Suicide prevention needs to go beyond the blue

From the Chair of Rural & Remote Mental Health – Genevieve Fraser

“Sunflowers” by Vincent Van Gogh

Visitors to Canberra during budget week were able to immerse themselves in more than the budget thanks to the National Gallery’s well timed “Masterpieces from the National Gallery, London”, featuring Vincent Van Gogh’s famous Sunflowers. $5 million dollars’ worth of refurbishments were undertaken last year to eliminate all dark corners of the Canberra exhibition space to shed equal light on each masterpiece. Despite these efforts the darkness of Van Gogh’s tragic story remains. In 1880, after the paint had dried on the petals of his celebrated flowers, Van Gogh walked into a nearby field in Auvers, France and shot himself in the stomach with a revolver.

Politicians who were able to take in Sunflowers over the past few months might spare a thought for those who equally lose hope in fields and homes across rural Australia 2021. Rural Australians suicide at two to three times the national average – a tragedy the 2020 Mental Health Productivity Commission asked our leaders to focus on in future funding decisions.

The report explained unambiguously who was dying, where, and why. The central recommendation for rural Australia was that half of those who suicide in Australia are NOT engaged with the medical system so future mental health spending needed to focus on community-based prevention.

Leaders were also told our suicide prevention model needs to change because suicide rates escalate the further someone lives from a capital city.  And this pattern is consistent across every state and Territory.  

Many of those who suicide in the country have no mental health history but are dealing with a trauma. It could be the loss of a child, a marriage, or a job, and they simply don’t have the tools to cope. They live a long way from mental health specialists, are not talking to their GP’s about their problems, and most of their friends and family don’t recognise the signs.

The families of Dolly Everett and Dr Andrew Bryant have both generously shared their experiences in recent times and both called for more community awareness because it is friends and families that need to know the signs to look for.

Rural Australians considering suicide are most likely to be saved by someone who already knows them or their community. Friends, family and work mates are the main line of defence.

Rural mental health charities like Rural & Remote Mental Health talk face to face with rural people and train locals in suicide prevention because it is the only way to save those not using our mental health services.

We don’t run million-dollar advertising campaigns on council buses and highways because the people we need to reach don’t have council buses or highways. Our work runs on cups of tea, biscuits, sandwiches, town halls and thousands of kilometres on country roads. Our trained presenters live and work across all states and territories. Most have other community-based roles – rural adversity nurses, indigenous elders, mine employees.

If people in these communities put their rural postcode into an online mental health directory it would often deliver the message  “there are no services in your area”. Clinics in neighbouring rural centres look promising until the fine print reveals it is visited once a month by a specialist from somewhere else.

The best way for us to save people is to visit more communities and more often. Without dedicated federal funding we can’t go where the risk is highest, only where there are funds ‘left over’ in local health network budget’s for prevention work. Communities support what we do and want us there. Since our funding stopped in June 2020 one community used the proceeds of a local pig race to fund us to come back. As grateful as we are, why are at-risk rural communities paying for a service that is funded via large charities in our more affluent cities? Rural Australians pay taxes too but are not receiving equitable investment in mental health.

That is why in 2020, charities like ours asked to be funded properly as part of the new mental health strategy.  Without the benefit of lobbyists or sophisticated marketing we provided honest hopeful submissions and genuinely expected that at least 5% of the billions being spent would be focused on the 29% of Australians who live in rural communities.

Our modest request for $2 million a year to reach at risk people across Australia was ignored and letters from politicians reminded us of the millions being spent on hospitals and resources in our cities and regional centres. Our charity is not alone. Many other rural mental health organisations lost some or all their funding and some folded or stopped going where they needed to go.

The responses we received from federal MP’s and ministers included:
“Your funding will not be renewed as the drought is over.”
“Apply to the rural Primary Health Network service – they might have funds left over”
“Doesn’t Beyond Blue/Lifeline/R U OK look after that?”

Many rural charities watched in despair during budget week. We had already received our “no’s” and we could only watch as hundreds of millions were allocated to the city based ‘national’ charities for core funding, project funding and special project funding – hundreds of millions of dollars allocated to a small number of very large organisations. Some of these organisations report over $50 million in cash reserves in their 2020 annual reports. The work they do is important and effective in the communities where they concentrate their efforts. But they don’t go where we go. We know it takes some digging to find those of us that work on the ground but we are there at the bottom of the pile of submissions on desks throughout Canberra.

Rather than give up, we are asking our leaders to allocate a fair percentage of our mental health prevention budget to charities serving the 29% of Australians who live in rural communities.

We need to reach places far from Canberra like the Kimberly where the suicide rate is four times the national average. Places like the Tablelands of Queensland where 55 people lost hope in 2020. Or Wangaratta (VIC) , Maryborough (QLD), West Tamar (TAS), Outback  North and the Outback Southern regions (QLD).

Places where the light of this mental health budget is not yet shining any light.

We need our politicians to see beyond the blue coastlines and cities and into high-risk red areas of our country. People need the tools to save themselves and others because some Australians will always be isolated from medical mental health facilities. Van Gogh’s brother Theo held him in his arms as he succumbed to the injuries inflicted in that rural paddock and lamented that he hadn’t recognised the signs of depression in time. We will keep sending our letters and visiting those paddocks and towns because we know this is our best line of defence.  But we need our leaders to recognise the signs and invest beyond the blue.

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