Margins to Mainstream: 5th World Conference on the Promotion of Mental Health and the Prevention of Mental Health and Behavioural Disorders

11/09/2008

by Dr Helen Szoke
Chief Executive
Victorian Equal Opportunity & Human Rights Commission

I wish to begin by paying my respects to the traditional owners of the land and to pay respects to elders past and present.

I am delighted that this conference has taken a particular focus on human rights in its deliberations and has seen the importance of a human rights framework in looking at the issues associated with mental health and prevention. I continue to be astonished by the cycles of public policy, and if ever there was a time to ‘strike while the iron is hot’ in relation to proactively addressing the incidence and management of mental health, it seems it is now. But I don’t underestimate what this takes.

I worked 20 years ago on the beginning of the decommissioning of Royal Park Psychiatric Hospital when mainstreaming of mental health services first began in Victoria. At that time, CAT teams, were in their infancy, acute wards were being decommissioned and relocated within acute general hospital settings and there was some optimism that if we spent more money on community based care instead of maintaining the vast lawns and building so the old asylums such as Royal Park, that we will have fixed the problem. That is not the case now, where mental health challenges pervade many areas of public and private life, and our response to them as a community often breaches basic civil and political rights as they pertain to the person experiencing the problem.

Despite discrimination being unlawful in Victoria for over 30 years, discrimination on the grounds protected by the Equal Opportunity Act persists in Victoria. While blatant forms of discrimination that directly exclude a person, such as employment advertisements unnecessarily specifying that the roles are for men or women only, are less common, discrimination is occurring and can often be systemic in its nature and have a serious impact on an individual’s mental health.

I would like to begin by reading to you a case study that was submitted to the recent Review of the EOA from a student counsellor which starkly demonstrates the links between discrimination, mental health and in this case homelessness.

Elena – who has a mental illness – was a keen and hardworking university student. It took her some time to get into university, as it had been a hard fight to get there in a society that she found didn’t tolerate different behaviour.

Elena was living in student accommodation where the other students found her behaviour ‘strange’. Some students complained about her to staff who had no experience or training in dealing with a mental illness.

The situation escalated and Elena was given 24 hours’ notice of eviction. She sought help from a student counsellor, who helped her make a discrimination complaint. As she was facing eviction and could not wait for the formal complaint processes to be completed, an interim agreement between Elena and the university was reached at a conciliation conducted by the anti-discrimination complaints body. Under this agreement, the university was required to find Elena alternative accommodation.

The alternative accommodation was a private rooming house. The rooming house accommodation was unsuitable, the move disrupted her studies, and her life was now too chaotic to continue with her complaint and her studies. The situation deteriorated until Elena found herself homeless.

This example and others I will talk about today show how discrimination has a detrimental impact on the fair distribution of life chances, including access to education, employment, housing and good health and how it limits human rights, impacts on mental health and contributes to disadvantage. The focus of my presentation will be on the capacity the Commission currently has to respond.

The VEOHRC administers three pieces of legislation the Equal Opportunity Act 1995 and the Racial and Religious Tolerance Act 2001 and the recent introduction of the Charter of Human Rights and Responsibilities, new functions under the Charter have enlarged the Commission’s previous, almost exclusive focus on discrimination to a more holistic and multi-faceted human rights mandate.

The Charter of Human Rights in Victoria came fully into affect on January 1 this year and combines a range of human rights into one domestic law. It imposes a positive duty on government to be compliant with those rights. The Charter of Human Rights recognises equality before the law and the right to non-discrimination. Under the Equal Opportunity Act, it is against the law to discriminate against someone because they have, or are assumed to have, a mental illness as well as other attributes that I will discuss today which include race and sex.

Disability Discrimination Disclosure

The effects of discrimination on an individual’s mental health is highlighted in research by Vic Health last year which found that there is a strong relationship between exposure to discrimination and poor mental health, especially depression. The report noted that by 2023, depression and anxiety will be the greatest contributors to disease burden in Australian women and the third-greatest in Australian men. Beyond Blue estimates that depression-associated disability costs $14.9 billion annually and results in more than six million working days lost each year.

At the Commission disability discrimination is the most common reason for a complaint. In 2006/07 there were 483 complaints of discrimination on the basis of impairment/disability lodged, 325 of which related to employment. This outlines the figures in 2007/2008, which are yet to be formally released but which continue this trend.

As you would be aware access to employment is fundamental to a person’s dignity and wellbeing and is a right that is protected under Victorian and Federal Equal Opportunity laws. Under these laws, a person with a disability who meets the genuine requirements of a job has the same right to be appointed to that job as anyone else.

Discrimination contributes to the high rate of unemployment of people with disabilities. People with disability represent a significant proportion of Australia’s working age population (16.6%), yet they participate in the workforce at lower rates, they are less likely to be employed when they do attempt to participate, and they will earn less if they do get a job.

