Paramedics put on hold as mental health triple 0 overhaul delayed

A key royal commission recommendation for paramedics to take charge of mental health callouts has been formally delayed after the Andrews government concluded it would struggle to meet its reform timeframe.

Under the government’s initial plan, paramedics were set to take over from police as the first responders to triple-zero calls for mental health from September 1, but cabinet ministers on Monday approved a deferral for an unspecified time, according to five sources with knowledge of the issue who confirmed it on condition of anonymity.

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

“That part has been postponed for more work to be done,” one government source said. “The minister [Gabrielle Williams] said if we rush it, we’re not going to get it right.”

The final report from the Royal Commission into Victoria’s Mental Health System, which was released two years ago, recommended that wherever possible health professionals should respond to people experiencing crises rather than police, with triple-zero calls to be diverted from Victoria Police to Ambulance Victoria.

The royal commission found police-led responses could lead to poor outcomes for people in crisis, and their involvement could increase trauma and stigma. In its final report, it said many patients, carers and service providers, including Victoria Police, 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.

But Ambulance Victoria has been pushing back against the government’s legislated timeline of September 1 because it does not believe the workforce is equipped to deal with the changes, according to three sources aware of the negotiations.

The emergency service has been swamped over the past few years, and, like the rest of the health system, has been buckling under pressure owing to COVID-19.

The delay will be confirmed in a bill tabled in parliament on Wednesday and will likely disappoint Victoria Police, which has been a staunch supporter of the reforms to free up its resources.

It will not include a revised deadline. But, according to a government source, Williams told her cabinet colleagues on Monday she would provide a revised timeframe in coming months.

Mental Health and Ambulance Services Minister Gabrielle Williams will confirm the delay in a bill to be tabled in parliament on Wednesday. Credit: Penny Stephens

Sources said there were fears that without a firm deadline, Ambulance Victoria and the Department of Health would not be held accountable to deliver on the reform while also handling plans to abolish the crime of public drunkenness in November.

Assistant police commissioner Glenn Weir in 2019 told the royal commission his members were being called to incidents of psychiatric crisis and attempts or threats of suicide every 12 minutes in Victoria.

The inquiry also heard demand for an emergency police response to people experiencing a “psychiatric crisis” was soaring each year, with figures showing an almost 88 per cent increase in callouts between 2014 and 2018.

“Our people do get frustrated because we aren’t trained clinicians,” Weir told the commission at the time. “We get frustrated by what seems to be a revolving door around people who are apprehended, taken, assessed and then, three or four days later, we’re back again.”

Victorian Mental Illness Awareness Council chief executive Craig Wallace described the delay as “pretty crap”.

“A great amount of distress happens for consumers who are apprehended by police [during a mental health crisis],” Wallace said. “We, as consumers, are looking forward to what was promised in the royal commission, which is consumers being at the centre of reform and consumers having a system that supports them … We see the delay as a setback.”

The deferral of the plan comes after last week’s state budget confirmed the Victorian Collaborative Centre for Mental Health and Wellbeing, another recommendation of the royal commission, has been delayed by 12 months.

The centre will bring people with lived experience of mental health issues together with researchers and experts in care to provide adult mental-health services.

A Victorian government spokeswoman said it was working closely with Ambulance Victoria and Victoria Police to successfully roll out the reform.

“We are dedicated to moving from a law-enforcement approach to mental health crises in the community to a health-led response,” the spokeswoman said.

“The new Mental Health and Wellbeing Act is about embedding human rights and lived experience – in line with recommendations of the Royal Commission into Victoria’s Mental Health System.”

A Victoria Police spokesman said its existing response to mental health callouts remains in place.

“We will continue to work with government and other key agencies … ahead of the commencement of the new Mental Health and Wellbeing Act,” he said. “Any further questions around legislative matters should be directed to government.”

Ambulance Victoria said it responded to more than 60,000 mental health-related cases per year, with police accompanying them on 25,000 cases.

“Ambulance Victoria is continuing to work closely with the Department of Health and Victoria Police on a phased implementation of changes to the Mental Health and Wellbeing Act,” a spokeswoman said.

“Significant work is underway to enable the safe transition to the health-led response.”

Police Association of Victoria secretary Wayne Gatt said in about 60 per cent of mental-health cases police were called to, their only role was to transport patients.

Police Association of Victoria secretary Wayne Gatt said in about 60 per cent of mental-health cases police were called to, their only role was to transport patients.Credit: Paul Rovere

“In cases where there is no risk to others, police should be able to transition care of patients to ambulance at the scene, indeed as the Royal Commission intended,” Gatt said.

“At the time, the government said that we do not send police out for heart attacks or strokes ... and that we should not be sending them for a primary response for mental health either. We hope this reform is not walked back, because if it [is], for that time at least, the system remains broken.”

Opposition mental health spokeswoman Emma Kealy said the government had “botched” the rollout of the royal commission recommendations.

“Labor was warned to bolster the mental workforce back in 2019 and has failed to do so,” Kealy said.

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