Rural and Remote Mental Health Services in Need of Overhaul

Mental health services in rural and remote areas needs a complete overhaul according to the National Rural Health Alliance, which has found there are only two psychiatrists for every 100,000 people in remote Australia.

NRHA undertook new analysis on the prevalence of mental health professionals in country regions, as part of its submission to the Senate inquiry into the Accessibility and Quality of Mental Health Service in Rural and Remote Australia.

It found there were just two psychiatrists for every 100,000 people in remote Australia, which the submission noted was deeply concerning.

“The key issue in relation to mental health service usage is that people in rural and remote areas have less access to mental health services, particularly psychiatric and psychological care services,” the submission said.

“As a result, emergency departments in local hospitals are used as the access point for mental health care by people in country areas.”

The analysis also found that in major cities there were 120 psychologists for every 100,000 people, but this dropped to just 25 psychologists in very remote areas.

For mental health nurses the split was 94 for every 100,000 people in cities, compared to 29 per 100,000 people in very remote areas.

Mark Diamond, the CEO of NRHA, told Pro Bono News that these areas found it hard to attract and retain medical professionals.  

“Generally speaking we find it difficult in country areas to actually recruit across a range of health professions, particularly in allied health professions,” Diamond said.

“There’s actually been quite a good improvement in relation to the distribution of general practitioners, certainly into regional areas and even in remote and very remote areas.

“But there’s big variations in the distribution of mental health nurses, psychologists, social workers, occupational therapists and even psychiatrists when it comes to very remote locations.”

While NRHA’s submission made seven recommendations, Diamond said there were two immediate priorities.

“Most immediately we need to have additional resources and funds to actually establish positions,” he said.

“These are salaried positions that work out of regional, remote and very remote areas. There’s an overhaul required of the current distribution, to do that requires a substantial investment in relation to the creation of new positions.

“The second big thing is about training and it’s about making sure that we’ve got young country high school students choosing health as a career option, undertaking their training… for mental health purposes and then being able to actually undertake that training in a country area.”

Diamond said it was vital that more students undertook their training in regional and remote areas.

“Students need exposure in a country location for all the elements of the course… because during that time their social relationships form and they become embedded within the communities that they’re in,” he said.

“They need to actually experience this connection during their training years so they choose rural and remote areas as their first option.”

Earlier this year, Frank Quinlan, the CEO of Mental Health Australia, told Pro Bono News that a “carefully planned workforce strategy” was needed to address a crisis in mental health service access in rural Australia.

MHA’s submission to the Senate inquiry reiterated the need for a strategy.

“The COAG [Council of Australian Governments] Health Council should be tasked to develop a rural mental health strategy, informed by a collation prepared by the National Mental Health Commission of the PHN [Primary Health Network] service mapping in rural and remote areas and other key data that identifies service shortfalls,” the submission said.

“The commission should also be tasked with monitoring and overseeing implementation of the strategy, reporting back directly to the COAG Health Council.”

Diamond said the Senate inquiry and the recent federal budget showed early signs that things were heading in the right direction.

“The recent budget announcement around the Stronger Rural Health Strategy included some [promising] components particularly in allied health,” he said.

“We’re saying there’s a range of health professions… that need to be there with the GPs to actually provide holistic support for people and particularly people with mental health issues.

“If they’re not able to access those services in country locations, their condition deteriorates and they end up having an acute episode that requires a hospital admission and that’s not serving anyone’s interests.”

The Senate committee is due to report its findings from the inquiry on 17 October 2018.