Senate Foreign Affairs, Defence and Trade Legislation Committee, , 5:36:43 to 5:54:04
A detailed review of mental health services in the ADF, covering staff uplifts, 24-hour support lines, and the implementation of Royal Commission recommendations. The discussion includes clinical governance, psychologist facilities, and anonymous complaint mechanisms.
Topics: Health, Workplace culture
Speakers: Sonia Bennett, Jacqui Lambie, Meghan Quinn, Justine Greig, Unknown Speaker, Natasha Fox, Raff Ciccone
>> Yeah, I have a feeling those girls would have went off their chops anyway and gone out and had a look at their own toilets to be honest with you. But thank you so much for clarifying that. That's great and I'm glad it's just a one-off incident at this point in time. Good >> Okay. So, I just want to talk about defenses. What changes has defense made to their delivery of mental health care? >> Have you made changes in the last 12 months?
>> Uh Senator um RAL Bennett Surgeon General in the ADF. Uh changes specifically I would I would say have not necessarily occurred. What has occurred though we have seen an uplift in the number of mental health professionals that we have looking after our uh members uh across all range of uh professional categories. So um psychologists, psychiatrists, mental health nurses uh and the like. Um the other the other aspect things like the all our support line for instance we've seen an uplift in that. Uh I know historically there'd been long wait times, call dropouts, etc. So the all our support line is is the health line specifically for people calling in with mental health needs. Uh and includes the options for family to call in if they're concerned about a member. Uh so working with our provider, we've seen an uplift of that in both uh personnel contracted to staff that line, a reduction in uh weight times and dropouts. So uh changes not specifically I I guess one of the changes and and I I don't know if it was in within 12 months or before would be our training for our mental health professionals. It's part of the Royal Commission recommendation uh about improving education for defense personnel generally. So the aspects of that which colleagues could talk to is not just educating um members and command in um suicide prevention training but our health personnel also have had uh a change in that training and an uplift to that. So they would be a summary of the high level changes. Can
I just can I just add from the um so in in recent times we've introduced the mental health and well-being strategy which goes from 2025 through to to 2030. It's got a whole series of uh of uplift in capability and training and support uh for members. We are working through uh the implementation of the Royal Commission into defense veteran suicide the the report which is a whole set of things particularly focused on suicide prevention including training courses. There's there's been the introduction of access to more than 25 different educational programs that have an impact on mental health and well-being. And we've also got a a defense lived experience framework which supports elements. Um, so there's a whole set of things in terms of strategies and packages to train that we're
>> I understand that, Miss Quinn. That's fine. I've got that. Um, no, no 24-hour
>> So, the Oh, sorry, Senator Justine Greig.
Um, Deputy Secretary people. So the the
hotline availabilities is either with the defense member and family support line that I know you're aware of or the direct uh health care line which are 24 hours.
>> Oh, they are 24 hours. >> Okay. All right.
>> That's the all our support line that's available to triage people who come in.
>> Who's triaged in them?
is the one I said we've seen an uplift in the all our support line. So it's it's specifically only for mental health concerns not just the member their family can call in that is our outsource service provider who provides that. They're mental health nurses who provide the service uh and depending on obviously the issue at hand there are range of outcomes that that can range from providing advice to referral to
different. Okay. So, it's basically like an octopus. They're coming in and then you'll fish them out to where they >> need to be. Okay. Um, can you just clarify with the garrison health contract in place who? So, is it the ADF the prime contract some subcontract is ultimately responsible for the health mental health treatment facilities? >> Who's in charge of the staff in there?
So Senator, if we're talking about Garrison health care, so the mental health care that we have is on base and off base is how we tend to classify it. >> On base, the mental health facilities we have are part of the garrison health estate. >> Uh so as commander joint health, I'm responsible for the facility. Um but also I said colleagues are responsible for the infrastructure.
>> Okay. Yeah. Yeah, I don't sorry I'll just let me rephrase my question. If I have a civilian, let's say psychologists, >> uh who do they report to? If they believe their work piece workplace may be being run uh by the hierarchy of defense, who do they go to? Do they go to baher? Do they go to >> what what happens there with those civilian um qualified >> because I think there's a bit of coming unstuck here and I'm just trying to work
understand the question. So it is as you're uh pointing out it's a multid-disciplinary and multi-employed workforce. Uh so it there is complexity within any health center. There's a commanding officer and a health center manager. Uh and there are also various roles that are combination of uniformed APS and civilian from a leadership point of view. So locally within the health center there are local arrangements with commanding officer of the center being um uh ultimately responsible for that center and the joint health unit. >> From a performance point of view however the civilian um the contracted uh psychologists or contracted health practitioners uh also are employed through uh ber as the prime contractor. Their performance is managed there and they also have that avenue to report as well.
