Mental health and relationships

Drought - Mental Illness - Suicide - Men not coping.

Psychiatric morbidity and mortality

Rural communities tend to experience a heavier burden of mental illness, and have been significantly more affected by the tragedy of suicide - particularly male suicide than their city counterparts

Anecdotal evidence suggests some increased presentation of mental health problems and mental disorder, associated with the drought - such as chronic stress, anxiety, depression, insomnia, and alcohol misuse

There is not yet significant evidence to suggest a drought associated increase in the rate of suicide in South Australian rural communities

The general prevalence of mental disorder affecting men is comparable to that of women. Each have 'stand-out' issues

Important points

Current efforts of prevention and early intervention may help arrest any major overall increase in psychiatric morbidity and mortality due to the drought. It is too early to tell

It is important to view the present drought in the context of a confluence of other ongoing issues - which in the long run may be much more consequential than the immediate problem of drought.

These issues need to be monitored closely as potential determinants of diminishing mental health in rural communities

The issues

Drought - some farmers and pastoralists have experienced up to five years of drought

Unusual weather patterns - such as major flash flooding

Changes in water allocation arrangements (irrigators)

Water restrictions, and the prospect of diminished property values

Farmers and Pastoralists having to pay to cart water for domestic needs and stock

Resort to expensive lot feeding practices

Stock control problems/fence damage

Dire predictions concerning global warming and climate change

Evidence that some marginal areas are becoming non-viable and that previously average land may become marginal

Scandal and upheaval in the grain marketing industry

Unfair trading conditions: other countries subsidising their primary producers

A recent period of high fuel prices

The need for rapid up-skilling: IT, chemical licensing, OHWS, management and marketing etc

The changing nature of farming - expanding properties and agribusiness conglomerates

Shrinking population of rural towns ('participation fatigue')

Reduction in viability and existence of social, medical, educational, financial, and other services

A diminishing number of children wanting to return to farms and stations after their education

Inability of young males who decide to stay on the land (or return to the land) to find suitable female partners

An ageing farming and pastoral population (now average of 58 years?)

Issues of succession, retirement, and family entitlements, are considered second only to immediate financial difficulties as a "cause" of personal and family distress

Different perceptions of need: (relative versus absolute poverty)

Media driven perceptions (summer rain, suicide & mental illness)

"Conspicuous compassion" - associated with the mythology of the bush

Consequences for some families

In some cases families are facing financial ruin, loss of farm and livelihood

With increasing levels of debt many are experiencing the anxious dilemma of not knowing whether to stay or get off the land

Marital conflict and separation

Conflict due to women taking off-farm work

Voluntary separation of husbands and wives: where wives are leaving some properties to live with relatives because of difficult conditions on the property; and where men are leaving to find work in mining towns and on civil engineering projects

Older children leaving home without intention of returning

Loss of plans, dreams, expectations for succession, financial security; fear about prospects for retirement

Increasing isolation due to diminishing population.

Consequences for some communities

Loss of essential services, as well as social and recreational clubs, associations and activities

Empty and unused halls and facilities once the centre of life for communities

Loss of social cohesiveness, community culture and spirit

Voluntary component of social order breaking down due to too few people trying carrying too much responsibility

Businesses closing, and loss of local employment

The collective grief of many losses, and many transitions and changes

An aging population with only the prospect of the dissolution of a whole way of life

Argument and recriminations over EC recipience and drought support and entitlements, creating further social 'distance'

Consequences for some individuals

Increasing isolation/social exclusion

Feeling increasingly alone and abandoned

Debilitating pessimism and fear about the future

A sense of personal role failure (most acute for men)

Prolonged stress

Anxiety

Feeling overwhelmed, impotent and powerless

Experiencing sustained irritability and anger

Succumbing to the self-medicating use of alcohol

Depression and suicidal ideation

Physical illness

How might some students be affected?

Financially: student loans, part time work, share accommodation; feeling a burden on their family; pressure to enter the workforce rather than continue study

Not going home because of travel costs

Avoiding going home because of home 'atmosphere'

Rethinking subject or course options, less consonant with preference or ability, and more in-line with financial imperatives

Altered sense of future, of entitlement, and security

Anxiety about what is happening at home

Diminished familial emotional resources, during times of stress or homesickness

'Accelerated' life transitions - such as being pushed too quickly into full adult financial responsibility

The re-emergence of a pre-existing mental health problem, such as depression, insomnia, anxiety or panic

Poorly modulated emotional responses, due to too much change, uncertainty, powerlessness

The experience of loss giving rise to grief - a reaction they may not recognise, understand, or know how to deal with

A tendency to hit out at others for upset that originates at home

Sublimating behaviours - acting out, excessive partying, substance misuse, promiscuity, out-of-character behaviour

Problem solving 'paralysis'; disorganisation, falling behind academically

Behaviours of regression/dependence - needing to be taken care of, wanting someone else to make decisions for them; acute home sickness, or a precipitous decision to give up study and go home.

Country Health SA rural mental health initiatives

Focus: promotion, prevention and early Intervention for mental health

Collaboration of: CHSA, SAFF, PIRSA, Beyond Blue, Australian Centre for Agricultural Health and Safety, SA Divisions of General Practice, Relationships Australia, Centrelink, and local rural community action groups

General Drought Hotline, and a Personal and Family Support Line (based at the Rural and Remote Mental Health Service)

Self-help resources

Mental health literacy education through a network of key rural health workers

Mental health education for NGO service providers and rural ministers of religion

SQUARE (suicide, questions, answers, resources)

Used with permission Dr. John Ashfield (please recognise the source if any part is used) copywrite 2007