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Aust. J. Rural Health (2014) 22, 340–341
From the Journal Associates Rural mental health matters Published data show that the recorded prevalence of mental illnesses in rural and remote Australia is similar to that in cities. Data from the 2007 Australian Bureau of Statistics’ (ABS) Mental Health Survey show that 20.4% of adults in capital cities have had a mental disorder in the past 12 months, compared with 19.2% in other urban centres and in the balance of state.1 Similarly, modelling of the 2011–2012 ABS National Health Survey suggests that 10.6% of the population in major cities exhibit high levels of psychological distress, compared with 11.5% in inner regional areas and 10.7% in outer regional/remote areas.1 While these data are the best we have, they obscure some of the important underlying issues that suggest we should still be particularly concerned about mental illness in Australia’s rural and remote communities. Many people living in rural and remote Australia face a range of stressors that put them at risk of mental ill health. They have a greater prevalence of chronic conditions, disability and generally poorer health. Rates of smoking, risky drinking and illicit drug use are also higher. There are fewer employment opportunities leading to lower incomes and less financial security. They have greater exposure and vulnerability to natural disasters. They also experience higher rates of overcrowding, housing stress and homelessness. Suicide rates are also much higher in country areas than they are in cities. Data from the Australian Bureau of Statistic show that the rate of suicide is 66% higher in the country than in major cities.2 Some population groups are particularly affected. The suicide rate for young men (aged 15–29 years) outside major cities is twice what it is in major cities.2 The rate of suicide among Aboriginal and Torres Strait Islander people is 2.7 times higher than that of non-Indigenous people, rising to 5.1 times for Indigenous youths (15–24 year olds).3 A study examining suicide in selected occupations in Queensland showed that farmers there were 2.2 times more likely to die by suicide than the general employed public.4 These suicide data suggest that although the recorded prevalence of mental illness in rural and remote Australia might be comparable to that in metropolitan areas, the outcomes are not. Part of the reason for this may be that many people with a mental illness in the bush National Rural Health Alliance piece for December issue From the Journal Associates © 2014 National Rural Health Alliance Inc.
struggle to get access to proper care; there are fewer health professionals, a much smaller choice of health service providers and scarce community support services. People in rural and remote communities, for example, have less access to GP (General Practitioner) care. In 2011–2012, there were 241 GP mental health encounters per 1000 people in remote/very remote areas compared with 668 in major cities.5 Access to specialised mental health care is much poorer in rural areas with almost 9 out of 10 psychiatrists employed in major cities. The number of mental health nurses and psychologists also decreases substantially with increasing remoteness. Medicare data also highlight the problem. It shows that in 2012–2013, Medicare expenditure per person was $47.83 in major cities, but $9.67 for people in remote areas and $5.21 for people in very remote areas.5 Because people in rural and remote Australia face unique stressors and have poorer access to services, the National Rural Health Alliance continues to make mental health a priority issue. The Alliance made submissions to the National Mental Health Commission’s Review of Mental Health Services and Programmes.6 In addition, the Alliance has recently conducted a survey of chief executive officers of rural Medicare locals. It found that 86% of respondents said that Medicare locals had a very important role in delivering mental health services, but 100% said that there were currently moderate to large gaps in service delivery. In the transition to Primary Health Networks, the Alliance will be advocating strongly for the maintenance and improvement of mental health services in rural and remote areas. The ongoing work to address the prevalence of mental health issues in the bush requires the efforts of many people. Whether you are a researcher, health professional, consumer advocate or passionate community member, we need to bring together our knowledge and expertise. The Alliance is always looking for partners to work with and bring new ideas to life so that there are better mental health outcomes for Australians in rural and remote communities. If you have an idea you would like to discuss, please contact us. Dane Morling Policy Officer Anne-marie Boxall Senior Policy Adviser National Rural Health Alliance doi: 10.1111/ajr.12158
341
References 1 Australian Government, Australian Bureau of Statistics. National Survey of Mental Health and Wellbeing: Summary of Results. Cat. No. 4326.0, ABS, Canberra, 2007. 2 Australian Government, Australian Bureau of Statistics, Australian Social Trends. Health outside major cities. March 2011, Cat. No. 4102.0, ABS, Canberra, 2007. 3 Australian Government, Australian Bureau of Statistics. Causes of Death, Australia, 2011. Cat no. 3303.0, ABS, Canberra, 2011. 4 Andersen K, Hawgood J, Klieve H, Kõlves K, De Leo D. Suicide in selected occupations in Queensland: evidence
© 2014 National Rural Health Alliance Inc.
from the State suicide register. The Australian and New Zealand Journal of Psychiatry 2010 (Mar); 44: 243–249. 5 Australian Government, Australian Institute of Health and Welfare. Mental health services Australia. Webpage, Canberra, AIHW. [Cited 11/11/2014]. Available from URL: https://mhsa.aihw.gov.au/home/ 6 National Rural Health Alliance. Review of mental health services and programmes – submission to National Mental Health Commission. [Cited 11/11/2014]. Available from URL: http://www.ruralhealth.org.au/document/review -mental-health-services-and-programmes-submissionnational-mental-health-commission
Copyright of Australian Journal of Rural Health is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use.
