Wide Bay has eight-highest suicide figures in nation
IN ANY given month, on average, 100 people will access public mental health services across Wide Bay.
In the past 14 years, George Plint has watched those services grow from a handful of staff to almost 200 across three cities.
As executive director of Wide Bay's mental health and alcohol and other drugs services, Mr Plint oversees a group of psychiatrists, social workers, occupational therapists and community consultants that are currently treating more than 800 people.
Mr Plint said evidence showed the Wide Bay had the eighth-highest suicide rate in Australia and had a higher-than-average rate of emotional distress.
A 2010 state government study also showed depression was one of the five leading causes of death in the Wide Bay catchment.
For other mental illnesses, Mr Plint said the Wide Bay showed similar statistics to other areas of Australia, with national figures suggesting about 40% of the population would be diagnosed with a mental illness at some point in their lives.
Beyondblue research shows one in six of us will have to face history's black dog, depression, and one in four will be diagnosed with anxiety.
Only a small fraction will ever require treatment for a serious mental illness, Mr Plint said, but mental health remains an issue that will touch every life.
"We all have mental health care needs, every member of the community," he said.
"That's life, and that's not necessarily an illness.
"We need to increase the literacy of the community and people's understanding of this whole concept of mental health."
In his three-decade career as a nurse, Mr Plint said both the stigma attached to mental illnesses and the nature of treatment had changed drastically.
"One hundred years ago, you would have an asylum that was separate from the community.
"The mainstreaming of mental health services over the last 50 years has very much broken that down.
"It's very much accepted now that you can go to your GP and talk about your mental health needs just as you can go to your GP and talk about your sore foot.
I think there is still stigma there. It has certainly decreased enormously.
The Fraser Coast's public mental health facilities now include a 17-bed inpatient facility in Maryborough, a community health facility, case management services, child and youth mental health care program and a program for prisoners at Maryborough Correctional Centre.
Mr Plint said a drug and alcohol psychiatrist was also recently appointed to the Fraser Coast's Alcohol and Other Drugs team, one of only two public doctors in Wide Bay able to prescribe methadone to recovering addicts.
The appointment has meant public Wide Bay Hospital and Health Services was able to double its capacity to treat addictions, such as opioid dependence, that rely on methadone as part of the treatment program.
Mr Plint said the mental health services had grown to be highly regarded since Maryborough's inpatient facility was established in 1999.
"The team is quite exceptional and highly skilled," Mr Plint said.
"There is a vision and there is an intent. I think that should be acknowledged."
In the not-for-profit sector, the Fraser Coast has had a major injection of services through national mental health program headspace.
Its newly refurbished Hervey Bay office has been open for less than a month in Central Ave.
It is manned by four clinicians, a community development officer and a team of youth reference group members tasked with telling organisers what the Fraser Coast's young people really want when it comes to getting help.
The renovations include bright green feature walls, furnished rooms and iPads in the reception area.
The bright colours are a deliberate attempt to strip away the clinical feeling of doctors' surgeries and hospitals, making welcome a generation that can feel uncomfortable seeking help from traditional sources.
"If they don't feel comfortable coming through the doors, they're not going to come," clinical lead service manager Max Mackenzie said.
"It is a specific type of service here.
There is a need for all types of services and ours is just one of those.
Mr Mackenzie said the program helped people aged 12-24 work through issues that range from "normal growing up stuff" to drug and alcohol use, family and relationships and primary health.
Four counselling rooms and two fully equipped exam rooms are routinely made available to outside services such as GPs, social workers and psychologists.
Parents can bring in younger teens and one room has been specifically designed to offer counselling for entire families.
Word of mouth has been a powerful way of getting more people to access services.
"We are getting more young people telling their friends about us," Mr Mackenzie said.
Youth reference group member Michael Teer, 17, said part of the problem in getting the younger generation to take care of their mental health was first getting them to admit they might need help. "It is normal to feel that way," he said.
"The problem is that most people feel it's not normal."
Fellow YRG member Casey Morris, 20, often appears as guest speaker at schools or community events to raise the profile of headspace and what it offers.
