Bro’s of the Aussie Outback

Country: that sun-kissed, wind through your hair feel, that fresh clean air and those large open spaces, that beautiful brown countryside – who could possibly get distressed in a place as peaceful as this? It is sad, but the reality is, even though people from the country are satisfied with where they live, so many still fall under the hold of mental illnesses.¹ In relation to young adult males it is surprising to note that the prevalence of mental illness in rural communities is similar to that of metropolitan males, and yet the suicide rate is doubled.²  So why? If rural communities are so satisfied and prevalence are similar between rural and metropolitan areas, how are suicide rates doubled?

The simple answer is access. Poorer access to health care services and the lack of specialised services, is a well-known reason for many hardships, not just suicide, associated with living in rural areas. However, whilst lack of access is certainly a major reason, the complete answer is much bigger and more complicated than just this. In order to completely understand this difference in mental illness outcomes of young males, it is necessary to firstly discuss the environments young males in rural communities find themselves in. Depending on the size and location of the community, the facilities on offer will vary. Schooling is limited, employment opportunities are confined and tend to be more dangerous in description, and there are little to no leisurely activities available to entertain this population. As a result of this they tend to be less educated, have lower income jobs, have an easier access to firearms and are more likely to drink alcohol, smoke and take illicit drugs due to boredom, and feelings of isolation.² All these stresses have been linked to an increased risk of mental illness and as a consequence suicide. In addition, jobs tend to be largely impacted on by climate, which leads to more financial stress and the feeling of a lack of control over one’s life in the country.³

Another major factor facing young adult males from the outback are cultural barriers. There is a high stigma associated with being a country man, they relate to being tough skinned, nothing can defeat them. They tend to be regarded as the bread winners and are self-reliant, they couldn't possibly ask for help as this is a sign of weakness. This mentality indicates they are less likely to seek help even if the community has specific health services available, and even though today there is access to phone and internet helplines.⁴ This reluctance to speak out is magnified by the fact that rural communities are small, increasing the chance of the whole community finding out about a person’s problems. This fear that there is no privacy in a small community coincides with the fear of being “different”, not being accepted, and of being bullied. Other factors to consider include; the life of the young adult male at home, the higher cost of living in rural areas, the quality of food, the lack of physical activity, and the higher rates of abuse.

All these factors contribute to a higher rate of poorer outcomes of mental illness because the identification of young males with mental illness occurs too late. So how do we fix it? These factors above can’t be changed overnight, but through small steps we can improve the rates of an earlier diagnosis and hopefully change the mentality of our Australian rural males. Community centred health development, like raising awareness through schools, encouraging and providing support to students to seek help, ensuring rural GP's are adequately trained in mental health, and holding community workshops which build community connections can all aid in this goal to improve early diagnosis in young adult rural males. It is said that rural towns have a better sense of community, so it is important for these communities to demonstrate this by working together with their government, industries, schools, and health services to raise awareness, break the stigma and support their young adult male population.²,⁴

References:

1.  Fact Sheet 15: Rural Australia. Deakin ACT: National Rural Health Alliance; 2009.

2.  Commonwealth of Australia. Mental Health in Rural and Remote Communities. 2008 [cited 2014 Apr 2]: Available from: http://www.responseability.org/__data/assets/pdf_file/0008/4796/Mental-Health-in-Rural-and-Remote-Communities.pdf.

3.  Fact Sheet 28: The Determinants of Health in Rural and Remote Australia. Deakin ACT: National Rural Health Alliance; 2011.

4.  Fairleigh A. Getting it right on rural mental health. 2013 [cited 2014 Apr 2]: Available from: http://www.abc.net.au/news/2013-07-17/fairleigh-getting-it-right-on-rural-mental-health/4825542.