Country Australians live with the twin realities of limited health care for bodies and minds.

Tragically the more remote we live, the greater the risk that we are exposed to mental health issues.

A rural Australian’s ability to access mental health care and support is, simply, less than the rest of Australia.

Technology and telemedicine are not a substitute for face to face local and personal support. That remains scarce and, where it exists, is often overwhelmed. Despite the staggered rollout of the National Mental Health & Suicide Agreement, there is no obvious national framework, investment or discussion at the national level to address this situation. The recent Federal Budget provided $658 million towards mental health care. It contains no vision or remedy for country Australians and continues strategic underfunding of prevention work outside our cities.  The Opposition are similarly silent.

Both major parties have missed the Productivity Commission’s clear signal that prevention needs to be community led. Both have focused on expanding professional services despite clear evidence that increasing mental health literacy is key to reversing escalating suicide rates. There has been much talk of hope in recent weeks but sadly little investment in it. Hope is what sustains people and it is personal.

As a country we should not continue to fool ourselves that websites and apps will succeed in saving the life of someone more than a helping hand and a listening ear.

The best way we can help people who find themselves without hope is to give them the ability to ask for help. Even better is when their workmates, friends or family recognise the signs and start important conversations.

Rural and Remote Mental Health want to change the conversation in country Australia but we are held back by a lack of cultural awareness amongst decisions makers.

People who live in large cities, where help seeking can occur anonymously and easily, should not be designing rural mental health services. Ignorance of rural life sees Head Space offices put on main streets where everyone knows your name and your business. Online databases present a false idea of regional resources where in reality the ‘local provider’ lives 6 hours away, visits twice a month and has a 6 month waiting list.

Across Australia the failure to provide anything approaching an equitable mental health prevention model has had stark consequences. While metropolitan suicide rates have stabilised in the last decade, our rural communities have continued an upward trajectory. Many rural communities record suicide rates triple the national average. Triple.

The recent budget did have some notable wins for mental health. These include increased funding for school programs, women escaping the trauma of domestic violence and targeted funding for some emotional wellbeing and suicide prevention programs in indigenous and CALD communities.  There was also welcome investment in eating disorder research and treatment, an area with high morbidity outcomes.

But these appear to be very selected targets with no real vision for the coordinated national approach and reform which the sector and community have been asking for. And there has been no consideration as to how these service might reach beyond our cities to our most at risk communities.

At RRMH, our national team works to improve the mental wellbeing of rural and remote communities and increase mental health literacy.

This requires proper funding, planning and collaboration with likeminded organisations who, like us, know that country Australia needs a different approach.

We want to foster co-operation between states, the commonwealth, those with lived experience, charities and the not-for-profit sector and health professionals.  By coming together we can develop the necessary care continuum from early intervention and prevention to tertiary care.  This requires a framework and understanding of roles but, most importantly, an appetite to let go of models that don’t work outside our cities.

Whoever wins government, we want to see a focus on increased investment in rural Australia and recognition of the wonderful non-professional support services delivered by volunteers, peer support workers, mental health leaders and others who live and work there.

With reliable funding, community led organisations and charities can provide much needed early intervention and prevention before the need to seek primary or tertiary care.

Helping people face to face, with local knowledge and context, in a personal environment – works better – we know that. The accoutrements of medicalization bring inherent barriers to people seeking help in times of need. Half of the people who lose their lives every year to despair had not seen a medical professional in at least a year.

These people will only be saved by themselves or someone who knows them which is why mental health literacy at a grass roots level is critical and urgent.

Early intervention and suicide prevention in the community led mental health sector must be properly acknowledged to turn our national fate around.

Those who truly influence suicide and mental wellbeing outcomes outside our cities deserve a legitimate place at the table.

Which party will give them a voice?