Wednesday, 29 November 2017
Robert Burke Motion
The Hon. K.L. VINCENT: To sum up, I would like to acknowledge the contributions of my parliamentary colleagues: the Hon. Mr Hanson, the Hon. Ms Franks of course, and the Hon. Mr Wade. As others have done, I acknowledge the presence in the chamber of Judy Burke, the wife of the late Bob, other members of the Sanctuary support group, and friends as well. Thank you for honouring us not just with your ongoing advocacy but also with your presence here today.
I would like to pick up on a few comments that have been made by my colleagues and also to reiterate, I suppose, the very genuine intent with which many of those comments have been made. Of course, today we are not just honouring but unfortunately remembering the late Bob Burke, a winner of the Dr Margaret Tobin Award for his work, together with his wife Judy, in establishing and for many years, since 2012 until the time of his death, running the Sanctuary support group, a support group for carers, friends and family of people with a borderline personality disorder diagnosis.
First, I want to touch on one particular comment from the Hon. Mr Hanson in which he stated that as many as 80 per cent of people with a BPD diagnosis have experienced trauma in their lifetime. While I acknowledge that trauma can be a common factor in the development of BPD, I think it is important to acknowledge that that statistic is somewhat debated. It is important to acknowledge that BPD does not always result from trauma and neither does trauma always result in BPD. It is a far more nuanced and complex issue than that. While I do not believe that there was any malice from the Hon. Mr Hanson in making that statement, I want to acknowledge that that statistic is somewhat open to debate. Other than that, I thank him for his contribution.
The Hon. Ms Franks reminds us that BPD is often regarded as the Cinderella of mental illnesses, unfortunately not for glamorous reasons. It is not as glamorous as it might sound because of course Cinderella was always the bridesmaid and never the bride, if you like, when it came to Disney princesses. She was often shunned, hidden away, told not to seek help or seek support or to go out into the community, and there are many parallels with the common experiences of people with BPD.
There are those within the medical profession who still deny the existence of borderline personality disorder as a mental health issue in its own right. There are those who see those with BPD as simply being attention seeking or perhaps reaching out because of trauma they have experienced, as the Hon. Mr Hanson touched on—again, with the best of intent. But at the end of the day, no matter what the reason that somebody is in pain, no matter what the reason that somebody is reaching out for help, it is up to us to acknowledge that experience and acknowledge that need and provide that support and that help.
I am pleased to see that it is gradually changing, not as quickly as any of us in this chamber today would like, I am sure, and we certainly have a long way to go. Of course, the Hon. Ms Franks also reminds us that, as much as there is room for improvement, there is already a cure, namely, most commonly, dialectical behaviour therapy (DBT). DBT is an interesting form of therapy for many reasons, not least of which is the fact that it was developed by a woman called Marsha Linehan. I have never been 100 per cent sure how to pronounce that name and I have not yet had the pleasure of meeting her, so she has not yet been able to correct me.
Through my reading, I have come to understand that Dr Linehan herself, if not diagnosed with BPD, at least experienced something very similar herself and I think that goes to the Hon. Mr Wade’s point about the authority of lived experience and how it is often the lived experience that can lead to the most effective treatments and therapies because it has actually been developed by people who understand deeply what it is to go through this and what does and does not work.
Often in this place, I am talking about people with disabilities or people with mental health challenges or elderly people or people from other minorities or with other challenges, and I often state that people need to be recognised and respected as the experts in their own lives. That is never more true than in the case of effective treatment for a host of mental health issues, not just BPD but others as well, and that is why it is fantastic that we are seeing a gradual increase in the use of strategies like peer mentoring and peer networking in the mental health community.
Long may that continue, but we have a long way to go, which leads me nicely to the next steps. The Labor government has finally joined me and my parliamentary colleagues from the Greens and the Liberal opposition in committing funding to a borderline personality disorder centre of excellence in South Australia—a spoke-and-hub specific model, which the Hon. Ms Franks touched on the importance of—for the treatment of people with borderline personality disorder.
