Regions working to tackle mental health load

Alarmingly, the rate for suicide of very remote areas at 24.5 deaths per 100,000 people, was 2.3 times the rate of major cities, where there were 10.5 deaths per 100,000 population, according to the Australian Institute of Health and Welfare.

But mental health advocate Montana Haywood took to social media three years after she had a mental health incident that landed her in hospital.

"I'm here for anyone, if that black dog is following you," she wrote, attached to a photo with her dog.

"The black dog still follows me, but his name is Bullet."

She says the delay of speaking out is due to feeling embarrassed but she is glad she is still here and "punching on strong".

"I feel like a bit of an idiot for doing that and I miss out on my hobbies now because of it," she said.

"But I believe if you don't speak up, it'll catch up to you and eat at you.

"I didn't want to tell people about my problems because I didn't want to be seen as though I was one-upping other peoples problems, so I kept it to myself.

"But now I feel like if you speak up, you might be able to save someone else's life if you're going through the same issue.

"I wouldn't think twice about reaching out, if I ever need to speak to someone."

But Ms Haywood says there is still stigma and other issues that may be influencing farmers not speaking out, such as a fear of losing their firearms, which they use for stock protection.

"I love shooting and it was one of my hobbies but I can't get my gun license now and I feel like the farmers will feel stuck to speak out," she said.

"Being able to exterminate feral animals that will kill your stock like pigs - if you speak about your mental health, you just don't know if it will get taken away from you and you just can't afford that."

Rural and Remote Mental Health acting chief executive officer Nathan Mercurio said the Royal Australia College of General Practice reported in rural and remote Australia people talk to their GP about mental health more than any other issue.

"This results in managing a high volume of mental health work as a result of geographical barriers and a lack of local mental health practitioners," he said.

"This is consistent with the information that we obtain through our activities and what we hear anecdotally when consulting with other organisations and service providers.

"Phone counselling and telehealth mental health services have increased.

"Timely, respectful and relevant communication between GPs and these services will assist patients to navigate a complicated health system and improves the quality of their care."

He said, according to AIHW, the rate of Medicare-subsidised mental health services in remote areas was less than half that of major cities.

"There are even fewer subsidised specialised services, with an average of 112 clinical psychology services per 1000 population in cities, compared to 30 in remote areas," he said.

"People that live in rural and remote communities are resilient and often find a way to solve problems, but mental health is hard to address by yourself.

"Being vulnerable and admitting you need support is a long way from being seen as normal and without judgement.

"Mental health needs to better understood and talked about."

He said improving awareness of mental health services and other supports could equip people with the knowledge to find solutions, have them willing to help others, and respond in situations where they recognise signs of poor mental health like they would if it was a physical risk or illness.

"The purpose of our programs are to ensure local people are appropriately trained and have the capability to provide local solutions to mental health concerns within their community," he said.

"LivingWorks training teaches people to recognise the signs of suicide, and to know how to help someone to keep safe, access further support and find hope.

"The statistics are bleak, but provide a window into how complex mental health can be in rural and remote communities."

ACT for Ag founder Steph Schmidt said the programs she ran were focused on building psychological flexibility for farming people and rural communities.

"It's all about key skills for managing our well being and mental health and I think it's really beneficial for rural communities because a lot of it is skills in managing those things that are outside of our control and that unpredictability of farming life as well," she said.

"I actually have a farm life wellbeing check-in on my website and so people can actually use that and just get a general checkup to see whether they're struggling or thriving on navigating their mental health.

"And then they'll receive some resources and tips on who next to go to for help and I think if people are really at a point where they're struggling, definitely linking in with their local GP and reaching out to friends and family.

"In SA, we do also have Regional Access, where you can get free phone counseling sessions for rural and regional Australia so that's a really important contact.'

Livestock SA, with PIRSA and ActforAg, is running Farmflex: foundations of wellbeing workshops at Clare, Murray Bridge and Naracoorte next month.

A similar service to Regional Access is This Is A Conversation Starter, which co-CEO Jason Banks said was only made possible due to Trademutt, the funky high-vis tradie workwear emblazoned with the phrase 'This is a conversation starter' designed to grab attention and begin discussions about mental health.