A 2004 HREOC report entitled WORKability 1: Barriers found that people with a disability face higher barriers to participation in employment than many other groups in Australia. HREOC reports these barriers include concern about costs involved in accommodating for disability in a workplace and misconceptions of disability that may be held by employers, for example the view that people with disabilities are less productive or will lodge workers’ compensation claims.

In the last few year the Commission has also noticed an increase in enquiries about mental illness to our Advice Line, which suggests that people are becoming more aware of their rights. Many enquiries related to telling an employer about a mental illness. Many people do not disclose their mental illness to recruiters and employers because they fear discrimination or exclusion from consideration for jobs.

In response the Commission recently published Disclosing Disability in Employment, a set of guidelines that provide practical advice on when and how to disclose a disability, including a mental health issue, in employment. There are two guidelines: one for employers and recruiters and another for people with disabilities and their advocates.

A case study from these guidelines highlights the nexus between discrimination and mental health;

Mary suffers from arthritis and it was alleged her output was below that of her colleagues. When her employer set out and presented work targets for her, he made it clear that if she did not meet them she would be sacked. She left work on the same day and was diagnosed as suffering from depression. The Victorian Civil and Administrative Tribunal found that that the work targets were set at a level that other employees had difficulty meeting, and were imposed on Mary after a considerable period of general criticism of her work and pressure placed on her to improve. The tribunal found that it was unreasonable to set such targets when failure to achieve them carried the threat of termination of employment and ruled that discrimination on the grounds of impairment had occurred. Mary was awarded $85,000 as compensation for loss of earnings, entitlements, interest on earnings and entitlements, as well as for stress, depression, anxiety and humiliation.

Women in Prisons

Another group that highlights the links between discrimination, mental health and disadvantage are women prisoners. Women in prison are 1.7 times more likely to suffer from mental health problems than men and 89% of those incarcerated are survivors of sexual abuse.[1]

In 2005 the Commission was asked by the Federation of Community Legal Centres and the Victorian Council of Social Services to conduct an investigation into allegations of systemic discrimination against women in prison.

A substantial number of the allegations disclosed possible breaches of the Equal Opportunity Act and included;

Women not having equivalent on-site acute care mental health unit which is available to men prisoners;

Only 10% of women in Victoria Dame Phylis Frost Centre are classified as maximum security. However 80% of women are held in DPFC which is a maximum security prison. The Classification of women does not take into account that women prisoners present less risk than men prisoners nor the needs of women with children.

Strip searches have a more traumatic effect on women than men given their greater history of experiencing sexual and other abuse. Women are subject to strip searches more frequently because strip searches are conducted before and after visits and women prisoners due to their stronger family ties and receive more visits. Strip searches are an unreasonable requirement given the lower risk attached to women prisoners.

Indigenous women prisoners suffer even higher rates of inappropriate classification than the rest of the female prison population because: they are more likely to be held on remand because they are homeless and not granted bail;

It was also submitted that CALD women prisoners do not have adequate access to information in their own languages in situations such as prison rules, health and education services.

The submission also alleged that women with mental illness and/or intellectual disabilities are inappropriately disciplined for behaviour that may require treatment or that could be better managed with training and awareness of the disability.

In response to these serious allegations the Commission proposed to Corrections Victoria that it would be useful to undertake a human rights audit of the policies and procedures governing women in prison, and that this audit would be best served if it was independent, informed by expert advice in relation to human rights and anti discrimination principles, transparent in terms of its formulation, implementation and findings and if the findings were publicly available. The Corrections Inspectorate continue to monitor the implementation of the Better Pathways policy improvements for women in prison as a result of an injection of additional resources, but do not make these findings public, thus making it impossible to ascertain whether progress is being made in these important areas.

African youth discrimination

Another significant focus area for the Commission in the last 2 years has been in the area of race discrimination.

Many of you here may be aware of the More than Tolerance Research by VicHealth which identified the way in which discrimination is a cost to the whole community. The report states that “as well as affecting individuals, discrimination has the potential to harm us all by undermining harmonious community relations and social cohesion, compromising productivity and placing an unnecessary burden on our health, welfare and legal systems.”

The research findings indicate that discrimination must be addressed to ensure social cohesion and a need for social policy interventions to create shared values and common goals and combat inequality.

The impact of racial discrimination on a group of Sudanese young people has been the target of recent research by the Commission. The research followed the bashing to death of a 19-year-old Sudanese boy at Noble Park Railway Station and negative comments by high-profile public figures about Sudanese people which led to increased negative feelings about African migrants in Melbourne, and led to elders and young African community members asking the Commission to help.

Our research found that many members of the African community in Greater Dandenong, particularly its young people, have experienced overt and indirect racism from a range of quarters in the community. As a result they are less likely to feel ‘safe’ in public than any other community in Victoria.

