk about Mental Health Awareness Month and the conditions that we can relate to our own lives. People find some conditions very challenging and society finds it very challenging in how we balance them. Minister Jackson has great responsibility in dealing with mental health conditions. I know she takes that role very seriously, as all Ministers who preceded her did. Those issues, and how we deal with them, can get quite complex.

It is important to be mindful of that, as well as checking on ourselves and marking R U OK? Day and Mental Health Awareness Month. I commend WayAhead and all of the mental health organisations across New South Wales for the all the work they have done. I also commend the Mental Health Commission for marking this month and working to ensure that, while we are mindful of mental ill health, we are mindful also that it is a condition like any other.

The Hon. EMILY SUVAAL (21:32): In reply: I thank all honourable members who contributed to this evening's debate. I wanted to thank everyone individually, of course, but owing to limited time, I will focus on a couple of aspects of the debate. The Hon. Aileen MacDonald talked about the effectiveness of the public health campaign around mental health and how we have come to recognise mental health as being as important as is physical health. I would argue it is more important. We cannot do anything without our mental health and that includes looking after our physical health. Being in a state of mental good health is more important than anything else, in my humble opinion.

I acknowledge the advocacy of Dr Amanda Cohn in this space. I thank her for talking about the social determinants of health, which are a really important factor when dealing with mental ill health. I know that Minister Jackson, who also has the Housing portfolio, is working hard. Housing is a really significant contributing factor to people's mental health and wellbeing. I commend the Minister also for the work she is doing in that space. During the debate, Minister Jackson referred to the importance of inclusivity in speaking. It is really important. The Minister referred to the importance of two‑way dialogue and reaching in as opposed to waiting for someone to reach out. I look forward eagerly to what more the Minister has to say in this space.

The Hon. John Ruddick—where to begin? When someone, in the context of a debate on mental ill health, refers to any type of mental ill health as feeling a bit gloomy, I can only assume that that person does not understand what it is like to be depressed or to suffer any type of mental illness. Depression is not feeling a little gloomy; it is not ruminating. It is being physically unable to get out of bed. There are physiological symptoms associated with depression, which include chemical imbalances in the brain, reduced neurotransmitters and not having enough serotonin. There are chemical reasons that contribute to people's mental ill health.

The Hon. Susan Carter talked about the importance of resilience. I thank the Hon. Dr Sarah Kaine for sharing her story and for her contribution. I commend the Hon. Scott Farlow for his participation in the debate. Telling your story sometimes means you can be the holder of stories. Somebody warned me about that very early and it is something I have had to be very mindful of when people share their stories with me. I thank the Hon. Scott Farlow also for his contribution in recognising the importance of schizophrenia. I commend the motion to the House.

The ASSISTANT PRESIDENT (The Hon. Peter Primrose): The question is that the motion be agreed to.

Motion agreed to.