"Trademutt quickly gained traction but its success of also led to questions of where tradies and other blue-collar workers could find further support," he said.

"TIACS provides free counselling to tradies, truckies, farmers and rural communities, blue collar workers and their loved ones right around Australia, with a mission to start conversations surrounding mental health among Australia's blue-collar workers while removing the physical and financial barriers associated with seeking mental health support.

"We like to let people know that it is OK not be OK and that opening up and sharing some of the challenges that people maybe experiencing is a sign of strength.

"Think of TIACS being your personal trainer for your mental fitness - we all have those not so good days and often its just you need someone to chat to."

He says TIACS is funded by the industry, for the industry and they "are always looking for more partners to link arms with so they can support more Australians with free mental health counselling".

Within regional SA there are six towns that now have an Our Town service, which advocates for regional communities to prevent poor mental health and wellbeing.

Our Town Kimba project steward Erin Lister says Our Town is a community-led initiative funded by a philanthropic organisation until 2030 to prevent poor mental health and wellbeing.

"We don't class ourselves as a service but are here to support our community however we can to build greater connection and belonging," she said.

"We are here as a drop in to listen to people and assist in linking people to what is available in the community and, if relevant, linking to mainstream services if that's what they want.

"The Our Town initiative is about utilising local people, programs and supports and also building the capability of community to support community.

"Regional areas and farming communities have always been very good at doing it for themselves so we are."

She said their funding covered most of their programs and they would continue to apply for grants to hopefully keep it that way.

She said they required grant funding into regional communities to keep expanding the Our Town initiative.

"We will continue to apply for grants but if there was less red tape and bureaucracy the money would go to where it is needed easily," she said.

"We also require the community to get involved anyway they can to contribute to make the ideas come to life by taking ownership and responsibility towards their own mental health and wellbeing as individuals and as a community."

An SA Health spokesperson said improving mental health services across the regions had been a key focus with more than $61 million being invested to support the mental health and wellbeing of regional and rural South Australians.

"This investment includes six new mental health beds being built in Mount Gambier and 12 in Mount Barker," they said.

"As part of an investment into 72 new rehabilitation beds across Adelaide, we are considering how more beds could be allocated to regional local health networks.

"In addition, new community mental health funding of $3 million has been allocated to country areas, in particular for older people's mental health, which will create eight new community mental health positions."

They said late last year, the independent Rural Mental Health Review was released with the recommendations designed to inform the government's future investment into rural mental health services.

"On October 5, Riverland Mallee Coorong Local Health Network launched its inaugural Mental Health Services Plan for communities across SA's East," they said.

"The five-year blueprint details how high-quality specialist mental health services across the region will be developed, which promote dignity, choice, and independence.

"We currently have 18 psychologists working across country areas, with specialist community support for young people through the Child and Adolescent Mental Health Service.

"A person living in a rural area can access mental health telephone support and advice (from Mental Health Triage) on 13 14 65.

"(Otherwise) a doctor can refer for telepsychiatry appointments or make a referral to the local community mental health team for specialist assistance."

Wellbeing SA interim chief executive Marina Bowshall said Wellbeing SA funds and supports community-driven projects that strengthen and protect the mental wellbeing of South Australians, including Our Town, Are You Bogged Mate?, and localised suicide prevention activities.

"Through grants, events, support, resources and training, we are helping to foster conversations in rural communities about wellbeing, with a particular focus on addressing the issue of depression and suicide in regional SA," she said.

"As part of this, we have provided funding for Lifeline South East; a Lifeline Centre offering telephone support services and other suicide prevention and mental health supports to regional South Australians."

Health and Wellbeing Minister Chris Picton said the state government was investing significantly in improving mental health care across regional SA.

"We are working with the federal government to establish Head to Health mental health services at Mount Gambier, Port Pirie and Mount Barker," he said.

"We are expanding the number of community mental health workers in regional areas, and employing more mental health staff in schools across the state.

"Private mental health services, such as private psychologists and GPs, are the responsibility of the federal government and we are working cooperatively with federal minister Mark Butler, who is taking his own action about expanding access through federal programs."