Rising to the Challenge 2nd International Urban Mental Health Conference

(Garvan Institute)

Thank you, and good morning, everyone. I would like firstly to acknowledge the Gadigal people of the Eora nation, the traditional custodians of this land, and I pay my respects to the Elders, both past and present.

I would also like to acknowledge the Governor of NSW, Professor Marie Bashir, AC, CVO, and on behalf of the City of Sydney, to welcome our interstate and international guests to this beautiful city.

Over the next two days you will be exploring the unmet need in urban mental health, which is especially acute within disadvantaged groups. You will be identifying research, collaborations and strategic directions to make inroads into this critical issue which affects the entire community and remains a significant challenge for us all.

There are many inspiring speakers and I hope that we inspire each other through hearing of practical examples which have resulted in enhanced mental health for members of our community.

At the City of Sydney and in my role as State MP, we are striving for a more compassionate and more effective response to help and support people who are in cycles of entrenched disadvantage. Many of our most vulnerable, despite living in a busy metropolitan City such as Sydney, are isolated and often find it difficult to access help.

We are making an impact through our many partnerships with others who are committed to a creating a fairer, safer and liveable city and our work on homelessness is a good example.

The City of Sydney committed to working on homelessness more than 25 years ago when we started the Homeless Persons' Information Centre, which now helps people all over NSW and takes over 64,000 calls a year.

In Sustainable Sydney 2030 which is our vision and plan for a liveable Sydney, the City adopted the national target of reducing rough sleeping by 25 per cent by 2013. Our first step was to undertake the first of many "street counts," which, with the help of volunteers, we've been counting the number of people sleeping rough in the City,

In February last year, we counted 418 people sleeping on our streets and parks; and the latest count last week found 363.

The Mercy Foundation, with help from the City and other non-government partners, surveyed people who were sleeping rough last November. More than half had at least one factor that significantly increased their vulnerability and risk. The count also found high rates of hospitalisation, mental illness and substance abuse problems.

I am pleased that Felicity Reynolds of the Mercy Foundation and Liz Giles of the City's Homelessness Unit will provide a detailed report on this work and suggest solutions later today.

Finding 90 people sleeping rough in Woolloomooloo prompted us to join with UBS investment bank, United Way, the Mercy Foundation, Freehills Foundation and the Way2Home Outreach Service in the project 90Homes 90Lives.

We also pulled together Centrelink and Housing NSW, health and legal services to hold a regular WISH or Woolloomooloo Integrated Services Hub, which helps rough sleepers get identification, housing and help with debt and legal problems. We build trust over time so that marginalised people will ask us for help when they are ready.

Our three year Complex Needs Coordination Project successfully housed 35 severely disadvantaged people who live with a mix of mental illness, disability, substance abuse, cognitive impairment and poor physical health.

Another of your speakers is Dr Sam Tsemberis, [sem-bear-iss] founder and CEO of New York's Pathways to Housing, has set an example that cities across the world are now following in order to provide housing to their most vulnerable people.

Pathways to Housing was the inspiration for our Complex Needs Project and is now influencing all our work because it tells us that a person needs a stable home before beginning the journey of recovery towards a stable life within their community.

This idea is so basic that we take it for granted.

Solving homelessness is not impossible when all levels of government commit to working with the communities they serve to put solutions in place.

We've seen this work in response to the loss of life and property from fires and floods. We have to learn how to make this happen for those whose descent into disadvantage and loss that is less dramatic and less visible.

Homelessness is not inevitable, but often the result of a series of events and interactions which require an integrated and sophisticated response.

These examples show what is possible when there is a commitment to change, when organisations harness skills and resources to provide coordinated, flexible approaches that meet people's needs at different points in their lives, and when people who want to help have clear direction and are able to get involved.

The Rising to the Challenge conference applies the same approach to inner city mental health.

With strong leadership from Peter McGeorge and his teams at St Vincent's and partners in the community sector, I have seen significant positive changes in inner city mental health.

This conference shows reinvigorated links with and learning from overseas inner-city mental health services, and looks for brave ideas and innovation from those who are grappling with similar situations.

After 11 years of lobbying and advocacy we now have a new Caritas facility, just over the road from where we are today. The new Caritas is linked directly to the emergency department and it's Psychiatric Emergency Care Centre, providing much better crisis help.

Caritas integrates mental health, drug and alcohol and community health services, improving service for people with complex needs, particularly people with a dual diagnosis of both mental illness and an alcohol and/or drug problem.

The consumer arts project mural, designed by Aboriginal women, will help welcoming those who come and mark it as a place to get help.

Hospital services have shifted to a recovery approach, teams and collaborative work, with continuing service reforms. We must try out new ideas and continue to tweak things to make them work for those we serve.

This means involving and empowering consumers and St Vincent's Coordinator Douglas Holmes plays a vital role forging those links and harnessing citizen resources to help.

St Vincent's Mental Health Service takes collaboration and partnership seriously, meeting with homelessness service providers, offering training and expert backup for community workers, and running outreach clinics. The Homeless Health Team takes services to people in our streets and parks.

My Lord Mayoral Salary Trust funded practical action through mental health first-aid programs for public tenants in Woolloomooloo and Surry Hills, an inner-city Hearing Voices self-help group for people who hear voices; a dual diagnosis worker at Lou's Place for women with a mental illness and drug issues; and the South Sydney Youth Services Mad Pride Youth Event last month.

I want this money to stimulate innovation and help people who have effective local projects, but currently miss out.

The Faces in the Street Urban Mental Health Research Institute and Schizophrenia Research Institute will link mental health services with practical research, and I congratulate St Vincent's and their generous donors for this exciting initiative.

As our work on homelessness has shown, understanding the complexities of the situation can help us act strategically, help direct resources, provide a space to test new ideas, think laterally and provide effective help.

At the same time, we already know a lot about what is needed - there is a long history of reports and inquiries documenting the need for expanded community care and support to prevent crisis, to help people get back on their feet and to ensure that they remain part of the community.

Public housing, prisons and the street are the new asylums.

We need much more low cost and supported accommodation, like the Housing and Support Initiative (HASI), which reduces hospitalisation dramatically.

I keenly await completion of the Camperdown Project, which will provide about 80 new homes with onsite integrated health and welfare support and is modelled on successful Housing First approaches.

We need much more daily support for people living with a mental illness to help them to live independently. We need much more community support and rehabilitation.

Mental health and drug and alcohol programs are the poor cousins in health. The goal of 15 per cent of overall mental health spending going to community support, prevention and rehabilitation remains a long term objective.

Some of the lessons from the examples I've mentioned today are:

  • link up with others who are committed;
  • keep your eye out for opportunities;
  • look for allies and partners;
  • update your practice based on research and evidence;
  • test ideas, start small and build up, and tell others about your successes;
  • remember community development - consumers, families and citizens have a voice; and
  • watch where the tides are going (and watch what the new Government intends to do!).

Mental health should be about staying well, and people getting the treatment they need when they are ill.

The best insurance against mental illness is a caring and engaged community and supportive family and friends, along with strong community support services.

I thank you for your work for a fairer and more compassionate society, and your contribution to people living with mental health in the inner city.

Related information: | Community Services | Lord Mayoral Salary Trust | Speeches |