Chapter 5 - Development in regional, rural and remote areas

In the rural and remote context, most mental health care, including recovery support and treatment of long-term illness, is delivered by primary and allied health professionals and Non-Government Organisations (NGOs) in the community.

Lived Experience workers can be invaluable in regional, rural and remote areas to understand and meet the needs of the local community and strengthen the mental health supports available locally. If Lived Experience work is to play a key role in transforming the mental health system, it must be embedded in community service systems as well as in large organisations and hospitals. A person seeking mental health services should be able to access direct support from a Lived Experience worker and choose a service approach that best meets their needs, including Lived Experience-led services and recovery-oriented services designed to meet their individual and cultural needs.

Build awareness of the value and unique challenges in regional, rural and remote areas

The first step in workforce development is to develop understanding. Building relationships and dialogue with services and individuals, including Aboriginal and Torres Strait Islander communities in regional, rural and remote areas assists to grow awareness of the distinctive needs of people in regional, rural and remote areas, particularly remote Aboriginal and Torres Strait Islander communities.

Some Lived Experience workers describe the strength in being known and ‘out’ as someone with lived experience. This allows them to challenge prejudicial attitudes, raise awareness within local community, and become an access point for the community. However, there are also specific challenges.

Additional challenges in remote areas include limited housing and employment, high costs of living, limited choices and access to services, and a very real sense of isolation. Areas for consideration in regional, rural and remote areas include the need to:

• • mitigate the risk of being discriminated against within small communities
• • enable workers to step out of the role when not working
• • be mindful of role ’creep’ and extra demands because of limited services
• • address limited career opportunities
• • consider distance and transport issues
• • enable provision of flexible supervision, education and training, including online options
• • prioritise culturally appropriate support and training for remote Aboriginal and Torres Strait Islander communities.

Appropriate remuneration and salary packaging arrangements acknowledge any additional costs of living in regional, rural and remote areas, including issues of travel and distance.

Develop the Lived Experience workforce for regional, rural and remote areas

An early step in regional planning for the Lived Experience workforce is to promote the value and benefits of Lived Experience work to service providers and local funding bodies/policy makers.

All organisations involved with the provision of mental health care in regional, rural and remote areas should include strategies for supporting and retaining Lived Experience workers in these areas including:

• • innovative models of Telehealth, local development of peer-led supports that can sustain communities who don’t get day-to-day access from a Lived Experience worker, the use of email or online forums to access peer support
• • hub and spoke models to increase reach
• • management support strategies including:
  • – regular communication by managers with individual workers and teams
  • – strategies to assist with high workload, unrealistic demands and role ’creep’
  • – assurance of staff availability to enable other workers to take leave.

Provide training and development opportunities

To support, retain and grow Lived Experience workers in regional, rural and remote areas, funding bodies/policy makers and individual employers will focus on training and developmental opportunities for employees in these areas. Strategies include:

• • provision of Certificate IV in Mental Health Peer Work training, including scholarships for people in rural, regional and remote and under-serviced areas, and Aboriginal and Torres Strait Islander Peoples
• • training and professional development opportunities, which are routine and regular
• • career development and progression options.

Strategies include the provision of ‘train the trainer’ workshops to allow ongoing, accessible training within the community. The opportunity to undertake training locally and build capacity ensures skills are not lost if people move away. It also values and enables the greater utilisation of local knowledge. This locally based training may also include a focus on understanding and incorporating cultural practices and benefits. If so, it will need to be co-produced by people from relevant cultural backgrounds and knowledge bases.

Organisations in metropolitan and regional/rural/remote settings may initiate ‘exchange programs’, whereby Lived Experience workers have placements in regional, rural and remote settings, both to learn more about the unique needs of people accessing services in those locations, and provide local service providers with exposure to cutting edge Lived Experience work and concepts.