Sunday, May 15, 2011

Project Update and Summary to date


The purpose of this project is to better understand the capacity building needs of rural producers and their communities to effectively address mental health issues in the face of increasing uncertainty with climate variability and change.   The focus has been on establishing issues, current capacity and gaps in order to develop intervention strategies to support capacity. The project approached this issue by undertaking workshops in twelve communities across south western Queensland: Warwick, Dalby, Kingaroy, Goondiwindi, Dirranbandi, St George, Mitchell, Roma, Miles, Chinchilla, Charleville and Cunnamulla.  The workshops will be completed by mid April 2011.

In each community   farmers and graziers, land care groups, fire brigades, show societies, schools, health care workers, police, non government organisations, rural financial counsellors, police, ambulance and rural boards e.g. the Cotton boards were contacted to be participants. Several methods were used to contact groups, phone, email, and letters with follow up phone calls.  Press releases were placed in local papers and several interviews were run on ABC radio. After each workshop a report has been written, sent to the participants for further comment or correction and then placed on a blog site. They are then able to read about there own workshop, as well as the other eleven and follow developments with the project and develop cross-linkages between the communities.

In addition a survey has been designed to be either posted or emailed to the people who were interested in the workshops, but were unable to attend. These surveys have also been distributed at a local cattle sale, left with some rural financial counsellors and distributed to the Crows Nest Show Society Members.

A common theme that has emerged from the workshops is that rural people and their surrounding communities are under sustained stress resulting from a mix of droughts, floods, mining, vegetation and water policy.  All were seen to impact on mental health and community well being.  Remote male rural producers were particularly identified as vulnerable and difficult to engage or support. A wide range of services and initiatives from government, non-government and the community have been identified during the workshops.  A community initiative of note was the “Tie up the Black Dog” program which has held events throughout the region and using sports starts and others to entice men to activities.  Costs are an issue in reproducing and continuing the momentum across the region.  Despite existing resources, gaps and needs remain if capacity is to be built and maintained to manage mental health issues.

A number of activities were identified during the workshops where social capacity could be built within existing resources.  This included greater networking and collaborations between agencies and groups concerned with mental health issues and collating information about and promoting services and pathways to residents to gain information and assistance.

There was a high level of interest in obtaining skills in Mental First Aid – with suggestions that providing such skills across the community could strengthen the community’s capacity to recognise and address issues as they emerged.   There was also a belief that such awareness and training could be better incorporated into other activities being run within the communities – for example when an agronomy workshop was run, or in conjunction with Chamber of Commerce activities etc.  The key would be to have materials readily available that could be adapted and used in these contexts and to have deliverers with sufficient training to effectively address the issues as well as their technical concern.

A key issue has been to establish opportunities for Collaborative Partnership for Farming and Fishing Health and Safety Program to pilot/implement capacity building activities for rural communities and their communities to manage mental health issues.   From the data to date, potential opportunities include:

Develop a Framework for communities and industries to use
Communities lack a clear framework and pathway to understand mental health issues and how they can better work together to address them.  This would include: providing the information that emerges from this research; and pointing to resources and opportunities (for example: how to access Mental Health First Aid Training; How to run activities in association with initiatives such as “Tie up the Black Dog”; how to develop and maintain a register of services and resources; etc).

Testing the Framework and Process for using it to develop capacity
Pilot studies could be run with 2-3 communities to refine and test both the content and process of using the framework.  The tested framework can then be promoted in other communities with associated training programs for key community representatives.  On line access and delivery can be used for the framework and associated training and support.

Development of materials to be used in other rural events
Materials and associated training packages could be developed and tested to be used in conjunction with other events (for example: agronomy workshops; community events) dealing with mental first aid and steps that can be taken to deal with issues.

These ideas will be further tested and defined leading up to Phase 2 of the project.

Project Leaders Reflection
The people in the rural communities appear to be “Time Poor”.  There is less labour force, more work and each climatic event brings it own extra work load; e.g. drought hand feeding and carting water, fencing with fire and floods , not to mention stock losses and crop damage.

They also appear to be mistrustful of government due to a range of government legislation which heavily affects them; tree clearing, Murray Darling Basin and Coal Seam Gas. On the positive, rural women were ever present at the workshops and should be utilised in the facilitation of the capacity building initiative. They have a greater flexibility in how they utilise their time, they love their families and are in a position of quite power and influence.

Cunnamulla Mental Health Workshop


Local context
Cunnamulla is a community of approximately 1500 people. This is a declining population, with the current trend of young people leaving and older people returning. There is anecdotal evidence of school numbers shrinking, going from 180 a few years ago to the present 120. The High School offers limited subjects for grades 11 and 12, although a wider range of subjects is offered through correspondence.

Older people are returning to the district because “It’s a good place to be if you are older”. A house can be purchased for $100 000, there are many free services, the doctor bulk bills and there is a flying doctor service. People in the community watch out for each other and check on each other
The indigenous community on the last census was recorded at 25%, however, it some participants believed that it is closer to 50%.

