Mount Isa is a sprawling mining town of some 22,000 people in remote, outback Queensland with a large fly-in fly-out workforce, low levels of schooling and a reputation for hard work. Access to many of the primary mental health care and community mental health care services is complicated and poorly integrated. Resources are stretched.
This is not positive news for people like Tommy*, who was referred to an Acute Care Team after presenting at the Mount Isa Hospital Emergency Department. He told the ER doctors that he wanted help with anxiety and feelings of worthlessness. After leaving school early with poor literacy skills he had worked unsociable hours at a local mine most of his life. A heavy drinker and smoker for many years, Tommy had limited family support and felt that his wife did not know how to assist him.
Luckily for Tommy he was able to get the help he needed and worked with a community managed organisation to develop strategies to improve his mental health.
Sadly, not everyone in remote, rural and regional Australia is so fortunate.
People living in the bush face a unique set of challenges, needs and health determinants. These need to be carefully considered; because when it comes to addressing mental health reform we can’t adopt a one size fits all approach.
People living outside of our major cities are statistically more likely to be unemployed and suffer from social isolation. Socio-economic disadvantage and chronic disease are more prevalent in the bush and there are stress factors unique to rural communities like drought and bush fires. It is a sad reality that suicide rates are one and a half times higher in rural and remote areas.
We know what these people in the bush need - proper access to primary healthcare, such as a local GP, as well as specialist mental health services like psychiatrists and clinical psychologists. Unfortunately, the release this week of the Report of the National Review of Mental Health Programmes and Services confirms that this is precisely what they don’t get. It warns that reliance on mental health services increases by remoteness but that the services just aren’t there.
Labor believes that the Abbott Government must take this issue seriously.
The report argues that while greater overall investment is needed, new technologies and community capacity could boost mental health services in the bush. E-mental health services have the potential break down one of the most significant barriers that people outside of our cities face in getting adequate help - distance. In addition to this strong consideration should be given to training community members to provide support. Projects like Farm-link, which educated and equipped members of the local community likely to come into contact with “at-risk” individuals, provide a helpful case study of how this could be achieved.
But to improve mental health outcomes in the bush we need to go much further. The Government must call off its relentless attacks on Medicare; including any so-called “value signals” designed to discourage people from seeing their local Doctor. Where psychiatrists or clinical psychologists are few and far between GPs are on the frontline of mental health treatment. They must be allowed to get on with the job free from uncertainty.
The Minister with responsibility for rural and regional health, Senator Fiona Nash, must be included and consulted. She has previously conceded that she was kept out of loop on the GP tax.
This cannot be the case for mental health in the bush.
When in power Labor’s mental health reforms recognised that the distribution of services across communities, including low socio-economic, rural and remote communities was poor and included a range of initiatives to address these issues. We invested in E-mental health, extended funding for the Mental Health Services in Rural and Remote Areas program and introduced wellbeing programs to offer a flexible package of services to remote communities.
The report of the mental health review affirms the need for continued reform that builds on Labor’s achievements. The Abbott Government still has no real mental health policy let alone a plan for how to improve mental health outcomes in the bush.
Senator Nash must consult with rural, regional and remote mental health providers and make sure that her Cabinet colleagues are listening to their input. Perhaps most importantly, Tony Abbott must promise that the next federal Budget won’t feature any cuts to mental health funding. Only then can people in remote, rural and regional Australia, like Tommy, get the help and support they need.
*Name changed for privacy reasons