Talking down rural Oz is bad for health

Mental health expert Mathew Coleman tires of the expression "the back of Bourke and beyond" to describe the challenges of caring for Australians living in remote areas.

"I always say: the back of Bourke and beyond is not very far away from Bourke," he told the Rural and Remote Mental Health Symposium in Adelaide on Wednesday.

Associate Professor Coleman, a national mental health commissioner, is frustrated by talk of the "tyranny of distance" surrounding rural Australia, a narrative that needs to change if health services are to be improved.

"We've got a quarter of the Australian population that live in rural and remote locations," Prof Coleman told the conference, which is examining ways to improve services and access in rural areas.

"But our voice isn't often heard. We aren't at the table on how to design services, or clinicians being able to train in rural and remote locations, or engaging communities.

"The deficit-disadvantaged narrative, even though we're trying to shift that, remains the ongoing problem."

Prof Coleman said workforce challenges could be addressed by recognising rural generalist doctor training across an entire community as more valuable than qualifying at a city hospital and overseeing a single ward.

"The training systems need to be changed. We need to use technology but we also have to aim high and talk about high quality training and education.

"And it needs to be in situ for all disciplines and all staff - not travelling."

John Mannion, a South Australian mental health commissioner, said rural people face tough stigmas when getting help.

"Feeling safe to reach out is very powerful," Mr Mannion said.

"What if the nurse happens to be one of your friendship groups, or someone from your sports club? Do you feel safe to open up and have that conversation?

"We've still got quite a lot of work to do ... around stigma and discrimination."

Funding streams for mental health programs need to last longer than a political cycle, he said.

"How do we make them sustainable? I don't want to go and tell my story to one person, then tell it to another because a funding stream has changed.

"All of a sudden I get lost."

Heather Nowak, another SA commissioner, said rural areas need innovative services, like urgent mental health centres found in cities and national Head to Health hubs, which direct people to available services.

"We've had things like COVID and bushfires and floods, all which test people's resilience.

"In the country, one of the most difficult things is access. Where does a person actually go?"