It is incredibly frustrating that it is only after six or seven years of lobbying that we have finally got to this point and got the government to see not just the sense but also the dollars and cents—it is an old one but it works well—the money that stands to be saved from getting people well again, from getting them back into employment, back into community, back into family life and not presenting repeatedly to hospital and to emergency departments, which alone are incredibly expensive. Even a one-off event presenting to an emergency department is incredibly expensive, so when you have repeat presenters the bills certainly do add up.
I do not say that to make people who might be listening to this presentation who are themselves diagnosed with BPD feel any sense of guilt about racking up that bill, because absolutely I understand that the only reason they need to do that is because their current effective therapies are not readily enough available. I do not want anyone listening to this speech to feel guilty for that, but I think it just goes to show how poor the recognition and response to borderline personality disorder in this state has been that people feel they have no other choice often but to report that they are at imminent risk of self-harm and present to hospital or, even worse and even more tragically, go through with self-harm in order to feel able to present to hospital.
It is hard to put into words exactly what kind of a place you have to be in to take that course of action and exactly how terrible it feels when you are so far down in that deep place of darkness and emptiness and despair that you feel that is the only course of action available to you. To then have family members, friends or, even worse, health professionals turn to you and say that your experiences are not valid, that you are just attention seeking and that you should be able to control these urges or the experiences—to say it is kicking people when they are down is insultingly simplistic, but I struggle to think of another analogy.
As my colleagues have reminded us, as we have together done many times in this place, there is a cure. That can only be available though with effective, holistic investment from all levels of government, from all parties and wherever necessary to ensure that that is readily available and that people no longer feel the need to go through with those desperate courses of action and to seek out the appropriate support.
As colleagues have already reminded us, as many as 10 per cent of people with a BPD diagnosis will end their lives by suicide. I do not know the exact statistics, but from my experiences, both personal and working with constituents, I dare to say that often that is not even intentional suicide. That is not to say that makes it any better or any worse, but that is to say that there are people who are crying out for help who feel that their only option is to go through with these drastic measures.
As is the case with many people who are considering suicide, they do not actually want to die; they just want the pain to die. They cannot see any other way, currently, without effective treatment, than to take these drastic measures that no person should ever be in a position to have to even consider let alone carry through.
Other colleagues have labelled themselves eternal cynics. Others have labelled themselves eternal optimists. I might go as far as to label myself a chronic optimistic cynic. We do know that the government has finally publicly come to the fore and agreed to commit funding to this important project over the next few years to finally catch up with what other states, like Victoria and New South Wales through Project Air and also Spectrum, have had in place for many years and have had great success with.
Of course, implementation is the next challenge and the devil will always be in the detail, but there is a meeting between myself and representatives from the Department of Treasury and SA Health, as well as many of the good people behind me this evening, to ensure that we get the ball rolling in making sure that this project does get underway absolutely as soon as possible so that we do not lose any more people to this horrific—unnecessarily horrific, I might add—illness. I am very much looking forward to that work. I thank those behind me who have put up their hand to be a part of those ongoing discussions because, again, I think that goes back to the importance of lived experience being the only way to achieve effective, holistic results.
If nothing else, I think the last thing I need to do today is, of course, once again place on the record my thanks to Bob for his ongoing work. I only wish he was here to see what is happening now and what will happen since. My thanks to Judy and other members of Sanctuary for carrying on in some very difficult times, not the least of which was the loss of dear Bob, and also to remember those constituents, family members and friends who have already lost their lives to this terrible experience.
It is perhaps most important to say to those who are still waiting that there may well be people out there who do not believe that what you are going through is genuine, and do not believe that what you are going through is worth investing in, but I hope that what has been said in this chamber here today and, indeed, before and hopefully long beyond, shows you that there are many, many more who do and will continue to fight for you. So, please, know that you are worth it, know that we are fighting for you and hold on. Thank you.