"What do you think if I talk to that Flying Doctor mob? Do you think you'd be okay to have yarn with them?"
Subscribe now for unlimited access.
or signup to continue reading
These are the words of Hannah Case, a school counsellor who lives and works full-time in a remote Indigenous community on Warlpiri Country, where she has been the sole mental health practitioner for several years.
Historically, remote communities in the middle of the Northern Territory have had little to no access to mental health outreach services.
"(With) anywhere between 400 to 500 people based out here and our average numbers at the school are about 30 students a day, (there is) a strong sense of community because it's quite small, but it's also really isolated and we don't have access to a lot of services out here, particularly around mental health for young people," Ms Case said.
"Up until November last year, we didn't have mobile phone reception, so telehealth wasn't an option and even then, young people don't have access to phone credit to do online counselling."
![RFDS Mental Health Clinician Hannah West with students Leshontay and Tracey. RFDS Mental Health Clinician Hannah West with students Leshontay and Tracey.](/images/transform/v1/crop/frm/181547318/9ac711d3-0d36-4311-816a-16be5f2bcbfa.jpg/r0_0_1370_901_w1200_h678_fmax.jpg)
As a silent mental health crisis continues its deepening hold in the remote heartlands of Australia, the RFDS is trying to stop it in its tracks.
Every week, the Northern Territory's Royal Flying Doctor Service (RFDS) Mental Health and Wellbeing team hits the road to visit remote NT communities, offering one-on-one support, running group activities and spreading awareness in aims to tackle the unfolding mental health crisis.
Often staying in communities for days at a time, and building on schools' established wellbeing programs, the RFDS team has been developing relationships in communities with teachers, families and students of all ages.
"We reached out to the Flying Doctor when we had some increasing concerns for young people in community around their mental health and how they were managing that," Ms Case said.
"Prior to the Flying Doctor coming out, we didn't have any mental health resources other than myself out in community.
"As one person servicing a whole community, there's only so much you can do, but when you have a team out here you can reach, access and support more people."
![RFDS Clinical Psychologist Alicia Van Dartel with student Rowena. RFDS Clinical Psychologist Alicia Van Dartel with student Rowena.](/images/transform/v1/crop/frm/181547318/10556a12-38a0-453c-a494-0420240ee384.jpg/r0_0_1370_1044_w1200_h678_fmax.jpg)
Ms Case said during 'nights in' for senior students, together with the RFDS team she would talk about mental health, relationships and personal safety, as well as provide one-on-one counselling or small group sessions around behaviour management, emotional regulation, and recognising feelings.
It is no secret the mental health landscape in remote Australia is bleak.
According to the RFDS, those living in very remote communities of the country have far shorter lives than city-dwellers and are more than twice as likely to die from suicide and other preventable illnesses, according to the Australian Institute of Health and Welfare.
As a young person, the situation is worse.
In the last 10 years, 15- to 24-year-olds have had the greatest increase in suicide rates. It has been understood for several decades that there is a 'ripple effect' in young people, in which suicide tends to appear in clusters of young adults who share social networks.
When it comes to tackling the stigma associated with reaching out for help, RFDS Mental Health Clinician Hannah West said working with schools to overcome 'shame', a deeply embedded cultural construct in Aboriginal communities, was the ideal setting to start.
"It's a privilege to work with kids from such a young age and begin building their knowledge of their mental health and wellbeing in a community where there is a strong connection to culture...," she said.
Ms West said connecting with schools had opened opportunities for broader mental health consultations with community members and school staff.
"Living remotely exacerbates mental health challenges that already exist, and it can create new ones as well," she said.
"When we're able to support the professionals who come out to live in community and have such important roles in the lives and the wellbeing of so many community members, the flow-on effect means we're helping so many more people than just the individual we're working with.
"Being able to walk into community and be recognised as part of a service that offers so much to so many people is a real privilege."
For Ms Case and the school staff, it's been fulfilling to see students become so willing to engage with the RFDS team and begin opening up about their wellbeing.
![Building trust, familiarity and relationships through a game of basketball. Building trust, familiarity and relationships through a game of basketball.](/images/transform/v1/crop/frm/181547318/b0522254-6d41-4156-9ac6-de4069ea2707.jpg/r0_70_1370_843_w1200_h678_fmax.jpg)
"When it comes to mental health in Aboriginal communities, it's really important to have cultural safety," Ms Case said.
"Aboriginal people have a lot of strength and resilience they can draw on through spiritual connections, elders, ancestors and knowledge that has been passed down through generations.
"For the clinical aspect of mental health support to be effective, it needs to be understanding of these different links.
"Out in community, it can always take a while to build relationships, particular with a new service, but with the RFDS, the young people are so willing to engage.
"You can say to a young person, 'I'm a bit worried about you, what do you think if I talk to that Flying Doctor mob? Do you think you'd be okay to have yarn with them?' and they're saying, 'Yes' because they're feeling like it's a culturally safe service."
Ms Case said she hoped the collaboration with the RFDS would continue to create an environment where young people felt safe enough to actively reach out for support when doing it tough, either for themselves or for schoolmates and loved ones.
"I'd just like to see a continuation of the teamwork and the relationships that have been built so as this current generation of students grows older, they'll be able to say to the next young generation, 'Hey this isn't something to be ashamed of - these are the people who can support you.'"