A poster presentation:
Wilson, R. L., & Usher, K. (2014). Mental health professional visitors in rural communities: What happens when they go back home? Paper presented at the ACMHN 40th International Mental Health Nurses Conference, Soffitel Melbourne.
Charity week at Robb College, UNE this week beginning 30 June 2014: Young people serving the community
This post is a shout out for a residential university college I am affiliated with – Robb College, University of New England, Armidale. If you are on campus at UNE or in Armidale, NSW this week and some in brown overalls asks you to donate – DO! It is for a great cause.
photo credit: http://www.buyabale.com.au/hay-distributions
Almost 200 young people live at Robb College each year while they study at UNE. I am privileged to get to know many of them – cheering them on as they work their way towards professional futures. It is a lot of fun… each year I am amazed at the caliber of the young people I meet at Robb. Sometimes older people are quick to dismiss young people, blaming them for societal ills… But, each year the young people I meet at Robb give me great hope and inspiration for the future. The young people I know are community minded and service driven, and I admire them for that. Each year at Robb there is a major fund raiser for charity and each year I am astonished at the hard work that goes into raising vital funds for many important causes. For the last few years the residents of Robb have been raising charity funds with a nude calender. This year the cause is Buy-A Bale to support farmers who have had a tough time with drought. Please consider buying a calendar to support the charity drive over the next few weeks... and add you voice of encouragement to the development of service in the lives of these young people, as well as the farmers who receive the help.
If you would like to know more about Robb College and their charity Buy-A-Bale here are the links:
- https://twitter.com/RobbCollege @RobbCollege
Rural Mental Health Professionals – even though it is a very tough job, with few resources, and bucket-loads of human pain to alleviate…. Never lose sight of hope and always remember to care.
photo credit Mark Saddler 2014
This is a very sad story from my research which motivates me to never lose sight of the value of excellence in mental health clinical practice, and that the important thing that mental health clinicians do is that they help PEOPLE.
This is a story that should be told. Future research should be undertaken to understand how a view can be formed by any rural Australian mental health professional that a gaol is a suitable location to receive adequate mental health care, and to explain why adequate mental health care cannot be achieved in small rural communities. Further, what is it that motivates such a person or people to celebrate the gaoling of a mental health client with a cake? The dialogue presented below does not require any further interpretation for it to be clear in its meaning. The text is challenging and has evoked tears and emotional responses among readers’ to date. It should serve to challenge mental health professionals to find more effective ways to improve care for the vulnerable in our community, and to ensure fairness and equity for rural people. An Aboriginal woman tells a story from her life experiences…
“ …I listened to a mental health worker tell a mother that her son is better off in gaol. …do you know what they do? (Emotion welling in her tone). After they send a kid to gaol…they buy morning tea. Chocolate cake! And celebrate… the mental health staff. (Loud anger filled tone). Yep. An orange cake today or a tea cake?
The mental health workers said to me: ‘Are you coming’? ‘Are you coming to have cake’? ‘To celebrate? He is GONE, he is off our hands’.
… all those kids have SO many problems and SO many issues, the mental health people don’t know how to address them, and I think they are just leaving them down there (in gaol) to get them out of the way. …they are getting sent (quiver in her voice) for so long, by the time they get out, the next generation is coming through. And it is just going to go on like a cycle.
But, how could they buy morning tea? (Disgust in her tone) …and celebrate when a kid goes to gaol?
Mmmmmm sad… (a long silent reflective pause).There is a BIG gap between the mental health workers and the client.”
In the last couple of days I have heard numbers of reports of the drought starting to impact the mental health of farming people… the tough times have commenced… and some have already taken their own life…. time for rural mental health workers to ready themselves to help…… here is a resource that is useful aimed at supporting rural men with their mental health – pass it around…. share. I will continue to load more info as I locate it for circulation to promote rural mental health in drought times…..
Received an advance copy of my new book today – smells new, looks shiny….. so pleased with the result and very chuffed to have worked with other mental health experts on this book – Nicholas Proctor, Helen Hamer, Denise McGarry, (Me), and Terry Froggatt. Available to the Public from January 2014. Link for more details direct from publishers – Cambridge University Press.
Depression, drought & mental health help. Bush Remedies – You and your mental health.
Here is the last in the Bush Remedies : You and Your Mental Health ABC New England North West Radio series for 2013. This year I have presented six mental health topics in Bush Remedies – all with a focus on rural people and place. This last one for the year features a discussion about drought and depression. I hope there are some useful tips as we approach summer in Australia for my fellow rural people.
Times are changing again in northern NSW with the shades of brown closing in on us and drought looming….
The health of the land and the climate has a big impact on the mental health of the people who live in rural drought zones. The changes in mental health can be slow and insidious. Mental health doesn’t usually just ‘snap’ or ‘break’ like a football broken leg injury, it happens slowly the same way that wrinkles and grey hair develop…. One day you notice that you have aged… but you don’t notice it every day. It is the accumulations of grey hairs over a long period of time…. And mental illness is a bit like that – especially depression. But in our rural case…. It is the slow shift from green pastures to brown bare ground that is reminiscent of depression. Mood, thoughts and senses all seem to slowly lose their flexibility and capacity for resilience.
It is not surprising that mental health is less robust in times of drought, and its impact is felt widely across the region. Drought is a chronic natural disaster… is slowly builds to a point where the impact is profound, and we know that people are vulnerable to those chronic changes – it is just plain human. Depression is not a weakness of character. Rather there are very clear explanations for why it should develop in the face of major decline of the health of the total environment, of which people are a part.