Cunnamulla is a rural based community, with rural industries including cattle, sheep and grapes.
One family of three brothers and their families have also diversified into organic cotton, wheat and lamb. Opal is another industry in the area, offering employment as well as tourism potential. There are many tourist attractions in Cunnamulla and surrounding townships. The council is a high employer in the community.

Cunnamulla is seen as a caring, friendly, accepting, safe and secure community.

Issues impacting on uncertainty, stress and mental health

Climate
·         Animal welfare due to reduced feed
Social
·         Succession planning
·         Lack of workers
·         Partners living and working away
·         Demands on wives quite high, bearing the brunt of anxiety from partners
·         Drugs in town
·         Mental health medication has a bad name
·         Bush attitude – We’ll cope with it
 
Government Decisions
·         Inequality of government assistance eg. Special circumstances.
·         Legislation regarding tree clearing for fodder i.e Mulga
 
Economic
·         Cost of restocking
·         Banks action regarding finance after drought recovery
·         Lack of income
·         Costs more to produce and product returns less
·         Decline in jobs sheep disappeared jobs disappeared
 
Current services and initiatives
·         Fly in, fly out doctor, who stays for two to three weeks every two months. There is no permanent doctor, although recently the same doctors have returned, offering continuity.
·         Two permanent doctors are also in town.
·         Visiting social worker, mental health worker, ATODS worker
·         The visiting psychologist has just finished.
·         School Chaplain
·         Lifeline is in town, but has no fulltime counsellor.
·         Primary health care centre
·         Farm financial counsellor, based in Charleville
·         Police
·         Minister for the Uniting Church, representing many denominations, with weekly services
·         Ministers travel to farms build up relationships, listen and show where help is available
·         Golf Club, Bowls Club, Tennis Club, Swimming Pool
·          Recreational Centre
·         Noorama Races annually
·         In house training at Primary Health care Centre
·         Healing through Art for older aboriginal men
·         Domestic Violence group once a month for young girls
·         PCYC, doing well now

What gaps are there and where is the need?
·         Recognition of mental heal concerns
·         Denial of problems
·         Awareness of where to go when you need help
·         Confidentiality issue of a safe place which is not so public
·         Dealing with the stigma
·         Need to hear the positive mental health stories

Steps that can be taken to address the gaps and needs
·         Addressing inequality of the services – drought assistance
·         Community Workshops (sewing, cooking, welding)
·         Information stall at the show
·         Continuity of Services, takes 12 months to build up rapport
·         Agri business managers need training in the farming situation – to understand issues
·         Education of people off the land of the real situation.
·         Utilise the mailmen and women by giving them Mental Health training

 

Potential RDC contribution

Based on the discussion and comments at the workshop, potential for contribution from RIRDC and/or other RDCs could include:
·         Review of drought assistance packages and pathways and identifying gaps and information products to landholders;
·         Providing information about mental health awareness and pathways for assistance for use at community events and shows – including stories for landholders who have dealt with issues.
·         Encourage mental health first aid training for a broader group – including remote mail deliverers and clergy

Charleville Mental Health Workshop


Charleville Mental HealthWorkshop

Local context
Charleville is a town of approximately 3200 residents combined with the rural community to around 5000. The predominant rural activity is grazing of sheep, cattle and goats. Sheep and shearing, which were once a strong employer in the area, have suffered a serious decline in the last decade. There is a meat works in the township which is a high employer and brings itinerant workers in to fulfil the work force demand.

It is a major regional government centre servicing approximately 10 000 people, many of these employees are itinerant.  Mining exploration has begun in the area, Coal Seam Gas is at Morven and Augathella and coal and other minerals are being investigated. There is a large pipeline from the Jackson Oilfields which goes through to the coast.

The population shows all demographics: A number of young people who left the area for schooling have acquired new skills or professions and returned to the community with their young families. This offers a strong social network with many generations of the same family supporting each other. The rural population on properties has declined, resulting in the number of children participating in School of the Air reducing from 240 down to 160. Smaller townships in the area have undergone an increase in population due to housing availability and cheaper rent. This can result in feelings of isolation for these residents with no close family support.

The indigenous community was seen to be well serviced and to have a strong community within themselves. It was believed that they represented approximately 20% of the overall population.

Flooding has had a large affect on the township, with businesses having trouble gaining or affording insurance. There has been little growth in the business sector, with new businesses not lasting much beyond the 12 month period. This combined with the rumours of stoppages to rail services, has left the town feeling vulnerable.

 

Issues impacting on uncertainty, stress and mental health
Government policy

Friday, April 8, 2011

Roma Mental Health Workshop


Roma Workshop
15th March 2011

 

Local context

The wider Roma community has a population of approximately 13200 with 8000 residents living in the town. The introduction of Coal Seam Gas mining to the area has seen the community growing and changing.  This has resulted in an increased number of Motels and some services, higher service charges, higher rents and a large proportion of the work population which does not live permanently in the community. Strain has been put on the trade services with long waiting times to access trades people. Employers have either lost their workers to the mining industry or have to pay higher wages to keep their employees.

