R U OK? (Out There)

As the nation asks itself  ‘R U OK?’ this week the simple answer from country Australia is ‘no’. Rural and Remote Mental Health Australia (RRMH) CEO Joe Hooper today declared the mental health gap between city and country Australia was now critical with suicide rates running up to triple the national average in some communities.

 “30 percent of Australians live in the country where the  suicide risk is much higher and we need 30% of the national mental health prevention funding,” Mr Hooper said. “Rural charities currently receive less than 1%,” said Joe.

Joe said given the lack of clinical services, grass roots prevention was the best way of improving mental health in the bush but funding had failed to arrive.

RRMH Chair Genevieve Fraser, said despite being higher risk communities, rural communities received very little direct funding.

“Without a reliable source of funding year on year, rural mental health charities like ours are relying on cake stalls, pig races, private donors or one-off grants. Some of the highest risk communities in our country are left out of funding models designed in capital cities for metropolitan communities,” said Genevieve.

 “It’s a systemic failure with decision makers annually allocating hundreds of millions of taxpayer dollars into suicide prevention in our cities but very little to the other 30 per cent of people.”

Genevieve said Australians need to bust the myth that people in the country are OK and  only need mental health when there is a natural disaster.

“Country Australians need mental health support every day – not just when in drought or flood,” she said. “But it is impossible for grassroots rural charities to be strategic and to reverse a ten-year trend of escalating suicide rates relying on the generosity of communities and private companies.”

Joe Hooper said risks were higher in rural Australia for many reasons.

“There is little to no on the ground help so mental health literacy is the first line of defence. Higher suicide rates are caused by many factors including lack of health professionals, affordability, long waiting times, and availability of care and hospitalisation.”

“Rural towns also have far less health workers than major cities.  Country Australia needs over 21,357 full time health workers to match staffing rates in major cities and with these staff missing health outcomes are worse.” (https://www.ruralhealth.org.au/rural-health-australia-snapshot)

Dr Roland Main, RRMH Board Member and Fellow of RANZC Psychiatrist reflected on the isolation of people living in remote areas and the negative impact of not having adequate health and well-being services.

“The vast landscapes and connections to the bush, indigenous culture and to other country people can be an enriching and supportive experience. But for those who are dealing with depression or anxiety, substance use or other mental health problems, this same vastness can bring isolation and loneliness. These experiences may increase the risk of self-harm and suicide,” said Roland.

“Rural people are also disadvantaged by the lack of health and well-being services, and continuity of such care can be poor due to difficulties of recruitment and retention of a health workforce.”

Annabelle Brayley is a former rural nurse, best-selling author of Bush Doctors and Bush Nurses and Board member of Australian College of Rural and Remote Medicine. Annabelle stands firm that stigma around mental health isn’t necessarily what prevents people in the bush from seeking help.

“It’s time everyone got over the idea that rural and remote Australians will not or do not want anyone to know that they need mental health support; it’s a crutch we need to ditch. Communities look to each other for help and to provide practical and emotional support where they can,” said Annabelle.

“What’s missing is the staff on the ground to provide appropriate professional guidance and/or treatment when its required. The most natural counsellors on the planet are hairdressers and the best support groups are sporting clubs or social clubs that encourage people to interact face to face. If we could increase the funding for prevention then we can give people the tools to recognise and help each other because clinical services are few and far between.”