Mental Health in Rural & Remote Australia

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In recent months, several new pieces of legislation have been introduced that could be viewed as a clarion call to all Australian employers – i.e., psychological wellbeing can no longer be the poor cousin of physical safety!

At a time when prioritising employee mental health has never been so important as we emerge from the COVID-19 pandemic, recent research results raise some alarming insights into a widespread lack of awareness about legal requirements to protect workers from psychological risks, with many employees rating the physical safety culture in their organisation much higher than the psychological safety culture.

But some organisations and industries are doing much better than others in addressing workplace psychological safety and wellbeing.

While we recognise there’s much more to be done, AWN has been at the vanguard of mental health and wellbeing in the agri-services space, with 66 certified Mental Health First Aiders deployed across the network. Our company was also recognised in May 2021 as a GOLD Mental Health First Aid Skilled Workplace in Mental Health First Aid Australia’s workplace recognition program.

Our progress in the mental health first aid space has benefited our organisation and helped us become more proactive than reactive around psychological safety. However, the major impetus behind launching the program was the 2018 drought, both in terms of the mental anguish experienced by growers as they struggled with stock losses and financial uncertainty, as well as the potential exposure of our client-facing staff to vicarious trauma.

When the country is not in drought, or our towns and prime farmlands are not being ravaged by bushfires or once-in-100-year flood events, farming can yield significant benefits and provide an enviable lifestyle. According to National Rural Health Alliance Inc., people in rural areas regularly score better than their city counterparts on indicators of life satisfaction and feelings of wellbeing. They posit that this may be a testament to the positive aspects of rural life and the interconnectedness of people living there:  ‘in rural areas, there are higher levels of civic participation, social cohesion, social capital, and volunteering and informal support networks between neighbours, friends, and the community.’ But people in rural and remote areas face a range of stressors unique to living outside major cities.

As I have mentioned in earlier articles, despite the benefits, farming is widely considered one of the world’s top ten most stressful occupations.

In this article, I want to explore the last point – i.e., access to mental health resources.


The risk factors include:

  • High-demand work environment
  • Low control
  • Low social support

Protective factors in farming include:

  • Being (happily) married
  • Having family
  • Having confidant at home / close friends
  • Access to mental health resources


One of the legacies of owning country is the restricted access to specialised mental health care services in many rural and remote areas. The numbers of psychiatrists, mental health nurses, and psychologists in rural/regional areas are generally significantly lower than those in major cities, with even poorer comparisons in remote areas.

Even when mental health services are available, help-seeking by locals can often be compromised due to the stigma associated with mental illness, e.g., you’re less inclined to visit your GP over a mental health concern if you know your GP plays golf with the owner of the local pub every Sunday!

The reported prevalence of mental illness in rural and remote Australia is similar to that of major cities, i.e., around 20 percent of the population will experience a diagnosable mental illness in any given year, and one in two Australians will experience a mental illness across their lifetime. While the prevalence rates are comparable, the rate of self-harm and suicide are significantly higher in rural and remote areas, particularly for men aged between 15-29 years and men over 85 (i.e., almost twice the rate of suicides of equivalent metropolitan populations).

Aboriginal and Torres Strait Islander people (two-thirds of whom live in rural, regional, or remote areas) are almost three times as likely as non-Indigenous people to report high or very high levels of psychological distress. According to Government statistics, the rate of suicide among Aboriginal and Torres Strait Islander people is 1.9 times that of non-Indigenous people, rising to 3.7 times higher for Indigenous compared with non-Indigenous 15–24-year-olds.

Despite all the rhetoric from both sides of politics over the years regarding the provision of mental health services in regional and remote Australia, there still exists today a great divide in the provision of mental health services across metropolitan and country Australia.

While the equitable distribution of appropriate health care services across all regions in Australia is key, prevention (and early detection) is essential. To that end, the provision of Mental Health First Aid training will become an increasingly important factor in regional and remote communities going forward.

On Wednesday, 22nd Dec 2021, the then NSW Minister for Mental Health, Regional Youth and Women, Bronnie Taylor, announced the largest mental health first aid program in the world – with her government committing to spend $130 million to train 275,000 people in rural areas in mental health first aid. According to Minister Taylor: ‘People at community centres, libraries, schools, sporting clubs or social clubs will be encouraged to join the training. Recent studies have found that up to 70 percent of men say they are unlikely to discuss mental health issues with a doctor, but they might turn to a friend or a co-worker, or someone at the footy club; many parts of the state do not have doctors or psychiatrists available, but we can have well-trained community members in small towns or communities that will act as the gatekeepers.


Key findings included:

  • Rural outcomes for mental health are persistently poorer despite a similar prevalence rate (i.e., 20% of the population experience mental health illness each year, irrespective of where they live)
  • Rural people face distinctive challenges including environmental, economic, social, technical, demographic, and geographical.
  • Current approaches to rural mental health services based on metropolitan assumptions appear to make little difference
  • The rural mental health workforce is stretched beyond capacity and capability; Telehealth alone is not the answer
  • Prevention is a largely neglected strategy. Building local strategies to address social connection, transport accessibility, mental health literacy and stigma reduction is a fundamental step.


The concept of ‘reaching out to a friend, co-worker, or someone at the footy club’ for help with mental health challenges has also been identified as an important factor in mental health and wellbeing by the Centre for Rural and Remote Mental Health (CRRMH).

In October 2018, CRRMH hosted a meeting in Orange NSW of prominent mental health researchers and service providers from New South Wales, Victoria, Western Australia, and the Australian Capital Territory, in conjunction with The University of Newcastle, Swinburne University of Technology, The Australian National University, The University of Sydney, to explore issues pertaining to rural mental health and wellbeing. This powerful think tank conducted what’s arguably one of the most comprehensive reviews of regional and remote mental care provision in Australia at the time. The findings from this seminal meeting were published in July 2019 in what is now commonly referred to as ‘The Orange Declaration.’

Key amongst the recommendations coming out of the Orange Declaration was the concept of ‘grow‐your‐own’ and ‘skills escalation’ strategies. These approaches seek to identify existing local practitioners and residents with the potential to become future health and community service workers, peer supporters, or volunteer navigators.

Building on this important research, AWN is keen to work with small groups of farmers across all parts of the country to develop the concept of farmers-helping-farmers to destigmatise mental illness, improve farmer resilience (particularly in the face of adversity), and promote general farmer wellbeing.

AWN seeks to sponsor the training of farmers in Mental Health First Aid (MHFA) by hosting small groups (i.e., between 6 to 12 farmers) in the version of MHFA training referred to e-Learning Standard Community MHFA. This course combines around seven hours of online learning with five hours of Zoom-based group work. Following completion of the training, AWN would facilitate regular (e.g., quarterly) face-to-face or Zoom-based group catch-ups framed around central mental health themes, farming best practice, and other topics of interest to participants.

Our goal is to encourage the development of small farmer ‘cells’, galvanised around the MHFA program, that facilitate initiative exchange and also serve as early detection vehicles for mental health problems.


Farmers interested in participating in the program are encouraged to contact their AWN representative.


Article by Harry Petropoulos, General Manager People & Culture.


[Image Caption]

Wool & Sheep Specialist / Stud Stock / Real Estate and Certified Mental Health First Aider – John Croake discusses the Mental Health First Aid (Community) program with a client



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