Peter has vivid memories of seeking help at the local emergency department during his lowest point. “I'm feeling suicidal”, he tells the triage staff. The waiting room is busy. “Sir, I can't hear you. You'll have to speak up”. He glances around, hoping there are no familiar faces in earshot as he repeats himself in a louder voice.
Peter is not alone with his privacy concerns. Many older rural Australians share similar concerns about how social visibility affects their experiences of seeking mental health support. There is a sense that although people look out for you in rural areas, they are also looking at you, which leaves many feeling they need to choose between privacy and support. "You know it gets around town very fast” Joan explained. “People judge you to the point you don't feel like doing business at all in the town. And you do pull away." Withdrawing socially to avoid the rural looking glass is a strategy several people describe using when they feel unwell, even when they can see increased isolation has a negative impact on their wellbeing.
Our conversations at the Manna Institute with older rural Australians have highlighted several significant social challenges affecting their experiences of accessing mental health support. A lot of people expressed concerns about stigma around mental health and the inability to discretely seek help in their rural community. It was also clear that traditional ideas about gender influenced older adults’ willingness to seek help. "I think a lot of fellas won't seek it because they don't think they need support,” Roy told us. “You know that way that old fellas go 'oh I'm ok'. You've got to be strong and wise, and you don't show weakness."
We also heard several stories like Jane’s, from carers who sidelined their own health while they focused on supporting a partner or other family member. “No one ever refused to help me, I just didn't ask for the help, and it wasn't offered, because the whole pattern of our family engagement with each other was that the women provided the care and support for the men.”
It wasn’t all bad news though. These stories also showed how rural life could play an important role in supporting good mental health and wellbeing in later life. Jane reflected on how being in a small community often meant people were more actively keeping an eye out for one another. "It's probably much more obvious to others in a rural and regional community. If you're not out and about and engaging in community life, your absence is more visible here." The strong sense of community also provided important opportunities to connect with others, which many people saw as crucial for their mental wellbeing.
A key takeaway from these conversations is how important it is for older adults in rural areas to have a safe space to talk about mental health. Worries about stigma and a lack of privacy in rural areas means that older adults are still reluctant to ask for help and to access mental health supports. For service providers, a great starting point is to consider how supports can be designed and delivered in ways that prioritise privacy and accessibility. But this is also a job for all rural people. Poor mental health is not a normal part of ageing. We need to normalise talking about mental health across all age groups, to ensure that older rural Australians are not just seen, but also heard.
* Names have been changed
Add new comment