>> Okay. So, how many complaints have been
>> I'd have to take that on notice, Senator.
>> Okay. Do we discuss this with Ber at all between defense and ber?
>> Thank Thank you for that question. Part of it the the other part of the answer to that question, Senator, is that there are there are layers of governance including um garrison management committees where senior executives at different levels, but certainly for me the the one most near is the garrison management committee which met just yesterday or the day before senior executives from BER and Garrison meet uh around a range of things but where those sorts of issues around complaints or performance would be discussed.
>> Okay. So, how many complaints in maybe the last year have have where if I had um civilians, whether they're GPS in there or psychologists in there, uh and they have a military member that they got to report to. Uh obviously that's a problem for them. What do then they've got to go to BER? What's Ber doing about
>> So, it depends on the complaint, Senator. And
>> okay, if it's a poor performing person in uniform, >> What's BER doing about it? And how many complaints do they have?
>> So, so Senator, if the performance is around a uniform member, that would be the uniform leadership's responsibility. So, certainly the civilian psychologist could report within the within the chain of command in the health center. But if it's a uniform member's performance, that is the commanding officer's responsibility. I if it's a contracted health practitioner's performance, that will be booper's responsibility. But our teams work together at all levels given that they are
>> okay. So if you're working together as ber mentioned anything about complaints coming through to them.
>> I can't answer yes or no senator. I'd have to take that on notice. My team would have the answer to that.
>> Okay.
>> Can I just just note that there's also an anonymous complaints mechanism in defense that covers all aspects of concerns. So if someone has a complaint that there is a mechanism that they could take it to a new independent complaints resolution
area. >> Okay. When did that start?
>> Uh Senator uh Justine Greig. So that commenced in January this year. It was uh a recommendation um previously of the ombbudsman and the royal commission to ensure that we had an avenue for complaints including anonymous complaints and also complaints outside of the chain of command. So that's been operational since January this year.
>> Okay. And how many anonymous complaints have you received?
>> Uh I think it's 92, but that's just in terms of general complaints. I'm not talking about medical complaints. We've
had 308 complaints overall and 95 were made anonymously and they cover a whole range of different types of uh issues. Um and they they can go to the to this service uh and they will be triaged and it will be dealt with through whether it's an APS member, an ADF member, whether it's of a a military police matter, whether it's a code.
>> Okay. So, how many of these have been resolved out of all those complaints?
>> I don't have that. right here but happy to take it on notice. It would depend on you know all the different components. So um happy to take it on notice.
>> Okay. Can you tell me whether when it comes to our psychologists um does the officer or the manager of those places in charge of those psychologists do they need to have actual qualifications in mental health
>> Senator I'll I'll take that question. Um certainly in any um psychology team there would be a designated leader uh who has qualifications in mental health. The commanding officer of the joint health unit or the health center manager do not necessarily have qualifications in mental health. If they are a health practitioner, they will have had the mental health um they will they will have had some certainly the safe side training I was just talking about as all of our health practitioners are do, but they won't necessarily have specific u mental health
>> training. Why is that? Because I'm hearing you've got some nurses that are in charge too of these um civilians and they haven't got mental health training themselves.
>> They do or don't. Sorry, sir. >> They don't. No, because it's a multi-disipliner plary team center. All health teams whether they be in defense or elsewhere. Uh leadership is often due to which health professional can fill that role and then done on merit. um in the same way uh that uh even jobs as myself will have different professional training but we lead a a diverse and multi-professional team and you have >> you have access to the specialist input required to be able to understand what the needs of those teams are. But if
you're a nurse in charge of um psychologists, would you not require that nurse when they got in to go and have um different training to make sure that they're up on on what they're dealing with, which is the psychologist to have mental health training beside
them. So there'll be two aspects to the leadership. One is the leadership of that person uh in performance and the other is the technical aspects which is the subject matter expertise. So any leader,
>> I'm sorry, but when you're dealing with mental health and you haven't got any mental health courses you've done yourself, how does that give you expertise to be telling psychologists what to do and how to deal with things? I can understand that and understand some of these guys have been in the war zone and whatever, but what I'm asking to you what I'm asking for specifically is why don't they have mental health training with them and why haven't they already started if they're in those
positions? So Senator, the the commanding officer or the leader would not be telling a psychologist what to do from a professional point of view. What they are doing is running that health center and the and and the and the command or the joint health unit. They wouldn't be specifically providing advice to a psychologist as to how to manage a patient for instance.
