Imagine a future in which mental wellbeing is prioritised by our government, our communities and within our culture. Imagine a deep understanding of the connection between social inequity and poor mental health outcomes informing our approach to mental health and wellbeing. Imagine if the prevention and treatment of mental ill health was considered holistically through an intersectional lens, within policy, practice and investment. This is a vision for the future that Women’s Health Goulburn North East (WHGNE) believes is achievable through engagement with the development of the Victorian Government’s first Wellbeing Plan.
Across the country, but particularly in remote, rural and regional areas, demand for mental health services exceeds availability and accessibility. In the last issue of Partyline, I wrote about the response to WHGNE’s Community Voices survey, which demonstrated the frustration of rural communities at the lack of mental health support during the COVID-19 pandemic and associated restrictions. Ongoing systemic issues that contribute to mental ill health – like family violence, gender inequity, disconnection from Country, queerphobia, housing insecurity and socioeconomic disadvantage – remain under-addressed as drivers of poor mental health outcomes.
As is often the case when faced with the seemingly monumental task of structural and systemic change, it is helpful to conceive of smaller actions in the creation of a larger plan before perceiving a meaningful path to growth. This is called a ‘theory of change’. The 12 Victorian women’s health services, five of which serve rural and regional areas, have come together in the development of a mental health and wellbeing theory of change. In a recent consultation, facilitated and attended by many of the women’s health services including WHGNE, in addition to academics, clinicians and various other community organisations, several areas for improvement in how we approach mental health and wellbeing were identified.
Crucially, we must approach the prevention and treatment of mental ill health as a structural issue and refrain from propagating a narrative of individual responsibility. For many people, the barriers to accessing mental health services are too great to overcome without systemic and structural change. Secondly, we must acknowledge the gendered components of mental health and wellbeing. Gender inequities such as unequal division of labour, housing insecurity for older women and single mothers, the increasing gender poverty gap and, of course, gendered violence all contribute to mental ill health in women, trans and gender-diverse people. This is exacerbated in rural and remote communities.
Sitting alongside this area, is attention to the multiple intersecting forms of discrimination and oppression that compound barriers to access and negative experiences within an unsafe mental illness system for Indigenous Australians, people with disability and those from culturally and linguistically diverse communities. With this in mind, we must tailor mental health approaches to different communities – both geographically and demographically – and take a holistic approach that considers cultural and spiritual aspects to mental wellbeing.
It's fair to say that we have come a long way in our collective understanding of mental health in the past few decades. People in Australia display good mental health literacy and help-seeking behaviours. This is not to say stigma and discrimination aren’t still at play – they are. However, the overarching challenge we must overcome to ensure our collective wellbeing is prioritised, is not an individual or behavioural one. The systems and structures designed to promote good mental health and address mental ill health have not advanced at the same rate as public awareness and support needs. Through consultation around Victoria’s first Wellbeing Plan, it is our hope that a commitment to promoting good mental health outcomes at a whole-of-society level will be matched by policy, practice and investment.