The ongoing bushfire emergency has sharply reinforced the need for people living in regional Australia to get a better long-term deal on mental health.
As we know, living in regional Australia carries with it unique risk factors for mental health and wellbeing, including isolation and natural disasters such as droughts, floods and bushfires.
Access to mental health services remains lower than the cities and reflects a long history of service rationing, access problems and mental health workforce shortages in regional areas.
A well-resourced and motivated workforce is an essential part of any mental health system: it plays a vital role in delivering high-quality support to individuals, their families and carers. Structural problems do, however, adversely affect the workforce's ability to work effectively and efficiently. In large part these problems are associated with workforce shortages and the recruitment and retention constraints that underpin them, along with poor job satisfaction which comes from working with stretched resources.
It is not just a question of money. It is also very difficult to attract and retain mental health professionals in regional Australia, despite the obvious lifestyle, family and health benefits.
The coming 12 months will arguably be the most significant year for mental health reform in decades. In March, the Council of Australian Governments is scheduled to meet, with mental health and suicide prevention flagged as top priorities. In May, the Productivity Commission will hand down its report and recommendations into mental health at a national level, while in October, the Royal Commission into Victoria's mental health system will hand down its historic report and recommendations - all of which the Victorian Government has committed to implement. Clearly, our politicians recognise that mental health is a top priority for Australian voters.
With this in mind, we need government policy makers to develop new strategies to recruit and sustain a much larger mental health workforce in regional Australia. In the short-term, it will require overseas recruitment campaigns, including resources to assist mental health services to recruit internationally, new recruitment partnerships between organisations, and mentoring programs for new employees.
Workforce reform will also mean developing new educational and training pathways as well as incentives for people to train, work and live in regional areas. Critically, we need to make mental health a desirable career choice for young Australians as well as older people seeking a rewarding and worthwhile career change.
While everyone's focus is on responding to the immediate and short-term impacts of this terrible fire season - and we should commend the Commonwealth and States for digging deep to fund emergency mental health services for impacted communities - we need to be planning for the long-term support of those affected. We also need to assume that this is the 'new normal', with disasters increasing in frequency and severity, and plan accordingly.
As highlighted in the National Strategy for Disaster Resilience, emergencies do not impact everyone in the same way. The impacts can range from mild to severe, can be short-term or long-lasting, and can change over time.
Studies showed that several years following the 2009 Black Saturday bushfires the majority of affected people demonstrated resilience without indications of psychological distress. But a significant number of people reported persistent Post-traumatic Stress Disorder, depression, and psychological distress, indicating the ongoing need for mental health support services, community-based initiatives, and family and other informal supports.
The Royal Commission into Victoria's mental health system heard last year, despite the community's overall resilience, high rates of PTSD, depression and psychological distress were still evident a decade on from the 2009 Black Saturday bushfires. The Commission also heard that involvement in community groups, relationships with family and close friends, as well as broader social connections, were all found to be important influences on resilience, recovery and good mental health.
It is clear that we need to be planning for the long-term support needs of individuals and regional communities who inevitably bear the brunt of responding to natural disasters on behalf of the broader population.
As we embark on a decade-long reform process in mental health we need to ensure that the unique needs of regional Australia are not overlooked. Long-term post-disaster mental health support for individuals and communities is one of those needs. So is a well-resourced mental health workforce in regional Australia and service parity between the country and the cities. We should not settle for anything less.