SUICIDE in RURAL & REMOTE AREAS of AUSTRALIA - Living is for ...

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Suicide in rural and remote areas of Australia
Second, the precarious economic nature of modern
farming means that heavy demands are made on
those connected to the farm, which have been
exacerbated in times of drought (Fuller et al, 2009;
Judd et al, 2006b). To simply remain sustainable,
farms may need full participation from everyone
which can be a heavy responsibility to bear. Family
members may feel they are a burden if they are not
perceived to be pulling their own weight; those
people who are not coping may suppress their
emotional pain, which can leave them vulnerable
to suicidal behaviour, or they may leave the farm
altogether, which further exacerbates the drain on
the rural population (Judd et al, 2006b).
Third, limited help-seeking may be more connected
to the lack of access to health facilities and services.
People can’t seek help if it simply doesn’t exist in
their community (Barnes et al, 2004; Caldwell et
al, 2004; Ellis & Philip, 2010; Judd et al, 2006b;
Macintyre et al, 2002; Quine et al, 2003). When
added to the heavy workload and responsibilities
attached to rural and farming life, it may mean that
people simply can’t afford the time away to access
suitable help. The traditional focus on practical
solutions within rural culture, as opposed to seeking
‘help’, may also mean that this type of support may
not be considered worthwhile enough to seek (Judd
et al, 2006b). Further, even if there is accessible and
available care, it may not be appropriate or relevant
to the people most vulnerable in the community
(Quine et al, 2003; Thacore & Varma, 2000). A
study, including three district hospitals in rural
Western Australia, found that nurses were uncertain
as to how best to treat people who presented with
deliberate self-harm; they felt uncertain, helpless
and frustrated (Slaven & Kisely, 2002).
However, it must be noted that some research has
found that limited help-seeking may not necessarily
mean no help-seeking; people may seek help
outside the mental health framework (Judd et al,
2006b; Taylor et al, 2005b; Taylor et al, 2004).
Seeking help from a general practitioner may be
more likely to occur within a rural community as they
are accessible and the help available is perceived
to be more ‘medical’ than ‘mental’ (Judd et al,
2006a). In this way, rural GPs become important
gatekeepers in terms of recognising those people atrisk
of suicide and providing prevention frameworks
to protect them (Judd et al, 2006a; Malcolm, 2002,
2000). However, these responsibilities can also lead
to high rates of GP burnout (Malcolm, 2000). One
study also found that men may also confi de in rural
fi nancial counsellors as their mental health status
appears to be deeply entwined with the fi nancial
status of their farm (Fuller et al, 2009; Sartore et
al, 2007). Further, support groups and programs
have been started in several states where men are
able to seek help from their peers in a safe and
relevant environment. Examples of these include the
‘Working with Warriors’ program which is part of the
Wheatbelt Men’s Health Inc (http://nrha.ruralhealth.
org.au/cms/uploads/factsheets/fact-sheet-14-
suicide.pdf) and the Farm-Link Project, under the
National Suicide Prevention Strategy (http://www.
crrmh.com.au/Current-Projects/nsps.html). Women
also play an important role in male help-seeking in
that they are more likely to discuss problems with
others, including healthcare professionals (Alston &
Kent, 2008). However, a worrying consequence of
this is that women may often blame themselves for
the health status of the men in their lives; further,
“women ignore their own health needs, placing
themselves last in decisions about resource
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