An interesting research study was done in Western Australia where there are some salinity problems. Salinity creeping to agricultural lands has devastating impacts for people, place and livelihoods, and it is very hard to turn back that clock… if at all. In this case, researchers compared maps of the land and salinity with population data and data about how many people in that region were discharged from hospital after treatment for depression. They found that there were significant increases in people requiring hospital treatment for depression who came from the salinity affected areas compared with the wider population. Drought might have similar impacts… those studies still need to be done, but there are lessons we can learn from the salinity impacts in Western Australia. (Here is the reference if you want to find out more – sorry there will be a pay wall for that one: Speldewinde, P. C., Cook, A., Davies, P., & Weinstein, P. (2009). A relationship between environmnetal degradation and mental health in rural Western Australia. Health & Place, 15, 880-887. )
So, Drought proofing our mental health…what can be done?
We can predict that depression will accompany drought – and will last slightly longer then the drought. Recovery takes time… for the land and for minds and emotions.
We know it is coming, so it makes good sense to make some plans to drought proof and depression proof at the same time. Perhaps we can’t take away all of the pain, but we might be able to minimize it, and reduce the impact by getting in early. Here are some tips:
- Mental health first aid – learn the basics about mental health and what to do if someone you know needs some mental health help in a crisis, and how to get them to expert help if and when it is needed.
- Consider doing a mental health first aid course – either you, or someone in your workplace or community…just the same way people do for physical first aid. Make sure there are enough people around in your rural community who have done mental health first aid so that someone knows how to get expert mental health help if and when it is needed.
- Look for opportunities to find the glass half full – not everything is bad all the time, but when your mood is low, it is harder to see the good, because the bad just seems to close in. Fight for that little glimmer of hope – don’t let go.
- Actively seek at least one thing that is deeply satisfying everyday-it can be something simple and that doesn’t cost money… there will be one thing! If you can’t find one thing every day – that is an urgent sign to see a health professional and get some help with your mental health. Don’t put off that appointment.
- Rural people sometimes equate being healthy with being able to work, so when they feel a bit low they counter that with trying to work harder (because if you can work hard, you prove to yourself that you are well). But it is a trap we rural people set up for ourselves…. If you struggle to be motivated, can’t remember the last time you felt happiness, not sleeping, and grumpy with the people you love the most…. Then working harder won’t fix it – BUT a visit with a mental health clinician might!
- Don’t work too hard. If you have put in a full day, then you have done your best. Be satisfied with your effort, rather than damming that you couldn’t do more. Drought is an endurance race…. The work that goes with it will be like a marathon – but tackle it one leg at a time. Don’t try to race to the finish line without stopping to catch your breath and recharge your emotional batteries. Take a day off – or a half day off if you need to. Look after your mind, so IT can look after you longer!
- Sleep – you need about eight hours a night…. Try and get yourself into a healthy sleeping routine. (See a blog or two ago for more about this!)
- Eat and drink well – that means not too much alcohol (it is a depressant drug itself – so don’t double dip into depression), plenty of water, fresh foods – not too much processed food. And, then eat slowly and mindfully – enjoy every mouthful, give it a moment longer in your mouth to relish flavor and be mentally and nutritionally satisfied.
- Talk… talk to others about how they are travelling… it might be that others are feeling the same way you are, ‘a problem shared is a problem halved….’ Bottling up emotions doesn’t work well – and eventually it explodes (like homemade gingerbeer… messy!).
- If you are not travelling too well – see a mental health worker sooner rather than later… there are no prizes for being stoic. It just doesn’t work!
If you do need some help – this is where to look:
- Local hospital (accident and emergency – if it is urgent), community health service or multipurpose health facility will know how to get you linked up with some help.
- Local GP – again, they will know where to point you in the right direction.
- NSW Health have a 24 hour Mental Health Line 1800001511 (free from landline – charges from a mobile). Call them anytime and speak with a mental health clinician. Calling this number it is the best way to access public free mental health care. You can call for yourself, to get information for a friend, or even ask them to do a welfare check if you are worried about someone else (eg you are worried about whether they might be thinking about suicide).
- There are a range of non government organizations – I have listed a few of them in previous blog posts…. Scroll back through some blogs.
- NSW Department of Primary Industries have The Rural Womens Network http://www.dpi.nsw.gov.au/rwn/support
- NSW Rural Assistance Authority have some practical supports that are worth checking out – some of which include rural financial counselors. Here are some handy links to them:
We can’t stop the drought – but we can take the steps needed early to make sure that the impact on our mental health is reduced. The more aware rural people are of the early warning signs the earlier mental health help can be started, the better. The sooner help starts the less the impact. If it is left a long time before getting help – the harder it is to shift; and the longer the recovery. Depression proof – get in early!
Some first signs that depression is developing:
- Talking about dying, wanting to die, or musing that it would be better off if you/they were dead
- Changes in eating- no appetite, or craving for processed and oil saturated foods
- Drinking more alcohol than usual; drinking to get to sleep at night
- Not sleeping restfully throughout the night; finding it hard to get up in the morning.
- Anxious- an little more on edge then usual.
- Finding it hard to concentrate.
- Can’t recall being happy in recent times.
- Low flat mood, without any modulations. Just low all the time, never seem to have moments of joy.
- Grumpy with others; angry, a short fuse.
Any, some, or all of these feelings (above) are worth further investigation. Make an appointment to see a health professional to get back on track with your mental health. A health professional will be able to make a plan with you for your recovery; it mightn’t be a big deal, it mightn’t take too much effort (especially if you get in early) and it might just be worth the awkward moments of reaching beyond any stigma or small town talk to get back to emotionally-normal-for-you as soon as you can. That way you will be better positioned to cope and you’ll be more resilience to the blows that accompany riding thorough drought times.