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The Guardian - AU
The Guardian - AU
National
Dellaram Vreeland

Regional Australia has higher rates of self-harm than the cities. We need to address the problem

Profile of man in silhouette at dusk
‘The mental health crisis in regional Australia is not only contributing to the loss of life, it also affects issues like housing, poverty, education, gendered violence and substance abuse.’ Photograph: Westend61/Getty Images

In 2023, Ballarat launched the Live4Life mental health education and youth suicide prevention program. It came in response to a spate of suicides that had taken place across the city, including 15-year-old Bridie Cocks and her boyfriend, Nick Watts, as well as teenager Rohan Cosgriff who was the victim of a sextortion scam.

Initially engaging more than 1,200 students across eight schools, the program involves a collective of secondary schools, health provider networks and community organisations and aims to train young people in mental health first aid. It’s just one example of an initiative in a regional area that has been born out of grief, but which is bringing together a variety of community leaders, individuals and professionals to combat an enduring crisis.

“While the initiative is built from a devastating event, you can see how they mobilise community networks and support and often bring in additional funding to reduce some of those gaps which are amplified in regional areas,” says Prof Myfanwy Maple, director of the Manna Institute, a mental health research and training institute for regional Australia.

Suicide rates are higher in regional, remote and rural areas than metropolitan centres. According to the Victorian Suicide Register, there were just over 1,500 suspected or confirmed suicides in regional Victoria from 2018 to 2023, with 83 in Ballarat alone, between 2018 and 2022. The Australian Institute of Health and Welfare states that Australians living in the regions face unique challenges due to their geographic isolation and often have poorer health and welfare than those living in major cities.

With access to mental health services an ongoing point of concern and with many towns finding it difficult to attract health professionals, the future is seemingly bleak. But it doesn’t have to be. Community-led preventive solutions are growing.

“There’s this tension in regional communities, this stoicism that I can solve my own problems, but on the flip side our regional communities are quite close knit and offer support to one another,” Maple says.

Another Ballarat organisation, Hand in Hand, was founded to address youth mental health. Its co-founder, Leah Ashton, says the peer-to-peer charity aims to equip young people with the tools and resources to “deal with whatever life throws at them, even before they know they need those tools”.

Ashton says suicide is a “whole community problem”. “There is no one magic solution, no one perfect program or one brilliant project. This is more than that,” she says. “This is a whole community coming together to tackle youth mental health and that’s what we believe in.”

Another example of a community initiative can be seen in Clarence Valley in northern New South Wales. About 10 years ago, after the region experienced an unexpectedly high number of deaths by suicide, the local response was to adopt a community-wide positive mental health and wellbeing initiative encompassing health promotion, prevention, advocacy and collaboration.

While many community initiatives are started by the family and friends of those who have died, and who don’t necessarily have experience in the health sector, Maple says to be effective it’s important they find ways to “embed themselves in the broader suicide prevention sector”.

But she adds the community buy-in of grassroots organisations is vital.

In the regional Victorian town of Ararat, for instance, a new charity One Red Tree has been placing trainee psychologists into schools in the Grampians region.

Founded in 2022 by clinical psychologist Carly McKinnis and educational leader Tammie Meehan after a number of suicides in the town, the organisation partners with local government, Federation University and a range of health services to provide placement and employment opportunities to provisionally registered and early-career psychologists while ensuring that students have ongoing access to support in a positive and nurturing environment.

The Manna Institute has a similar model with its Social Workers in Schools program, which gives university students first-hand experience across public schools in NSW.

“It’s about resilience building from the get-go and providing safety and security and extended networks outside of the nuclear family where our children can go without fear of being judged,” Maple says.

Suicide prevention requires more than just the support of the medical system, although better funding to support people through both inpatient and outpatient care is sorely needed. It also requires more integrated community support.

“People who live in regional areas are not necessarily more psychologically vulnerable than anyone else,” Maple says. “We have to consider the socioeconomic and demographic challenges faced by regional Australians and the broader social issues. It’s not psychological distress straight away, but the impact of one’s environment can lead to isolation and stress and exacerbated by lack of access to timely services.

“Time and time again, family members are angry that they never had support and they find themselves starting from scratch. That’s devastating.”

The mental health crisis in regional Australia is not only contributing to the loss of life, it also affects issues like housing, poverty, education, gendered violence and substance abuse.

The whole-community approach to addressing the issue needs to integrate education, training, connection, health and support into programs that are holistic, evidence-based and shared across all sectors.

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