House Select Committee on Mental Health and Suicide Prevention

18 May 2021

The National Rural Health Alliance (the Alliance) welcomes the opportunity to provide a perspective on mental health and suicide in rural, regional and remote (hereafter rural) Australia to inform the House of Representatives Select Committee. The Alliance comprises 44 national member organisations and is focused on improving the health and wellbeing of the 7 million people residing outside our major cities. Our members include health consumers, health care professionals, service providers, health educators, students, and the Indigenous health sector. Well-rounded representation of the rural health sector enables us to work toward our vision of ‘healthy and sustainable rural, regional and remote communities’.

Though the reported prevalence of mental health conditions in rural Australia is similar to major cities, rates of suicide and intentional self-harm are higher, as are rates of substance abuse. The burden attributable to mental and substance use disorders is also comparable across geographical regions, yet the burden attributable to injury, particularly suicide and self-inflicted injuries, increases dramatically with remoteness. The anomalous statistics for prevalence of mental health conditions in rural Australia may mask significant under-reporting.

The livelihood of many rural people relies on the land and associated industries, making them more exposed to the effects of extreme weather events and climate change, including drought, bushfires and floods. In the broader context of lower incomes, lower educational attainment and higher rates of unemployment, rural people face the challenge of cumulative and ongoing adversity, with its subsequent impact on mental health and wellbeing. When combined with inadequate health workforce to meet population need and barriers to accessing services – geographical distance, costs, waiting times, privacy concerns, attitudinal factors and digital barriers – it is evident that there is significant unmet need.

Aboriginal and Torres Strait Islander (Aboriginal) people, who make up a higher proportion of the population with increasing remoteness, have unique mental health and social and emotional wellbeing needs and their experience contributes significantly to the overall experience in rural Australia.

Rural lives are being lost due to lack of available and appropriate mental health support and people are not being enabled to achieve a state of optimal mental health and wellbeing - allowing them to live fulfilling lives and contribute fully to society - and this is a strong imperative for change.

This submission will expand on the key data that illuminates the current state of rural mental health and wellbeing and paint a picture of the various contemporary issues impacting mental health and wellbeing for rural people. It will develop the issues of workforce and access to services and discuss how the system needs to change to better meet the needs of rural people and communities in the context of recently published reports (as per the terms of reference of this committee). Recommendations for action will be presented.