Cattle grazing, grain production and forestry (cypress harvesting and milling) are the main rural industries.  The changes to legislation (milling on public land has ceased) is expected to have an impact on rural and milling industries

Roma was described as a friendly town although the social networks have changed. Where once,  for example, people might attend regular social events (eg tennis days)  these activities have nearly become non existent.

Issues impacting on uncertainty, stress and mental health

Participants were asked to consider the specific issues that impacted on their community – resulting from climate variability or other factors in their rural and urban communities.  The issues raised are listed below:

Economic Stress
·         Commodity Prices, same price at gate as 20 years ago, yet increased price on services and goods
·         Affordable Housing
·         Are we paying too much for products?
·         Difference between the income of property and the cost of production

Government Policies and Regulations
·         Threat to Cypress Industry, decreased employment, importing timber (present cypress industry is sustainable)
·         Loss of control in decision making.
·         Imposition of Rules and Regulations - PMAU and NLIS
·         Native Title Issues.
·         Does small population equate to small funding

Impact of Mining Industry
·         Is mining good for the community?
·         Water quality
·         Increased costs to labour due to competing with the mining industry
·         Affordable housing -  rents at $500/ week
·         Coal seam gas?

Lack of Services
·         Patient transport Subsidy Scheme, awareness and paperwork
·         Availability of General Practice doctors.
·         Continuity of health service providers (not the same face each time)
·         Education - lack of secondary opportunities in outer regions.
·         Children have to go away.
·         Supervisors needed for University courses.
·         Practical training for the Agricultural industry
·         Loss of Agricultural colleges
·         More education facilities, TAFE, university opportunities for medical, engineering and financial.
·         Apprenticeship incentives for employees and employers.
·         Local tourism promotion lacking.

Social Concerns
·         Succession planning – planning for the future sustainability of the family
·         People are just burnt out
·         Fly In Fly Out, not part of the community
·         Incentives to get the children to come back after formal education
·         Aging population on our rural industry
·         Because we live over the range we do not exist

Climate
·         Difficult to work with seasonal climate extremes, can not predict

Current services and initiatives
Participants pooled their knowledge of current programs and initiatives targeting mental health and well being support.  These are listed below:

Facilities
·         Hospital with emergency facility
·         Mental health respite services.
·         Mental health Nursing Service
·         Inclusion of health positions within organisations e.g. Council
·         4 – 6 General Practitioners
·         Q Health - Adult, child, youth and older person Mental health support
·         Spiritus – Family Mental health
·         Centacare – Domestic Violence Counselling
·         Rural Financial Counsellor
·         QRAA
Community
·         Sports Clubs
·         Service Clubs
·         Rom Net – forum to talk about Men’s issues
·         Churches
·         Care outreach
Events
·         Pit Stop
·         Men’s Health Nights
·         Tie Up the Black Dog
·         Men’s Shed

 

What gaps are there and where is the need?

After reflecting on current initiatives and the issues faced in the region, participants were asked to identify gaps that needed filling to complete the support picture.  These are listed below:

·         Lack of services and access in remote areas
·         40 – 60 year age group have little support
·         Awareness of availability of support
·         On going therapy support
·         Connections with men on properties
·         Co-ordination
·         Continuity of specialists
·         Lack of services close by
·         Financial gaps-running events, manpower, time
·         Central information service e.g. web, stands and up to date
·         Not enough people to service - for holiday leave and paper positions
·         Cultural gaps in health professionalism


Steps that can be taken to address the gaps and needs

Participants were asked to discuss and come up with specific needs or steps that should/could be taken within the community to address gaps or build on current initiatives.  There suggestions are listed below:

Services
·         More mobile services
·         Service gaps, Autism spectrum  (presently serviced by Occupational therapist)
·         Employ a Mental health worker at the sale yards.
Events
·         Cultivate social benefit Field days etc
·         Increase Social events  that are easily accessible
·         Big brother, Big sister program
Training
·          Training general Practitioners in Mental Health Issues
·         Aussie host training – Respect for Customers
·         Informal contact with training where farmers and graziers gather
·         On line computer training
Foster Collaboration
·         Co-ordination of Services
·         Integrate referral system
Information Awareness
·         Paths and Referrals for GPs and Mental issues
·         Longer appointment mandatory
·         Notice board out at Saleyards with a list of available services
·         Informal contact at saleyards with training
·         Program to reach rural men.

 

Potential RIRDC contribution

From the list of ideas and steps suggested, the following are proposed to be most relevant to RIRDC:

·         Provide resources to be used for information or training at “add-on” events (community/ agricultural etc)
·         Advocate to governments for more services in rural communities – provide the basis and framework for directing funds that will address identified needs