Continuity of care in places of trauma

Following the devastation of the Black Summer bushfires, the trauma within the Far East Gippsland community was deep and the need for accessible mental health support was evident. However, while providing care in the immediate aftermath of a significant trauma is important, ongoing support is essential to bring about the best possible mental health outcomes.

Compared to metropolitan areas, rural and remote communities are at a clear disadvantage when it comes to accessing mental health support, particularly free or low-cost services. Distance is also often a significant barrier, as the closest towns with availability can be many hours’ drive away.

Understanding the importance of locally available care, the Royal Flying Doctor Service Victoria launched their Bushfire Recovery Counselling and Support service in Mallacoota and Cann River in February 2020, which is still operating today with a few of the same mental health clinicians who were there from day one of the service.

A second service, Flying Doctor Outreach CARE, was launched across East Gippsland in August 2021 in direct response to community calls for a mental health service that was less clinical and therefore more accessible to local youth who needed a casual environment in which to vocalise their trauma.

‘The Flying Doctor was particularly interested in providing a service that worked for people who would not usually reach out for help from a formal mental health service,’ says Michelle Connell, Team Leader for Flying Doctor Outreach CARE.

‘Outreach CARE was developed after formal consultation with community groups and stakeholders and tailored to the identified needs of each community. We went out into each community with a clear goal: to listen, learn and deliver what the locals needed and not what we thought they would want.’

The service became a driving force in providing social recovery following the bushfires, with the Outreach CARE model including face-to-face wellbeing conversations and group activities. Importantly, the service acknowledged that time was not enough to heal the emotional and mental wounds of the fires, and that consistent, long-term care was critical to helping the communities take strides towards recovery.

‘The bushfire disaster triggered those people with complex trauma and others with previously untreated mental health conditions that require longer-term interventions for recovery,’ says local general practitioner, Dr Sara Renwick-Lau.

‘The Flying Doctor understood the importance of regular, consistent visits, which allowed them to build trust and relationships and embed themselves in the local community. This has ensured that their work has been effective and has contributed in a significant way to the social recovery of individuals, families and the community as a whole.’

A lack of continuity of care can be particularly damaging to adolescents and younger children who, in particular, often require time to establish trusting relationships with support workers. As noted by Trindi Suratman from Mallacoota Medical Centre: ‘As with all trauma recovery, it is the time it takes to build relationships within communities where we see the most benefit. Especially with our young people who have seen service providers come and go; it has been the consistency that Outreach CARE workers Michelle Connell and Amber Wade have shown us that has enabled young people to build trust.’

Trauma recovery in rural and remote communities is a long game that requires patience and a dedicated presence. Royal Flying Doctor Service Victoria has become a familiar face in Mallacoota, Cann River and the surrounding communities, not just through Outreach CARE but through the many other mental health services provided in the community to service local needs. Among them is a relatively new service specifically for children aged 12 and under. As such, the Flying Doctor is well placed to remain an ally and a partner for these communities for as long as the road to recovery lasts.