Four-year delay in transferring power from police to paramedics for mental health callouts

A key royal commission recommendation for paramedics to take over mental health callouts from police has been delayed to 2027, four years later than the Victorian government promised.

Labor had announced that paramedics would take over from police as the first responders to triple-zero calls for mental health crises from September 1, 2023, but cabinet delayed the reform that year, citing an inability to meet the timeline.

Mental health royal commission chair Penny Armytage released the report into Victoria’s mental health system with Daniel Andrews in 2021.Credit: Eddie Jim

The change had been pushed back to 2027 despite the Justice and Health departments receiving the necessary funding, parliament’s public accounts and estimates committee said in a report on the 2023-24 budget tabled on Thursday.

“However, implementation has been delayed, and it is now due to be completed by 2027, three years later than recommended by the royal commission,” the committee said in its report.

“It is not clear why the implementation of recommendation 10 has been delayed.”

The committee recommended that the Justice Department, Health Department and Victoria Police consider reporting on specific actions taken to progress the recommendation and provide reasons for the delay.

The final report from the Royal Commission into Victoria’s Mental Health System, released in 2021, recommended that health professionals should respond to people experiencing crises rather than police wherever possible. Triple-zero calls should be diverted from Victoria Police to Ambulance Victoria.

The then-Andrews government originally committed to rolling it out by September 2023 before abandoning that timeline.

The royal commission found police-led responses could lead to poor outcomes for people in crisis, and could increase trauma and stigma. In its final report, it said many patients, carers and service providers had expressed dismay about the growing involvement of police in responding to mental health cases.

“The Victorian government has acknowledged that a lack of mental health services is contributing to an increased reliance on the police to respond to people experiencing mental illness or psychological distress,” the final report stated.

The Age previously reported that Ambulance Victoria had been pushing back on the 2023 timeline because it was not equipped to take charge of the responses, after the emergency service had been swamped during COVID-19.

The parliamentary committee said police were now responding to one mental health crisis every 10 minutes, having received 54,400 callouts in 2023-24 – an increase from 43,000 or a call every 12 minutes in 2017-18.

Police Association of Victoria secretary Wayne Gatt said the key recommendation should already have been implemented.

A Victoria Police spokesman says the force supports the transition being finalised.Credit: Eddie Jim

“The Police Association has long said that its members are not the most appropriate or qualified to act as the first response to incidences of mental health crises,” Gatt said.

“This should have already happened, and it remains a high priority. The longer the delay in implementing this reform, the more chance there is of adverse outcomes for people suffering mental health crises in Victoria.”

The government provided $7.5 million over two years to design and develop the program in the 2021-22 budget, and an extra $11.5 million was allocated in 2023-24 to plan and design services.

A Victoria Police spokesman said the force was aware the transition had been delayed but supported the rollout being finalised.

“Officers will continue to seek the informed advice of authorised health professionals wherever possible in exercising their powers under the Mental Health and Wellbeing Act.”

Victorian Ambulance Union secretary Danny Hill said any change to the system needed to be properly resourced to be effective for the community.

An Allan government spokesman said the recommendations of the royal commission would be delivered.

“We are working with Ambulance Victoria and Victoria Police to deliver a health-led response to people experiencing a mental health crisis,” he said.

Research by the Victorian Alcohol and Drug Association shows services in the sector provide on average 50 hours of mental health crisis interventions every week, amounting to 200,000 unfunded hours of work a year.

Association chief executive Chris Christoforou said making paramedics first responders to a mental health crisis was a critical priority.

“As per the evidence received by the royal commission and in particular given the stigma that people who have dependence to illicit drugs continue to encounter, police are not best placed to lead a health response,” he said.

Christoforou said some alcohol and drug agencies had to temporarily close their waitlists and refuse new clients because of high demand combined with the challenge of managing people with complex mental health concerns.

Victorian Mental Illness Awareness Council chief executive Vrinda Edan said it was disappointing to see the recommendations stall, and the callouts reform was one of the most urgent recommendations.

“These reforms are deeply personal for every consumer harmed by the system, who has experienced a poor response during a crisis, or who courageously shared their story with the royal commission in the hopes of change,” she said.

“Where are these reforms really at, and what do we have to show for the $11 million already allocated to making them happen?”

Opposition mental health spokesperson Emma Kealy said every delayed recommendation meant Victorians missed out on promised mental health care.

“It’s a cruel blow to people living with mental ill-health, after repeated promises by Labor that all recommendations would be implemented, funded and delivered on time,” she said.

The Morning Edition newsletter is our guide to the day’s most important and interesting stories, analysis and insights. Sign up here.