The National Mental Health Commission has published its snapshot (LINK) of Armidale residents' access to services based on a meeting at the Town Hall a fortnight ago.
Dr Amanda Jefferys, the UNE Psychology Clinic's acting director, said she was reassured to see the commission move towards mental wellness, and staving off mental illness.
"While we continue to band-aid mental illness, and label it," she said, "we're not going to get the traction we need to have a functioning fit community."
Dr Jefferys met the NMHC's CEO Christine Morgan and chair Lucinda Brogden when they visited visited Armidale on their three-month "Connections" tour of Australia, discussing challenges to accessing services for mental health and suicide prevention, and discovering what communities need.
Ms Morgan will write a report to help federal government transform the mental health system by 2030, and try to reduce the alarmingly high suicide rate to zero.
"We can't continue the way we are," Dr Jefferys said. "It's too out of control; the existing model isn't serviceable anymore, and it's not leading to the outcomes we need."
The Town Hall meeting participants were asked what stopped them or someone they knew from seeking help.
"People in our community who need good supports may not be able to access those things because they found it difficult to seek help, whether through stigma, isolation, or feeling confronted," Dr Jefferys said.
Mental illness still has a negative connotation, and residents did not want people to know they sought help.
Others said they did not even know where to turn for help - to Dr Jefferys's concern. Their first port of call should be their doctor, she said.
She encouraged people to seek help from both their GP - normally the operational hub who guides treatment - and from other services in the community.
"There's not a one-size fits-all," she said.
Some attendees worried that a GP Mental Health Care Plan (used to help patients access treatment, often at no or minimal cost) might affect their insurance policies. Anxiety or relationship breakdown, Dr Jefferys said, wouldn't have any impact; they were environmental factors.
"It's quite normal, really, to have hiccups in life," the psychologist said. "Help-seeking means that you should get the supports in order. You hum through that, and start to do quite well relatively quickly. There's a problem when those behaviours start to become enmeshed or entrenched; then we see people with depression or other attributes of mental illness that have been in place for years or decades."
Some women feared that mental health issues could affect their right to custody of their children.
"The things that impact on you having access to your children are if they're neglected, or you're taking drugs, or other behaviours," Dr Jefferys said. She also thought it would be unusual for someone in a domestic violence situation not to have anxiety or other problems.
Big ideas or initiatives
Participants also suggested initiatives to improve mental health in their community.
One of the most popular suggestions was a centre that offered physical and mental health, classes, arts, therapy, and wellbeing.
"Society is demanding that anyway," Dr Jefferys said. "At the moment, we have ad hoc services offering all sorts of different allied health [treatments]. It would be amazing to think that we could integrate a lot of that."
As head of the university's psychology clinic, she wants to foster connections with other organisations, and encourage them to work with the community. She would like the clinic and other services to look at how they could work as a collective hub to support the public, independent of the Commission's report.
"How do we work in a collective and collaborative way?" she asked. "How do integrate some of these services? We don't need to wait for the government to do that."
Another attendee suggested a nation-wide campaign to promote positive mental health, like the 'Life. Be in it' campaign of the 1970s and '80s.
"We really need a more global shift to supporting people to function well, versus continuing to focus on mental illness," Dr Jefferys said. "I don't think that's doing us any favours."
Research from other countries shows that a focus on wellness, with advocates in the community, can help people going through a rough patch get back on track quickly. She expects Australia will move to a more holistic, community-driven model, similar to Canada's or European countries'.
Dr Jefferys would like to see workshops or short courses teaching the community how to flourish in adult life, rather than simply coping with mental illness.
She also welcomed the suggestion to train community members in mental health first aid, and fund pharmacists and pharmacy nurses to identify and support people with mental health conditions.
She believes we could prevent a lot of suicides this way, particularly if the public knew how to access support services.
Another participant wanted modern technologies so that skilled technicians could reach people in rural and remote areas.
Telehealth is already being used in rural and remote communities, Dr Jefferys explained, because there aren't enough clinicians on the ground. She thought it important to have more rural practitioners working with rural people.
"There's not much point in having someone in Sydney talking to someone in Bourke, and thinking they can understand," she said.
"Communications across long distances [in Australia] is challenging; moving people in large areas is challenging; where people are living and working can add to that isolation."
The role of the UNE clinic
Dr Jefferys thought Ms Morgan and Ms Brogden's visit to the clinic gave them insight into a rural facility that offered numerous modalities - from helping patients to training clinicians - and collaborated with other services.
"It's quite unusual to have a facility of this calibre and kind delivering a number of services across the community," she said.
The psychology clinic and other faculties, including social work and pharmacy, want their research to support funding or growth for community organisations.
Dr Jefferys suggested that organisations approach the university about assistance with research. Medical people and psychologists, for instance, could help them to formulate focus groups or design surveys.