Fit for purpose: Improving mental health services for young people living in rural and remote Australia

Abstract:

People living in rural and remote areas face unique mental health risk factors and have more limited access to mental health services. Service provision and workforce issues have been the subject of many reviews, inquiries and policy development. The extent of mental ill-health experienced by young people living in rural and remote Australia is unknown. What is known, is that young people experience high rates of suicide and the rate of suicide increases with remoteness. A critical reference group was convened to understand the issues that need to be addressed to improve delivery of mental health services for young people in rural and remote Australia. There are three key areas in rural and remote mental health requiring new policy solutions. This policy paper presents solutions to address workforce gaps, enhance service models and identify how technology can play a role. DEVELOPING SOLUTIONS: Attracting and retaining mental health professionals to rural and remote Australia continues to be a challenge. The Productivity Commission has identified that working in rural and remote areas is ‘less attractive from both a professional and personal perspective’. For many young people living in rural and remote Australia primary health professionals are the only health providers they have access to. Professional support and development are required to equip them for these expanded roles. Where a doctor is not available the lead primary health care providers needs to be accredited to provide referrals to specialist mental health care. A number of barriers exist in providing supervision and professional development in rural and remote health services. The practice of inter- professional supervision needs to be supported by professional bodies and coordinated at a service level. Existing inter-professional practices provide an example for the development of such initiatives in rural and remote contexts. An ageing workforce in rural and remote areas highlights the need to educate and train the future workforce. There is evidence that undertaking education and training in rural and remote areas leads to continuing practice. Trialling bonded scholarships for allied health students would provide an incentive to practice in rural and remote areas. Technology present a means to help solve some – but not all – of the barriers to delivering mental health services for young people in rural and remote communities. While digital service delivery is a focus of health policy (with telehealth and mobile applications expanded in response to the coronavirus/COVID-19 pandemic) it is important new service models and platforms are designed with young people. Orygen supports the Productivity Commission’s draft recommendation [5.1] for an MBS item for psychiatrists to provide advice to GPs over the phone and suggests that it be expanded to include expert advice on alcohol and other drug disorders in young people. Innovative responses to support primary health services provide mental health care are required to enable improved access for young people. A trial of new initiatives in local contexts provides an opportunity to test ideas and identify solutions that can then be implemented more widely. KEY POLICY SOLUTIONS: A number of policy solutions are proposed in this policy paper that address workforce challenges, service innovation and the role of technology. Three key solutions have been identified that build on existing policies and have the potential to improve mental health care for young people.