Mental Health
The following content draws upon, in part, the Joint Australian NGO Coalition's fact sheets prepared for the Universal Periodic Review.
Access to appropriate services
Mental health services are significantly under resourced in Australia and there are widespread problems with access to care, quality of care and adequate accommodation for people requiring mental health services. In 2009, Australia was reviewed for its compliance with ICESCR, with the Committee noting its concern with "the insufficient support for persons with mental health problems, as well as the difficult access to mental health services, in particular for Aboriginal and Torres Strait Islander peoples, prisoners and asylum seekers in detention". In this regard, the Committee recommended that Australia:
- allocate adequate resources for mental health services and other support measures for persons with mental health problems in line with the United Nations Principles for the Protection of Persons with Mental Illness and the Improvement of Mental Health Care;
- implement the recommendations of the Australian Medical Association's 2008 report on Aboriginal and Torres Strait Islander health;
- reduce the high rate of incarceration of people with mental diseases; and
- ensure that all prisoners receive an adequate and appropriate mental health treatment when needed.
Recommendations of the UN Special Rapporteur on the right to health
In 2009, the UN Special Rapporteur on the right to the highest attainable standard of health undertook a Country Visit to Australia. During his visit, the Special Rapporteur focused on the standard of living and quality of health care and health services for Aboriginal and Torres Strait Islanders, the health of people in prison and health of immigration detainees. In his report released in June 2010, the Special Rapporteur made a number of recommendations, including that Australia:
- develop a national health policy which includes a detailed plan for the full realisation of the right to health;
- increase engagement with community health providers by prisons, which would improve continuity of care and facilitate reintegration into the community;
- increase resource allocation for diagnosis, treatment and prevention of mental illnesses within prisons;
- assess and invest in the primary health care sector throughout the prison system;
- undertake research regarding Aboriginal and
- Torres Strait Islander incarceration issues as a matter of urgency;
- reconsider the policy of mandatory detention of irregular immigration arrivals;
- place detainees with a history of torture and trauma in community detention; and
- reconsider the appropriateness of detention facilities continuing to operate on Christmas Island, and assess provision of mental health services to this population as a matter of priority.
Prisoners' access to appropriate health care
As identified above, following his visit to Australia in 2009, the UN Special Rapporteur on the right to the highest attainable standard of health made the following specific recommendations relating to health services in prisons:
- increase engagement with community health providers by prisons, which would improve continuity of care and facilitate reintegration into the community;
- increase resource allocation for diagnosis, treatment and prevention of mental illnesses within prisons;
- assess and invest in the primary health care sector throughout the prison system; and
- undertake research regarding Aboriginal and Torres Strait Islander incarceration issues as a matter of urgency.
Similar recommendations were also been made by the Committee on Economic, Social and Cultural Rights in 2009, as well as the Committee against Torture in its 2008 Concluding Observations, regarding the insufficient provision of mental health care in prisons and mentally ill inmates being subjected to extensive use of solitary confinement.
What the UN Human Rights Council recommended in the Universal Periodic Review
In January 2011 Australia was reviewed by the UN Human Rights Council during the Universal Periodic Review (or UPR) (a process whereby the human rights performance of all UN member states is reviewed by other states. In June 2011 Australia provided its response to the 145 recommendations made by the Human Rights Council.
The Government has accepted over 90 per cent of the recommendations and has committed to incorporating the recommendations it has accepted into the National Human Rights Action Plan.
In relation to mental health, the Human Rights Council made a number of relevant recommendations. Australia has responded to these recommendations as set out in the following table. Recommendation Stance Explanation Take measures to consolidate domestic legislation to end discrimination against people with disabilities in line with international standards (recommendations 86.41, 86.45 – 86.47). Already reflected Australia accepts the recommendation on the basis it is reflected in existing laws or policies and Australia will continue to take steps to achieve relevant outcomes. "Close the gap" in opportunities and outcomes between indigenous and non-indigenous communities (recommendations 86.116 – 86.117). Already reflected Consolidate Commonwealth anti-discrimination legislation to ensure full enjoyment of all human rights by every member of society (recommendations 86.42 and 86.44). Accepted Australia will consolidate federal anti-discrimination law into a single streamlined Act to enhance the regime and give effect to existing grounds of protection. Put an end to systematic discrimination on the basis of race in particular against women of certain vulnerable groups (recommendation 86.48). Accepted The Australian Government considers that its current laws, policies and programs do not discriminate on the basis of race. Ensure all victims of violence have access to counselling and assistance with recovery (recommendation 86.82). Accepted The Australian, State and Territory governments will continue to provide services to victims of violence including counselling and, where appropriate, financial assistance through victims of crime compensation schemes. Carry out a comprehensive assessment of the actions and strategies aimed at improving socio-economic conditions of indigenous peoples, in consultation with the communities concerned, and if necessary correct these actions (recommendation 86.118). Accepted The Council of Australian Governments Reform Council will provide a comprehensive report each year on progress against relevant targets. Take immediate legal measures to remove restrictions against access of indigenous women and children to appropriate health and education services and employment opportunities (recommendation 86.119). Accepted No legal impediments to access have been identified. Ensure asylum seekers, particularly those held in detention, have access to health assistance (recommendation 86.131). Accepted-in-part All persons in immigration detention have the right to request and receive consular access at any time without delay, and have access to appropriate health care commensurate with care available to the broader Australian community. Enact comprehensive equality and non-discrimination legislation at the federal level (recommendation 86.43). Accepted-in-part At this stage, the Australian Government does not commit to enacting a substantive guarantee to equality.
