Putting regional mental health on the map

Australia is a vast land that encompasses everything from arid deserts to tropical rainforests. Regional and rural Australia is full of stories, larrikins and gorgeous landscapes that provide peace and tranquillity. Small towns call to their urban counterparts as an escape from the busyness of everyday life – so it is no surprise that living in regional Australia shows slightly higher satisfaction indicators and overall wellbeing.

Yet smaller towns and the distances between them mean the roads are longer, both literally and figuratively. This can be true of the roads to mental health support.

For the 7 million or 28% of Australians that call regional and rural Australia home,  accessing mental health support is not always without challenges. The National Rural Health Alliance Inc found that while the prevalence of mental illness in rural and remote Australia appears similar to that of major cities, resources are much harder to access. The ratio of available mental health professionals in regional areas was significantly lower than that of urban areas, with fewer psychiatrists (36%), mental health nurses (78%) and psychologists (57%) in regional and rural areas.

The report also revealed that rates of self-harm and suicide increase with remoteness. Aboriginal and Torres Strait Islander people, two-thirds of whom live in rural, regional or remote areas, are almost three times as likely as non-Indigenous people to report high or very high levels of psychological distress. Distance or culturally appropriate support are not the only barriers faced. Issues with physical access collide with a reluctance of country folk to seek support via the GP mental health treatment plan with only 5% uptake in outer regional areas compared to 21% in inner regional areas.

Yet in true country spirit, what seems like a challenge is embraced by many as an opportunity. Countless individuals and organisations in rural and remote areas are coming together to apply their strengths and build mentally healthy communities via community-directed early intervention programs and their own brand of outreach.

Let’s look at the ways regional and rural Australia are changing the conversation around mental health.

Having frank, open conversations

Mental health conversations and discussions about the challenges individuals and communities face can help people feel supported and get assistance. Despite decreased access to professional support in regional and rural areas, there are several community-driven initiatives that are helping to normalise reaching out and tackling stressful conversations.

You can increase mental health and well-being support to individuals and communities in regional and rural areas by:

• Reminding farmers to ask for help, reach out to friends, and escalate the problem via a mental health program specific to men in rural areas, Are you Bogged Mate?
• Looking into specific challenges faced by regional businesses with Ahead for Businesses resources, and getting involved with their Rural Agribusiness Wellbeing Project
• Accessing counselling programs that understand specific challenges via Rural Aid
• Engaging in culturally appropriate conversations via Aboriginal and Torres Strait Islander run 13YARN
• Investigating models like the UK’s Frazzled Cafes initiative that helps normalise the idea of meeting at a local café to talk about challenges, stresses and mental health conditions
• Undertaking Mental Health First Aid® training to increase skills to recognise and respond to mental health problems, create mentally healthier communities, and build Champion Communities that take a whole-of-community approach to early intervention.

Rethinking the drinking

Reports show that people living in regional and rural areas tend to consume alcohol at higher rates than their counterparts in major cities, significantly increasing the risk for alcohol-related harm.

There are several factors that contribute to higher alcohol consumption in regional and rural areas. From backbreaking farm work to the immersion in drinking culture via alcohol-related agriculture, tourism and hospitality, it can be challenging to break away from alcohol usage in the social context. On top of this, other risk factors such as increased isolation, higher unemployment and lower income levels can increase reliance on alcohol in these areas.

This higher usage means that Australians in regional and rural Australia are accessing alcohol-related treatments at a higher level than people in major cities, despite needing to travel much further to access treatment.

A growing number of regional and rural Australians are improving their relationship with alcohol by:

• Shifting the local meeting place from the pub to other venues for alcohol-free experiences
• Opting to meet for a Manwalk to exercise and build connection, as an alternative to meeting for drinks
• Taking advantage of telehealth programs such as Clean Slate Clinic and St Vincent’s Alcohol & Drug Telehealth Service pilot program in NSW’s Murrumbidgee region
• Learning it’s okay to say no with the support of grassroots communities such as Sober in the Country.

Building on existing strengths

In regional and rural settings, people coming together to volunteer, socialise, lend a hand and support one another is often a way of life. It’s what helps people stay connected, builds resilience during natural disasters, and keeps the town’s wheels turning. The close nature of these communities also provides an opportunity for open dialogue and informal community support.

Working together can reduce the impact of problems faced by sharing the physical load – and the same can be true of the emotional and mental load. Established connections may serve as a great starting block for developing further strategies to reach out to a neighbour in need.

Leveraging established rituals and extending their reach may take the form of:  

• Moving away from “how are you?” by asking “what’s been happening today?” for a more present and mindful response
• Making time to stop for a chat or organising a social catch up over lunch or a coffee
• Making use of virtual calls or social media to boost connections, especially if geographical distance or time constraints affect the ability to regularly socialise face-to-face
• Normalising mental health and conversations by embracing R U OK? Day and World Suicide Prevention Day to spark conversation
• Building community food gardens with guidance from the Transitions Town movement to help bring people together and grow nutritious food for the neighbourhood
• Embracing community activities related to events such as National Reconciliation Week, LGBTQIA+ pride via Rural Pride Network, and Seniors Week, to help vulnerable communities feel welcome and included.

The power within communities

Addressing stress in regional, rural and remote communities while having open and honest conversations about mental health can help to create positive change – and so too can meeting people where they live, regardless of the distance between them.

If you would like to become a change maker in your community, why not sign up for the Mental Health First Aid Instructor’s course or request Mental Health First Aid® training for your area?

References and Resources

Australian Bureau of Statistics. Main Features – Small Towns [Internet]. www.abs.gov.au. 2018. Available from: https://www.abs.gov.au/ausstats/abs@.nsf/Lookup/2071.0main+features1132016

National Rural Health Alliance. MENTAL HEALTH IN RURAL AND REMOTE AUSTRALIA [Internet]. 2017 Dec. Available from: https://www.ruralhealth.org.au/sites/default/files/publications/nrha-mental-health-factsheet-dec-2017.pdf

Australia’s health 2018, Proportion of people with mental illness with a GP care plan [Internet]. Australian Institute of Health and Welfare. [cited 2023 Mar 12]. Available from: https://www.aihw.gov.au/reports/australias-health/australias-health-2018/contents/indicators-of-australias-health/mental-illness-with-gp-care-plan

Alcohol and other drugs in regional and remote areas – Alcohol and Drug Foundation [Internet]. Adf.org.au. 2019. Available from: https://adf.org.au/insights/regional-remote-aod/

Alcohol and other drug use in regional and remote Australia: consumption, harms and access to treatment [Internet]. 2016. Available from: https://www.aihw.gov.au/getmedia/78ea0b3d-4478-4a1f-a02a-3e3b5175e5d8/aihw-hse-212.pdf.aspx

• Suicide Call Back Service on 1300 659 467
• Beyond Blue on 1300 22 46 36
• Headspace on 1800 650 890