Mental health and chronic pain a challenge in the bush
While country life may seem idyllic, calling city dwellers forth for a tree change, here are some sobering realities: in rural and remote areas there is a higher burden of mental health problems and the impact is much greater. There is also a greater likelihood of experiencing chronic pain and susceptibility to mental health problems.
People living outside major cities are 23 per cent more likely to experience back pain, and 30 per cent more likely to have a long-term health condition due to injury.
Major depression is present in as many as 40 per cent of people living with chronic pain, they are two to three times more likely to experience suicidal behaviour compared with the general population, and they also have high rates of generalised anxiety disorder, post-traumatic stress disorder and substance misuse.
Despite these dramatic statistics, chronic pain has not received the same attention as mental health in health policies and public awareness campaigns, and remains largely misunderstood despite its prevalence in people with a mental health condition.
Pain specialists are generally only available in major cities and there are few GPs trained in multidisciplinary pain management. There is also a shortage of mental health professionals – there are only three psychiatrists and 30 psychologists per 100,000 population in remote and very remote areas.
Best practice multidisciplinary pain management clinics are concentrated in major urban centres, and the travel required to attend pain clinics is often too uncomfortable, painful or just unaffordable.
An important way to help bridge the gap is with effective education about pain and self-management. Studies have shown people who have a greater understanding of pain and how to manage it, and who are empowered and adequately supported, show improved wellbeing and mental health.
It is time that the relationship between pain and mental health and the deep impact of this in rural and remote communities be recognised and prioritised in national mental health strategies.
Developing education campaigns and providing ongoing support through web-based services and resources, along with improving access to dedicated pain services and allied health professionals trained in pain management, are also urgently needed.
A specific rural pain program that builds capacity in pain management among health professionals and community health services and utilises telehealth, would also help bridge the gap.