Media release: New Zealand Rural General Practice Network, 8.10.2014
Seek help with mental health issues urges NZRGPN
Rural folk who are feeling anxious, stressed, depressed or suicidal must talk to their GP or health professional sooner rather than later. That’s the message from the New Zealand Rural General Practice Network in line with Mental Health Awareness Week (October 6-12).
“We need people to come in and talk through issues at an early stage rather than waiting until everything collapses and there is a crisis. There is no shame in asking for support, says Network chairperson Dr Jo Scott-Jones.
Raglan GP and Network Board member Dr Fiona Bolden says about 80 percent of her consultations on any given day have some mental health component although that does not necessarily mean someone is mentally ill. For example, a patient might be anxious and that anxiety might relate to chronic conditions such as respiratory disease. Dr Bolden categorises mental illness in three ways: moderate to severe, moderate and mild. “Every surgery I do I’m seeing at least one person in the moderate category.”
The ability to access services over and above what the GP can provide is another issue, she adds. “This area is hugely under-resourced and under-funded. At a time when there is increased recognition of the needs in the mental health area the reality is that demand outstrips resources.”
Dr Bolden says there were five suicides in her area in 2011-12 and none since.
Mental health is a major issue affecting the workload of rural general practices. In his practice, Dr Scott-Jones says about 30 percent of his patients have psychosocial issues mostly mild to moderate depression and anxiety related disorders, often on a background of chaos in their family and friend support network and lifestyle choices. “Three or four times a week I have a long consultation up to an hour with a patient in crisis or requiring counselling around an issue relating to mental health problems. “We also provide services to patients who are on long-term antipsychotic medications but currently relatively stable, and for people on methadone supplementation.
“We have three to four suicides a year, mostly young men, most often they are seasonal workers often with drug and alcohol problems and most often have a history of domestic violence. Communities see ‘spates’ of suicides from time to time especially when younger people are involved. ‘Economic’ suicides – people who have lost work, lost their financial stability – happen from time to time, often this seems to be the background for older male farmers.”
Network deputy chairperson and Temuka Nurse Practitioner Sharon Hansen says in an average week she sees between 12-15 people with mental health needs – about 10 percent of her patient workload. Of those, most would be a review for ongoing medication for depression, anxiety or schizophrenia, with two to three acute cases where the patient is very depressed and requires same-day psychiatric services or more intense management. She reiterates the impact of psychosocial issues on people’s mental health.
Suicide figures are harder to pinpoint. “About four years ago we lost seven mostly young people to suicide. If it’s not youth we lose it is older males. Usually we hear of about four to five suicides in a population of around 50,000 people per year. Until the coroner releases the information it’s hard to know exact figures.”