The public spaces and venues these young people use for social interaction, learning, and public transport are the places where they have increasingly experienced both verbal and physical racist attacks.

One young person said; “I can’t wait at bus stops as I get abused”

Feeling generally more fearful in public spaces, the young people of African descent have responded by travelling in groups and staying away from the necessary support services available to them; further compounding the problem.

Worryingly, it is not just fear of verbal or physical attack that has affected these young people in their use of public spaces. Our researchers found that these young African people even doubted their right to even be in public spaces by virtue of who they were.

One young person told us that he had heard that the government is going to send them back to Africa as they are trouble makers.

The impact of discrimination on these young people feeling a part of the Victorian community and their mental health is of particular concern. Through this research the Victorian Foundation for Survivors of Torture told researchers that racial prejudice and new humiliations can further exacerbate a young person’s recovery from trauma and exacerbate feelings of shame and loss of identity.

Research by the Centre for Multicultural Youth has also found that the extent to which a young person is able to build on strengths and effectively negotiate systems will determine whether they experience a growing sense of mastery and comfort in Australia, or alienation and marginalisation.

It is clear that this community of young people of African descent faced abuses of human rights, expressly in terms of discriminatory behaviour, and systematically in terms of it impacting on their day to day lives.

What is clear from our research in the City of Greater Dandenong is that the enormous efforts put in by local, state, Federal and non-government organizations did not address the barriers to inclusion, and did not address the barriers to the achievement of human rights in a way that made a difference for the community.

CALD employment discrimination

Other research undertaken by the Commission into Racial and religious discrimination in employment, reveals the extent migrants are battling entrenched racism in the workplace.

The research reveals that migrants continue to suffer from racist attitudes, racial and religious discrimination, and harassment in the workplace. They have trouble finding a job and then if they do obtain work, they face bias against promotion.

Many migrants have trouble getting their overseas qualifications recognised, resulting in them being over represented in low-skilled, low-paid employment. They are also under-represented in the public sector.

At a time when the newspapers are full of concerns about labour market shortages, skill shortages and recruitment challenges, we have an under-utilised group in our community who want to work, who have the experience and willingness to work, but who are not even able to get to first base.

The research uncovered a number of examples of systemic and embedded discrimination. In one case, an employer called up a Job Recruitment agency asking for a receptionist. A Chinese woman who had great experience at the Shanghai Hyatt and had worked in a China trade company was recommended. The potential employer was excited until they heard she was Chinese and had a Chinese accent. The employer said they wanted someone with an Australian accent.

In another instance, a job recruitment agency provided the resumes of nine young people aged 16 to 25 to a city financial institution. Only the four people with Anglo-Saxon names were given interviews, despite the other five people with Asian names being equally and better skilled.

The commission has developed a number of recommendations to the finding of the Harnessing Diversity report into racial and religious discrimination in employment which we will work on over the next year.

EOA Review – Systemic Discrimination

The systemic nature of the discrimination I have described results in entrenched disadvantage and exclusion. The Commission currently has a limited capacity to address the lack of equality for many people who may be systematically treated less favourably, or for changing institutional practices that treat people less favourably.

What is needed is a major shift in attitude. The debate needs to be recast as everyone having a responsibility to actively eliminate discrimination rather than the current situation of there being a passive obligation not to discriminate.

It is our view that addressing disadvantage requires a human rights lens, addressing the link between disadvantage and discrimination requires a suite of regulatory powers that encourage human rights compliance, demonstrate what human rights compliance looks like and provide opportunities to expose where systematic evidence of non-compliance occurs. In the cases outlined above, different regulatory interventions may be utilized to address some of the systemic racist responses.

The recognition of overseas qualifications has already been placed on the agenda of governments at both a state and federal level, and it may be that the experience of the Iraqi male from Shepparton could be reversed with a movement away from the obsession with Australian experience as a pre requisite but also additional transitional help to ease people into work in this country. This issue may be one that a modern Equal Opportunity body would expose in an own motion inquiry to government.

The experience of the recruiter trying to place a Chinese speaking receptionist may be the subject of an investigation into racism in the hospitality and retain industry which results in the development of education and guidelines which outline how these issues could be addressed.

Similarly the discrimination faced by people with disabilities in the workplace is evidence of a fear on the part of employers to take on different employees or create a different culture within the workplace. The development of guidelines, the collection of case studies and the encouragement of Equality Action Plans starts to proactively develop workplaces where this sort of discrimination is not embedded into the institutional fabric that prevents people even getting to first base.

In Conclusion

As reflected in my speech despite Victoria’s many successes in addressing inequality some kinds of inequality remain at intolerable levels.

With the introduction of the Charter of Human Rights and the review of the Equal Opportunity Act, we have some important tools for addressing systemic discrimination.

We, at the Commission, are looking forward to grasping that opportunity and taking the Victorian community with us.