Mental health challenges in rural and remote Australia are widespread and serious. Although the prevalence of mental illness is about the same across the country – about one in five people report having had a mental health problem in the last 12 months – a higher proportion of people in rural and remote areas pay the ultimate price of mental illness and related concerns; suicide rates in rural and remote Australia are 66 per cent higher than they are in major cities.
There are many positive aspects to rural and remote living: people in rural areas, for example, report higher levels of civic participation, social cohesion and social capital. However, there are also many particular challenges associated with rural life. Some people have a sense of pessimism about future prospects; others experience financial uncertainty and pressure, socio-economic disadvantage, or struggle living with chronic conditions. Such challenges may well prejudice the mental health and wellbeing of people in rural areas.
Also, people in rural Australia often have trouble getting to see a mental health professional when they need to. Medicare data bears testimony to this. They show that Medicare expenditure per person on mental health services in the bush is only 60 per cent of what it is in the city. This is likely to be because there are far fewer GPs, psychiatrists and psychologists per person practising in rural and remote Australia than in the cities.
Some rural people appear to be suffering more than others. Farmers, for example, are twice as likely to die by suicide than the general employed public. The rate of suicide among young men living outside major cities is twice as high as it is in major cities. And the suicide rate among young Aboriginal and Torres Strait Islander people is five times higher than that for young non-Indigenous Australians.
In response to these startling statistics, the National Rural Health Alliance has developed three modest proposals that will help make it a little easier for people to access the care they need. The proposals are as follows.
- Introduce Medicare rebates for telehealth services delivered by psychologists and others through existing programs, such as Access to Allied Psychological Services (ATAPS), and the Better Access to Psychiatrists, Psychologists and General Practitioners.
- Continue mental health first aid training for Rural Financial Counsellors. Funding for the program is due to cease on June 30, 2015.
- In consultation with Indigenous experts, speed up the availability of culturally-appropriate online mental health resources specifically for Aboriginal and Torres Strait Islander people, perhaps using Aboriginal Health Workers with special training in e-mental health.
The Alliance has taken these proposals to Parliamentarians, suggesting that they should be considered for funding in the upcoming Budget. We will continue to advocate for these proposals in the coming months because they are cost-effective and practical measures that would make a real difference to the health and wellbeing of people living in rural and remote Australia.
The Alliance has recently published a Fact Sheet highlighting some of the issues relating to mental health in rural Australia. We have also published a Rural Mental Health Help Sheet with valuable information on where to find advice and support. Both are available at http://ruralhealth.org.au/factsheets/thumbs.
Anne-Marie Boxall, National Rural Health Alliance.