Why Australia’s assistant mental health minister decided to run for parliament

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Assistant Mental Health Minister Emma McBride feels her portfolio is deeply personal.

The former hospital pharmacist spent nine years working in acute mental health inpatient units before she was elected to parliament. Back then, she would watch people in serious distress, or with complex mental illnesses, brought in by ambulance or the police before ending up in seclusion.

Emma McBride says suicide affects every Australian community she visits.Credit: Alex Ellinghausen

“Then you get to meet them and understand what’s happened to them, and how they’ve ended up there,” McBride said. “You just need to change it … it’s really what led me to being in parliament, wanting to see that we can make a fairer healthcare system for everybody.”

McBride now has that opportunity. The third-term Labor MP from the NSW Central Coast was appointed an assistant minister for mental health and suicide prevention after the last election.

She is charged with helping Health Minister Mark Butler co-ordinate the policy landscape – not only within the federal government itself, but alongside states and territories as well.

“It’s a responsibility that I take very seriously,” she said in an interview. “And it’s one that I know matters to so many people and families and communities.”

McBride has taken on the responsibility at a time of elevated distress and when the need for better services is particularly acute. The latest suicide data shows numbers spiked last year after Australians experienced waves of successive crises including fires, floods, the pandemic and soaring inflation.

But the Medicare system for clinical psychologists forces almost 70 per cent of patients to pay an out-of-pocket fee averaging $90, while the median wait time for someone to see a professional is 22 days, according to the government’s own review.

Children’s wellbeing in particular has suffered after two years of school closures and uncertainty wrought by the pandemic.

A Senate inquiry report published last week showed school refusal among struggling or anxious kids is on the rise. Children’s Commissioner Anne Hollands has renewed her call for a dedicated federal minister to co-ordinate policy in that space.

But McBride said she believed the current approach – in which responsibility is shared between health, education and youth ministers – was appropriate.

“We have a very collaborative and cohesive approach to this, which is I think is what it needs because the levers that can be pulled often sit outside health directly … we’re working in very close partnership to make sure we can reliably and consistently provide the support that children and families need,” she said.

McBride acknowledged Australians young and old had been struggling with mental illness at rising rates.

Suicide in particular is an issue that affects every community she visits. “It’s something that we are very determined to try to turn around … At the same time, we have to make sure that what we do is evidence-based, that it’s safe, and that it’s effective and properly evaluated,” she said.

The Labor government’s report card in mental healthcare has so far been mixed.

Its budget investment in the psychologist workforce was welcomed by the sector, as was the creation of two new lived experience peak bodies in January.

McBride points out Labor is investing in research as well as opening 61 Head to Health centres for mental health support, strengthening Headspace centres for people under 25, and launching new Kids Hubs for younger children.

“There’s now 16 [Head to Health clinics] up and running around Australia where you can walk in without an appointment, without a diagnosis, without a referral and get the right kind of support and care,” she said.

But her government’s most controversial decision in mental health was to revert the number of Medicare-subsidised psychology sessions from 20 to 10 a year. While the measure expanded access for thousands more people to enter the system, psychologists say it has left those with complex mental illnesses lacking support.

McBride said the government is still looking at that program; its full response to an evaluation is yet to come. But she pointed out that states and territories also had a responsibility to do more for people living with complex mental illnesses such as bipolar, schizophrenia or obsessive compulsive disorder.

McBride said she is taking a collaborative approach to suicide prevention, which she described as a “subtle shift” involving conversations with the ministers responsible for finance, housing and industrial relations about the levers they can pull in their own portfolios.

“There’s normally three or four contributors [to] distress – it could be relationship breakdown, financial security problems, insecure housing,” she said. “Although suicide is complex and individual, rates of suicide can reflect communities.”

Carolyn Nikoloski, the chief executive of peak body Mental Health Australia, said she supported that whole-of-government approach.

“But we also know the mental health service system itself is inadequate right now. That’s where we need government to step up, the myriad issues with the service system have been documented for years,” she said.

The sector expects a more detailed response from the government about its plans for system reform by the end of the year.

When asked how Australians should judge her efforts by the end of this term, McBride said her goal was to see fewer people in crisis, feeling hopeless and ending up in the hospital system.

As for whether the government was also aiming to improve out-of-pocket costs, wait lists and regional services? “We need to. That’s what the Australian public have trusted us to do,” she said.

“People would always like things to happen sooner, but we’re working very determinedly towards a better mental health system of care for all Australians.”

If you or anyone you know needs support, call Lifeline 131 114 or Beyond Blue 1300 224 636.

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