Daniel* is legally blind and has lived in a regional Australian town. He has also been living with a mental health condition for many years and he is not alone.
According to a report published by the Australian Institute of Health and Welfare (AIHW), one in five Australians between the ages of 16 and 85 have experienced a mental health condition in the previous 12 months.
And the numbers are worse for people with a disability, with 32 per cent of people with a disability saying they have experienced high or very high levels of psychological distress compared with eight per cent of adults without a disability.
The comparatively high rates of poor mental health among people with a disability have been linked to a number of factors including low levels of employment, bullying and discrimination.
Getting help can be very challenging, particularly for those in regional or rural areas.
For Daniel, who grew up in a small community, mental health services were not easily available and he experienced considerable stigma when he eventually disclosed his condition.
“When I tried to have a conversation with my GP about my depression, I felt like it was a little bit dismissed,” Daniel said.
“It was a little upsetting, because it took years of worrying about it to get to a point where I could disclose and then when it wasn’t taken seriously I suppressed what I was feeling a bit further.
“It wasn’t until years later that I got any significant access to mental health support.”
Daniel said part of the stigma he experienced was based on an assumption within his community that his disability was the cause of his mental health condition and there were no other contributing factors.
“People couldn’t see I had bigger mental health challenges than my blindness,” he said.
Social stigma isn’t the only barrier
Kerry Howard is a psychologist and the founder of Rural Help, an organisation which provides online mental health services to people in regional and remote communities.
Having worked in a number of regional areas throughout Australia for many years, she has first-hand experience of the way stigma can flourish.
“The information and experiences people are exposed to in regional or rural areas means their values often remain unchallenged and societal changes don’t happen as quickly,” Ms Howard said.
“It’s different in more densely populated areas where people can congregate together based on shared experiences and form larger movements which influence the people around them to become more accepting.”
But social stigma is not the only barrier people with a disability can face in seeking help.
When Daniel began accessing mental healthcare, he found it difficult to travel to his appointments without help from others.
“I didn’t want to have to ask a friend to drive me to a psychologist because I didn’t want them to know,” he said. “Not being able to access public transport made things more challenging.”
Those who can comfortably travel to and from appointments may still find it difficult to find the right mental health professional and see them regularly.
More mental health professionals needed in regional areas
According to the National Rural Health Alliance, Australians in regional or remote locations experience poorer health outcomes due largely to limited access to primary healthcare, specialists and hospital services.
Psychologists in regional areas, for example, often get booked out quickly.
Ms Howard said this is often because of a lack of available psychologists: she herself has been looking for staff to work in her private practice for six months.
“Most psychology graduates don’t want to come out of university and work in the private space, they want to work in health departments or education,” she said.
In this year’s federal budget, the government announced it will put $1.4 billion toward the creation of a network of diagnosis and treatment centres across the country, but Ms Howard is unsure how these centres will be adequately staffed.
“In all of the budget announcements about providing more mental health centres, the government has not addressed the workforce issue at all,” she said.
Although the shortage of mental health professionals affects all people in regional and rural communities, it can be uniquely problematic for those whose disabilities make it difficult to communicate and who may not be able to find a psychologist who understands these challenges.
Taylah*, who has both autism and attention deficit hyperactivity disorder (ADHD), has been struggling for a long time to find the right psychologist.
“The ADHD and autism make connecting with people and understanding my emotions much harder,” she said.
“When I talk to others about accessing mental healthcare, their experiences are very different to mine.
“The longest I’ve ever stayed with the one counsellor or psychologist for was approximately four months.”
The recent increase in availability of telehealth services due to the COVID-19 pandemic has made it easier for some people with a disability in regional communities to connect virtually with mental health professionals from all over Australia.
Still, despite the benefits of telehealth, it only goes a little way toward addressing the challenges faced by people with a disability seeking mental health support in regional areas.
*Names changed to protect privacy