By ELLEN DUNGER:
Mental health issues and psychological disorders are rife on farms in rural and isolated communities. Often these issues go unattended due to the demands of the rural lifestyle.
Life on the land is tough.
Suicide amongst farmers is double the rate of people in other occupations. More and more we are hearing of farmers taking their own lives when times get tough. This often affects the whole rural community as well as their families.
For many years there has been a high number of mental health conditions in regional communities. The numbers are so high, they equal the levels in major cities. However, the difficulty people have with mental health disorders in rural or remote communities is much greater than those in cities.
Mental health can be defined as a state of emotional and social well-being. Mental health can influence how people deal with everyday stresses in their lives.
The Australian Bureau of statistics has found one in five Australians will experience some form of mental illness per year, with three in one hundred seriously affected.
Evidence suggests depression and mental illness begins in adolescent years and in many cases goes untreated and stays with the sufferers throughout their lives.
BeyondBlue recognises a prevalence of mental health disorders in men aged 45-64, who are from rural or remote communities. They believe the farm environment can be hazardous to mental health. Many people live on the land after inheriting family farms. Often these farms are passed down through the generations. In a lot of instances, these men who inherit the family farm have older children themselves and get sandwiched between two generations, adding to the pressure of living on the land.
Former Rural Mental Health Board member and CSU lecturer, Judith Gullifer, says being in between two generations is tough. She says tensions in relationships with older farmers become apparent when changes in technology and farming practices are introduced. Droughts play a major part in psychological disorders in male farmers.
“Productivity decreases and they’re not putting in their crops. They’re selling their stock. What stock they do have, they either have to feed or euthanize if they’re not well and the financial burden of trying to keep the property running, having to take loans, trying to support the older generation if they’re still on the farm”, she said.
“That age group has a lot of tensions even when times are good but you add the complexity of the drought ad you’ve got this perfect storm almost of all these things happening at once and that farmer having to make decisions of whether they have to go off farm to work.”
The Mental Health Council of Australia estimates around one million Australian adults live with depression each year.
Male suicide rates continue to be higher than females. The 2007 National Health Survey of Mental Health and Wellbeing recognised 77% of suicides that year were males. In 2006, male suicide rates were higher in every age group than females.
Suicides in very remote regions are nearly double those in major cities. Between 1997 and 2001 in South Australia, the farm suicide rate was at 33.8 deaths per 100 000 men and 6.7 for women.
There are many factors which are believed to contribute to the high numbers of people with psychological disorders in rural and remote areas. Factors such as isolation, lack of social support, costs, cultural differences, smaller choice of health care providers and less mental health professionals in rural areas. 91 per cent of practicing psychiatrists are based in metropolitan areas.
President of the Australian Psychological Association, Professor Tim Hannan, says men from rural or remote areas are less likely to seek help than men from metropolitan areas, due the accessibility and limited knowledge on what is available to them.
“One factor which we are aware is a more limited access to mental health services in rural areas. That is, the number of psychologists and other mental health professionals in rural areas. Or the ratio of psychologists and mental health professionals in rural areas to the public is much smaller than it is in urban areas. There is more limited service provision,” he said.
“Secondly, it may be the case that men of that age who live in rural areas have less familiarity with or engagement in out services. They’re less informed about what is actually available for them.”
The 2007 survey also found only 35 per cent of people with a mental illness are actually seeking professional help and half the amount of men are seeking help compared to women.
Another factor which plays a big part in men seeking help, is the visibility they would receive in their smaller communities. They may be reluctant to seek help due to the stigma attached. There is a culture of self-reliance in rural and remote communities.
“There’s a lot of stoicism in rural and remote communities. They look after themselves, there’s a sense of pride in looking after yourself ”, says Ms Gullifer.
“It’s not as prevalent as what it used to be a decade ago because of the campaigns around but certainly there still seems to be this stoicism that you have to be strong in rural areas, that saying you need help is a sign of weakness. Also the busy lifestyle of people who live in rural and remote communities, particularly those who live on the land. You’re lucky to get them to see a GP, let alone a mental health expert to help them with any mental health issues they may have.”
Research has found a link between psychological disorders and substance abuse. 75 per cent of people with drug and alcohol issues also have mental health problems. The 2007 survey found men had double the rate of substance abuse compared to females. Around a third of attempted suicides are done so under the influence of alcohol. Mr Hannan says often it is used as a coping mechanism and way to manage their problems.
“Those who are anxious or depressed may use alcohol or drugs to reduce their anxiety or manage their depression. It’s a method of coping,” he said.
“These substances are used as a consequence of having a mental health problem. If you are a frequent user of alcohol or drugs it leads to other behavioural or emotional problems.”
Ms Gullifer agrees with these claims and says the rates of substance abuse is far greater in rural and remote communities than in metropolitan areas
“In rural areas we find the prevalence rates of substance abuse increases as you move further away from metropolitan areas and we also know that psychological disorders increase.”
In addition to substance abuse, there is evidence to suggest people living with depression and other psychological disorders, may suffer from physical health conditions. People living with depression have a 60 per cent higher risk of developing heart disease compared to those with no history of mental health disorders. Many people will develop symptoms of depression and depressive illness after they suffer a heart attack. This could arise from stress factors and massive lifestyle changes such as exercise and diet.
So what are the solutions to address possible psychological disorders in rural or remote communities?
“GP is the first point of contact. They maybe be less stigmatising for the community especially in rural and remote communities,” said Ms Gullifer.
“A GP can then refer on to a psychologist. The psychologist can then work with the patient or the client on addressing depression, anxiety, etc.” she said.
Psychological disorders often start at a young age. In local communities there are specific places for young people to seek help. In Bathurst HeadSpace has psychologists Monday- Friday to help with any issues young people may have.
Locally, the Central West also has Centacare, a non-government organization which has counsellors and private providers. They have offices in various locations around the region, which can help people through difficult times in confidence.
Men’s sheds around the country provide support for men’s health and wellbeing. They provide links to services throughout the community and have a special interest in mental health and suicide.
TOMNET in Queensland provides support for rural men in isolated areas. They also work with local providers to aid those at risk of depression and suicide.
For men who are isolated from the above services, there are confidential helplines available:
MensLine- 1300 78 99 78
Lifeline- 13 11 14
BeyondBlue- 1300 22 4636
SANE helpline- 1800 18 7763
There are services out there.
For more information on where to get help there are websites with information available:
Black Dog Institute- www.blackdoginstitute.org.au
Mental health in Australia- www.mentalhealth.gov.au
THUMBNAIL IMAGE COURTESY OF: THE BORDER MAIL