In Australia, suicide and self-harm are major causes of death, with over 3,000 associated deaths annually. Over the years, the number of people dying from suicide has gradually increased. The more remote the location, the more people we lose to suicide. About seven million Australians live in rural, regional and remote areas. Some Australian rural communities have many more men than women and men have three-times higher suicide rates than women; in 2021 in Australia, 75 per cent of all deaths by suicide were males.
Men in rural and remote areas of Australia often deal with a range of stressors, such as a high number of chronic health problems, financial insecurity (for example unemployment and lower incomes) and homelessness. These stressors can negatively impact their mental health and wellbeing.
The livelihoods of many people in rural, regional and remote areas depend on the farming, mining, tourism, fishing or forestry industries. Natural disasters – such as drought, bushfires, floods and cyclones – greatly impact these industries, which can induce stress and mental health problems in those who work in them. This exposure to stress increases their risk of suicide. For example, extended periods of drought affect soil productivity, water supplies, crop growth and livestock, leading to food insecurity and increasing the economic distress of agricultural workers and businesses. A recent study in regional New South Wales found that rural males aged 10–29 and 30–49 years were the two groups most at risk of drought-related suicides.
Rural men face barriers to mental health support that can delay or limit access. Barriers include fear of the stigma against mental ill health, lower educational and income levels, lack of access to digital infrastructure (such as affordable and reliable internet and mobile phone connections), poor digital literacy and limited access to public transport. Men in the Australian farming community are less likely to access mental health care due to difficulties communicating with health professionals, privacy concerns about help-seeking, social isolation and resilient attitudes.
Although the use of community mental health services is high in rural areas, specialised mental health care by clinical psychologists and psychiatrists is significantly less. Delayed diagnosis, treatment and management of mental health problems increases the risk of self-harm, suicide and hospitalisation.
Targeted counselling services for people during droughts and other climate disasters are essential as rural and remote communities are more vulnerable to increased climate change and its impact on mental health.
Improving access to digital mental health support services can help ameliorate the shortage of specialised mental health professionals. With improved digital infrastructure, farmers can access online farming communities for both professional and psychological support. Mental health literacy and promotion programs, stress-management workshops, peer-support interventions, one-on-one peer listening and peer counselling programs effectively prevent suicide among rural males with farming backgrounds. Informal support groups with neighbours, friends and community members, as well as volunteering and industry association gatherings, are important sources of emotional relief and support.
Alongside government efforts, non-government organisations, civil society organisations and advocacy groups also play essential roles in influencing policy change for the urgent provision of rural mental health. The Public Health Association of Australia (PHAA) is one of the country’s leading advocacy groups for public health policy. They develop evidence-based policy statements and organise policy campaigns by partnering with state branches, special interest groups and public health professional groups.
The PHAA has consistently recognised rural mental health as a public health priority area. They aim to continue advocating for increased support, resources and funding for better mental health services to address the barriers to accessing culturally appropriate mental health and wellbeing support and services in rural, regional and remote communities in Australia.