She said a fear of being judged, being too easily medicated and even a fear of making parents or carers feel inadequate, can all be barriers to young people approaching their family or their GP for help.
Casey said traditional one-size-fits-all services often made younger people feel labelled.
"As a young person you don't feel comfortable going in and saying, 'I need something'," she said.
It makes you feel like a monster.
All three urged people to speak up if they needed help.
"Sometimes people don't feel like they're worth that time," Mr Mackenzie said.
"Everyone is worth that."
But what about the other end of the age gap?
Mental illness is a major risk for retirees who may be isolated in their own homes, and especially for those who are forced out of their homes and into care.
Beyondblue estimates up to one in three aged care residents will have or have had depression and one in ten retirees still in their own homes also have it.
Prescare chief operating officer Lee Martin has seen mental health programs become a bigger part of general aged care in his three decades in the industry.
He said people were now older and frailer by the time they leave their own home, and were often stripped of the choice of going into care.
"The impact of having to go into aged care is usually the result of an incident or something happening at home or a family decision that mum or dad aren't coping anymore," Mr Martin said.
"There is a greater angst about that move.
"Most clientele or residents going into aged care go through a period of depression."
The mental state for those who enter aged care can vary wildly, particularly for people who go into care after leaving empty, isolated former family homes.
"I've seen people blossom because they've finally got someone to talk to," Mr Martin said.
"There's someone willing to listen.
"The stigma attached to aged care is all unfounded."
At the other end of the scale, some residents don't see a healthy future in care.
"Some people when they enter an aged care facility, they say to themselves, 'well, I am at the end of the road. I may as well wish myself to death.' And they do. They give up."
A massive generational experience, such as the Second World War, contributes to the challenges in creating good mental health for aged care residents.
Mr Martin said a generation who learnt to scrimp and save, regardless of the health impacts, was now giving way to a generation dealing with the lasting effects of substance abuse.
"The effects of alcohol are quite dramatic," he said.
"Just behind them, we've got people with greater amounts of the crack and ice."
To encourage good mental health, Prescare's Groundwater Lodge in Granville runs daily activity programs as part of a holistic approach to 'mind, body and spirit'.
"We find out what people like to do and encourage groups or activities around that," Mr Martin said.
The same programs will also run at the formerly state-owned Yaralla Place nursing home which Prescare took over earlier this month.
Regional areas all over Australia face a bigger mental health burden than their city counterparts.
Cases of depression and anxiety are higher in regional areas, particularly in men.
Suicide rates are also far higher and only go higher the more rural it gets.
Beyondblue chief executive officer Kate Carnell said it was harder to seek treatment anonymously in smaller towns.
"The issue of stigma becomes very real," she said.
People don't want it to be obvious they are seeking help and therefore don't.
Natural disasters can also contribute to mental health issues, particularly high rates of anxiety, in smaller centres.
Multiple natural disasters, such as the successive flooding that has hit the Fraser Coast in the past three years, can put whole communities under enormous pressure, Ms Carnell said.
"It certainly has an impact on anxiety disorders particularly," she said. "They worry that it's going to happen again.
"The constant worry can easily escalate into an anxiety disorder.
"When things are really tough, we find both depression and anxiety rates go up.
"The fabric of the community is affected."
So what is the future of mental health care for the Fraser Coast? In the public sector, Mr Plint said early intervention would be an increasing focus.
A goal first raised at a mental health conference in 2012 to make the Fraser Coast into a centre of excellence for mental health care was an ongoing vision, he said.
He said more sophisticated local rehabilitation services were also beginning to take shape.
Mr Plint said a vision for the future of care included closer partnerships with the non-government sector to address other issues associated with mental illness such as unemployment or housing stress.
At beyondblue, the increase in online forums and phone applications have turned into a good first step for people to get help.
Ms Carnell said mental health programs in schools, trained GPs and more clinical psychologists should be part of Australia's plan for future mental health care.
"Services need to be more available and simpler to access," she said.
Phone Lifeline on 131 114 for confidental 24-hour crisis support.