>> I'm not asking for advice. I'm asking whether or not they have qualifications in that mental health area cuz that really bothers me. So, how are they supposed to connect with a psychologist in there? And yet, you've put them in charge. That's very rowing.
>> Uh, Senator, all I can say is that sort of standard practice in multi-disiplinary team.
>> Well, maybe the standard practice needs to change. I just don't understand that at all. Um, can you tell me how many does each unit when it comes to those psychologists who are dealing um with people in uniform, do they each have a consultation room? or they all out because I'm telling you a psychologist needs their own room to deal with their own patients. So having a nice big room where we can all sit and be polite is nobody's going to get their nobody's going to get their thoughts around. So tell me what's going on there cuz I'm hearing that's not happening.
>> Well, Senator, my expectation would be that anytime a psychologist sees a patient, they are in a a dedicated room on their own. So if that's not happening, I' i'd be very interested to hear. But that's certainly my expectation and that would be uh the health standard that we set. That doesn't mean the psychologist will have that room all day and certainly if they're doing administrative work it may be that there is there are shared work spaces but when consultations occur they should absolutely be occurring in a dedicated room one-on-one.
Okay. So other than that they're thrown in a room got to take phone calls from there do the paperwork from there without actually having a dedicated I'm just a bit that I'm a bit concerned about that just they're private matters and if you're putting them all together in a bunch because you so when you've got someone coming in you can go into a room other than that you've all got to
sit out here. Well generally what would happen Senator is a a a and this happen would happen with doctors as well if they're seeing patients and doing consults they would have a session. So it's not just in and out they would probably do half a day uh and then somebody else may come in and do a half a day session clinical session as well. And there are other spaces for administration where it is still private. Um you know people are working at their desk in private cubicles and they can do their work that way.
>> Do you think um the committee can have a list of um all the psychologists you have where they are and how many hours they're working whether full-time or part-time?
>> Yes.
>> Um we'll be able to do that. And can you if if a clinical psychologist resigns, what is a process in place to manage the transition for their patients to a new psychologist? Do we do a hand over here or it's just you're gone next one in?
>> Uh no, there would be an absolute handover, Senator. So uh and it whether it's resignation or for whatever reason a psychologist moves on uh clearly contemporaneous notes are the first and foremost most important thing. So the health record is what most clinicians rely on. Uh and then um where possible depending on the circumstances there would also be that that clinical handover of patients particularly the complex patients. Often if it's a complex patient you'll have a a team involved in the care of that patient. So even if the psychologist is changing out either the medical officer uh or the mental health nurse or the psychiatrist would be involved as well as other social workers and well-being. So for complex patients that's a little easier to manage for individuals. Um the the health record is the most important handover and if possible a practical handover would occur.
>> Okay. Um okay. So there are no disruptions during the the handover phase. What's what's the what's a revolving door look like with the psychologists in there? Are we having a revolving door? Are we what what does it look like in your world from where you're sitting? Cuz that bothers me as well. >> It's no good for anybody's mental health if we can't have this. We're not trying to keep those psychologists cuz it's a trust thing. obviously they can trust and if you're churning through them for whatever reason >> I'd like you to get to the reason and try and fix that because it will be a lot more beneficial I would I would suspect is there a sort of problem between yourselves and boop or anything
>> no Senator I'm I'm not aware of churn but I without the data in front of me I wouldn't like to say there isn't any so we could take that on notice to understand if there is a turnover and whether that's more than above average
Okay. Um, does anybody else have any questions on this line of questioning? >> Sorry, Senator. >> Anyone have any more line? Does anyone have any for the health professionals here? Does anyone have any?
>> It's fine. Like, we'll rotate the call and come back to you.
>> Okay. Yeah, that's fine. You can rotate the call. Okay.