Aust. J. Rural Health (2014) 22, 340–341
From the Journal Associates Rural mental health matters Published data show that the recorded prevalence of mental illnesses in rural and remote Australia is similar to that in cities. Data from the 2007 Australian Bureau of Statistics’ (ABS) Mental Health Survey show that 20.4% of adults in capital cities have had a mental disorder in the past 12 months, compared with 19.2% in other urban centres and in the balance of state.1 Similarly, modelling of the 2011–2012 ABS National Health Survey suggests that 10.6% of the population in major cities exhibit high levels of psychological distress, compared with 11.5% in inner regional areas and 10.7% in outer regional/remote areas.1 While these data are the best we have, they obscure some of the important underlying issues that suggest we should still be particularly concerned about mental illness in Australia’s rural and remote communities. Many people living in rural and remote Australia face a range of stressors that put them at risk of mental ill health. They have a greater prevalence of chronic conditions, disability and generally poorer health. Rates of smoking, risky drinking and illicit drug use are also higher. There are fewer employment opportunities leading to lower incomes and less financial security. They have greater exposure and vulnerability to natural disasters. They also experience higher rates of overcrowding, housing stress and homelessness. Suicide rates are also much higher in country areas than they are in cities. Data from the Australian Bureau of Statistic show that the rate of suicide is 66% higher in the country than in major cities.2 Some population groups are particularly affected. The suicide rate for young men (aged 15–29 years) outside major cities is twice what it is in major cities.2 The rate of suicide among Aboriginal and Torres Strait Islander people is 2.7 times higher than that of non-Indigenous people, rising to 5.1 times for Indigenous youths (15–24 year olds).3 A study examining suicide in selected occupations in Queensland showed that farmers there were 2.2 times more likely to die by suicide than the general employed public.4 These suicide data suggest that although the recorded prevalence of mental illness in rural and remote Australia might be comparable to that in metropolitan areas, the outcomes are not. Part of the reason for this may be that many people with a mental illness in the bush National Rural Health Alliance piece for December issue From the Journal Associates © 2014 National Rural Health Alliance Inc.
struggle to get access to proper care; there are fewer health professionals, a much smaller choice of health service providers and scarce community support services. People in rural and remote communities, for example, have less access to GP (General Practitioner) care. In 2011–2012, there were 241 GP mental health encounters per 1000 people in remote/very remote areas compared with 668 in major cities.5 Access to specialised mental health care is much poorer in rural areas with almost 9 out of 10 psychiatrists employed in major cities. The number of mental health nurses and psychologists also decreases substantially with increasing remoteness. Medicare data also highlight the problem. It shows that in 2012–2013, Medicare expenditure per person was $47.83 in major cities, but $9.67 for people in remote areas and $5.21 for people in very remote areas.5 Because people in rural and remote Australia face unique stressors and have poorer access to services, the National Rural Health Alliance continues to make mental health a priority issue. The Alliance made submissions to the National Mental Health Commission’s Review of Mental Health Services and Programmes.6 In addition, the Alliance has recently conducted a survey of chief executive officers of rural Medicare locals. It found that 86% of respondents said that Medicare locals had a very important role in delivering mental health services, but 100% said that there were currently moderate to large gaps in service delivery. In the transition to Primary Health Networks, the Alliance will be advocating strongly for the maintenance and improvement of mental health services in rural and remote areas. The ongoing work to address the prevalence of mental health issues in the bush requires the efforts of many people. Whether you are a researcher, health professional, consumer advocate or passionate community member, we need to bring together our knowledge and expertise. The Alliance is always looking for partners to work with and bring new ideas to life so that there are better mental health outcomes for Australians in rural and remote communities. If you have an idea you would like to discuss, please contact us. Dane Morling Policy Officer Anne-marie Boxall Senior Policy Adviser National Rural Health Alliance doi: 10.1111/ajr.12158
341
References 1 Australian Government, Australian Bureau of Statistics. National Survey of Mental Health and Wellbeing: Summary of Results. Cat. No. 4326.0, ABS, Canberra, 2007. 2 Australian Government, Australian Bureau of Statistics, Australian Social Trends. Health outside major cities. March 2011, Cat. No. 4102.0, ABS, Canberra, 2007. 3 Australian Government, Australian Bureau of Statistics. Causes of Death, Australia, 2011. Cat no. 3303.0, ABS, Canberra, 2011. 4 Andersen K, Hawgood J, Klieve H, Kõlves K, De Leo D. Suicide in selected occupations in Queensland: evidence
© 2014 National Rural Health Alliance Inc.
from the State suicide register. The Australian and New Zealand Journal of Psychiatry 2010 (Mar); 44: 243–249. 5 Australian Government, Australian Institute of Health and Welfare. Mental health services Australia. Webpage, Canberra, AIHW. [Cited 11/11/2014]. Available from URL: https://mhsa.aihw.gov.au/home/ 6 National Rural Health Alliance. Review of mental health services and programmes – submission to National Mental Health Commission. [Cited 11/11/2014]. Available from URL: http://www.ruralhealth.org.au/document/review -mental-health-services-and-programmes-submissionnational-mental-health-commission
Copyright of Australian Journal of Rural Health is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use.
