The barriers to mental health services for young rural men

Living in rural and remote areas often means people can feel socially isolated. This can contribute to stress, anxiety and depression which can have a detrimental effect on people's mental health and wellbeing. Those in rural areas seem to be less likely to seek help in comparison to their urban counterparts.

A recent study by Southland counsellor and researcher Kathryn Wright on the state of mental health services for young rural men has found that many of the perceived barriers for those needing help can be overcome.

Wright, who is herself a farmer’s wife and the mother of a 22-year-old shepherd who had been in the farming industry since she had left school, has completed a project to determine what barriers young rural men, aged 16-30 face when they need help with mental illness. She undertook this project after she discovered there was hardly any academic research available particularly focused on the effects of rural living in New Zealand.

Farmers were exposed to financial problems, stock prices and Government regulations; but the worst statistics were around suicide which was about six times more likely to occur in young rural men than in the general population.

It appeared to be all about interpersonal conflict, something she was hearing through the work she did with that demographic both in schools and privately. From what she had seen, the issue needed to be looked at. Rather than seeking help, it appeared young men seem to be "suffering in silence".

Her study has revealed there are three main barriers preventing young people from accessing help but that young rural men can get the help they need if they are told where to look.

First, many had no idea when and where to seek help – a lack of awareness of what is available. Wright says a general practitioner is a good starting point for those thinking they need help. She believes this is a fact that needs to be more widely promoted and understood.

“They don’t know where the bar is when they need to seek help, and they didn’t know where to start looking for that help - am I bad enough or are there people worse off than me?” she said.

The second perceived barrier is the stigma and feeling of shame associated with needing help. Anonymity and privacy are particularly challenging in rural communities. Because of societal stigma, young ones may be embarrassed if friends or family members find out they are seeking mental health treatment - a fear that can be viewed as the end of the world.

In the rural sector another fear is that seeking help or treatment for mental illness could result in the forfeiture of a firearms licence and firearms. “Hunting is so important, a way to interact and socially connect with friends but also providing exercise and a source of healthy fresh food,” Wright said. On this issue police told Wright that each situation is treated on its individual merits, and that there is no blanket ruling resulting in the forfeiting of licences.

The accessibility of counselling sessions is considered another barrier, but Wright said technology means consultations do not need to be in person but can be done by video. It can be difficult for someone from a rural area to travel to an urban centre for a face-to-face session with a health professional and it requires time off work. Video allows engagement with counsellors anywhere in the country and it can remove the potential discomfort of someone running into their counsellor in the local community.

Cost is also considered an impediment, but, according to Wright, it shouldn’t be a barrier as there are multiple funding sources that a general practitioner can source.

Wright said studies show rural people are twice as susceptible to suicide as those in the general population. In the general population 75% of suicides are males but in the rural sector this jumps to 92% and studies show 50% of those rural suicide victims are aged 15-40

Wright said young rural men dislike seeking help at school, seeing it as a weakness, and this trend continues once they enter the rural workforce. For many it is their first time living away from home and away from their traditional support structures.

Her study also reinforces the importance of social connection with other people -  young rural people can feel quite isolated - they need a sense of belonging and being needed. Living on a farm or in a small community, she said, young men can struggle to cope with the pressures of relative isolation, dealing with a relationship breakdown or conflict with their employer, working long hours while living on a nutritionally poor diet, capped off with easy access to alcohol, vehicles, and firearms. This makes social networking through clubs, teams and organisations crucial.

Mental health symptoms can include isolation, changes in appetite, mood, sleep patterns, and short temper. Wright said employers and managers should be aware of mental health symptoms so they know what to look for and when their staff need assistance. They should not judge them but rather should offer help such as time off to attend counselling. Wright also urged managers and owners to be supportive and to praise young workers, when warranted, for the effort they are making. A happy, productive employee is more beneficial to both of you.

Wright is promoting the study to practitioners and interest groups as a source of knowledge for how to help young rural men. She does some speaking at the likes of Young Farmers events and she intended to use the findings in her talks. She says we need more education and we need to work out how we can best cater for this generation of young people.

Need help?

Rural Support Trust: 0800 RURAL HELP

Need to talk?: Call or text 1737, free 24/7 phone and text number

Healthline: 0800 611-116

Lifeline Aotearoa: 0800 543-354

Suicide Crisis Helpline: 0508 828-865 (0508 TAUTOKO)

Samaritans: 0800 726-666

Alcohol Drug Helpline: 0800 787-797

General mental health inquiries: 0800 443-366

The Depression Helpline: 0800 111-757

Youthline: 0800 376-633, txt 234 or talk@youthline.co.nz

What’s Up (for 5-18 year olds; 1pm-11pm): 0800 942-8787