October 19 2011

Adjourned debate on motion of Hon. K.L. Vincent:

That the Social Development Committee inquire into and report on the issue of co-morbidity, which here refers to a dual diagnosis of both intellectual disability and mental illness, viz: —

1. Facilities in South Australia currently treating people with a dual diagnosis with particular reference to the Margaret Tobin Centre and James Nash House;

2. The possibility of establishing a new forensic facility similar to James Nash House in South Australia to deal specifically with offenders with intellectual disability;

3. The level of training offered to general practitioners, psychologists, psychiatrists and other relevant professional in the area of dual diagnosis and possible measures to enhance that training;

4. Information given to individuals and carers on how to manage a dual diagnosis;

5. Supports to aid individuals and carers in managing and living with a dual diagnosis; and

6. Any other related matter.

(Continued from 14 September 2011.)


The Hon. T.A. FRANKS (21:05): The Greens support this motion. I am very pleased to see the issue of co-morbidity placed on the agenda of this council, and I have every confidence that the Social Development Committee will admirably do the work of inquiring into and reporting on this issue. I am also supportive of the amendment to this motion that has been moved in the name of the Hon. Ian Hunter. I think that the amendment adds much to the definitions within the motion in the areas we are talking about.

Co-morbidity is a word that many people in the community may possibly never have heard; certainly, those who have heard it often have only scant understanding of what it implies and the effect it has. Co-morbidity is also referred to here as 'dual diagnosis' but, as the Hon. Stephen Wade noted, 'dual' might only be skimming the surface of what can happen when someone has not just a simple illness, not just a straightforward tick-the-box illness, 'This is what I've got, this is how you treat it.' The fact is that in real life co-morbidity is more realistic in terms of the treatment of real human beings than trying to fit them into a category of a particular single diagnosis.

People have complex needs, and the Greens and I would certainly agree that we need to move from a diagnosis basis to a needs basis. I know from my experience, having worked for the Mental Health Coalition of South Australia, that co-morbidity was not only the buzz word but also the area we focused on quite extensively, particularly when you discover, for example, that if someone with a mental health issue seeks treatment for that issue, but they are in fact self-medicating and have a substance abuse issue, they are quite often made to make a choice between having treatment or remedies, or roads and pathways to recovery for that mental illness.

They are told that overnight—cold turkey, in fact, to use the John Lennon reference—they have to lose the substance abuse problem. Of course that is not practical, and it does not happen in real life. As the Hon. Stephen Wade said, in the worst case scenario what happens is that because people cannot tick either of the boxes sufficiently to end up in one of those boxes, they miss out and fall through the cracks. I would say that much work needs to be done, particularly in terms of substance abuse and mental illness and the relationships there. As I say, they are quite complex, and I do welcome this council coming up with some better ways forward in terms of better outcomes for South Australians.

Where we can, we should be providing people with seamless paths to recovery. That does not mean easy paths to recovery; that means that they do not fall through the cracks on the way because our system does not accommodate them. I repeat what I said in my previous speech: this is about making sure that our community and our society is, in fact, inclusive of those people who exist within it and that it does not let them be excluded.

With those short words, I commend this motion to the council and indicate that the Greens will support both the motion and also the amendment.


Amendment carried; motion as amended carried.

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