The treatment of mental health in rural communities – Aaron Hawkins is a Rural Generalist in Deloraine, Tasmania. The town has a population of 3000 people, and Aaron splits his time between mental health treatment and general GP work. Originally from Queensland, he studied medicine at UQ and worked as a doctor for a few years in the Logan Hospital, working with vulnerable people and communities. He then moved to Tasmania with his wife to complete a fellowship in rural and remote medicine through the Australian College of Rural and Remote Medicine. His training as a Rural Generalist was a mix of emergency medicine, rural general practice and a chosen advanced skill. Aaron chose Psychiatry and worked as a Psychiatry Registrar for 12 months. The advanced skill training allows for trainees to bring services back to rural communities and that is exactly what Aaron has done.
We wanted to speak with Aaron and discuss the challenges that GP’s face in remote communities when balancing the general health and mental health of their patients. With a lack of mental health professionals in these areas, a lot of pressure is put on General Practitioners to play both roles.
“I worked as a psychiatry registrar in North West Tassie for 12 months in 2020, which was obviously a bit of a unique time to work anywhere in the health system. My experience was invaluable, I was lucky enough to work in a mix of adult community psychiatry, acute crisis teamwork as well as older persons psychiatry. Each of those experiences has been incredibly useful to bring back to general practice, where often these kinds of presentations make up a significant proportion of the day – now having the confidence and experience to manage these patients within our community I think it has been really rewarding,” said Aaron.
“There is absolutely a lack of resources, I think that is an issue all over rural and remote Australia. For people in Deloraine that are clients of the public psychiatric system, much of the care is managed by either telehealth or involves a significant drive into Launceston, which is just not viable for many of our patients. The private sector is even more difficult – private psychiatry in person is almost impossible to access for our community, and many are faced with a 3 hour drive to Hobart for this.”
“Thankfully Telehealth psychiatry has been a lifesaver, but this is just not ideal for a lot of people. Psychology and counselling is another really difficult area. We are lucky enough to have a psychologist who visits Deloraine 3 times a week but even with that she has no capacity for taking on new clients for most of the year, so patients are again faced with a costly and sometimes impossible drive to access psychotherapy.”
“Treating mental health is something that I love, so it’s been a privilege to try and bring that to the community – but despite that, the system doesn’t make it easy. General practice can be quite isolating, and for patients with mental health issues it is often absolutely essential to be supported by a team of people so that makes things very difficult at times – I think trying to build a team for a patient is something that I find the hardest.”
“I think rural communities would be the absolute perfect place for programs like yours to spread – the sense of community in a place like Deloraine is incredibly strong and locals are just so keen to support each other in whatever way possible – giving people the tools to do this safely and effectively (tools being education, resources, and the knowledge of where to seek more!) is exactly what people are craving.”
“Mental health is still something which remains taboo and stigmatised for many pockets of the community, it seems to me that massive headway has been made in awareness and removing stigma for young people but I still see a huge amount of this stigma in some of my older patients. Many of my patients struggle to understand what they are experiencing and struggle to talk about with me and their loved ones the mental health battles they have been silently fighting.”
It is great to see people like Aaron not only choose to become a Rural Generalist, but to also pick up additional Psychiatry training through the program and now provide much needed support to his community. The issue of poor access to services is, as Aaron says, common across rural and remote Australia and telemedicine is not suitable for all patients or all of the time. The challenges of driving long distances, costs, and time away from the farm or other work, are real barriers for many which means not all those who need care receive it. We congratulate Dr Hawkins and all those generalists working in rural practices.
If you have a similar story to share or would like to tell us about an issue in your town, please let us know by contacting email@example.com.
If you know someone who is needing support and wanting someone to talk to, please reach out to the below.
Beyond Blue 1300 22 4636
Lifeline 13 11 14
13YARN 13 92 76