Mental Health and
Financial Counselling:
Building Effective Links
PROF BRIAN KELLY
UNIVERSITY OF NEWCASTLE
• Rob is a 57 year old farmer living with his wife
June on an isolated pastoral property in the
north of the state.
• Rob had been worried about the financial status
of the family property and he has made
application recently for financial assistance in
response to the drought through “Exceptional
Circumstances” assistance.
• He has been talking with a rural financial
counsellor, and recently with his bank manager
about the property increasing debt level.
• His marriage has been under some strain for some time.
June is now worried about Rob – he doesn’t get of the
farm very often, and spends more and more of his time
on his own on the property.
• He is drinking more than usual, and appears to have lost
interest in the property and his usual social activities. He
has trouble concentrating, difficulty making decisions,
and has been avoiding the “pile of accounts” – “its all too
much bad news”.
• A friend of Rob and June’s (a fellow farmer in the district)
died by suicide 6 months ago and June is becoming
worried about how Rob is coping.
• Financial Hardship and Mental Health
• Evidence from rural sector
• Model of partnerships/linkages between
mental health and financial sector
• Challenges
• Impact of financial strain on mental health
of individuals and families
• Impact of mental health problems on skills
to manage financial adversity
• Rural financial counsellors:
• Assisting people to adapt to realities of financial
situation
• High level of mental health need among clients
• first points of referral contact in primary mental
health care
• Window of opportunity for intervention
•Local
•Accessible
•Knowledge of available assistance
•Little embarrassment associated with use
RFCs provide a unique blend of general counselling in
addition to financial counselling. While this can fill a
social and emotional void … many Counsellors are not
trained in this field
(Acknowledgement: Prof J Fuller, Flinders University)
To improve referrals
59% thought referrals could be improved
F ig u re 2 . S tra te g ie s to im p ro v e re fe rra ls
mor e s er v ic e in my r egion
f or mal r ef er r al pr oc es s betw een or ganis ations
netw or k w ith mental health/ other c ouns ellor s
r ef er r al guide
tr aining
0
10
20
30
40
50
n u m b e r ( 3 r es pons es /c ouns ellor n=68)
(Fuller and Broadbent, Aust J Rural Health 2006)
Building Service Collaboration to Support Early
Identification and Intervention for Mental Health
Problems
• 112 agencies from 149 identified (75%) completed a
telephone-based survey.
• 70% indicated that two thirds of their clients were in
need of assistance for mental health related problems.
• Agricultural support sector rated links with the health
sector as less effective than did the health sector (p<.05).
• The most highly linked agency across all towns across all
mental health exchanges came from agricultural support
(rural financial counselor),
(Fuller J, Kelly B,et al, BMC Health Services Research 2009)
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Funded by Australian Rotary Health Research Fund
NSW Farmers Mental Health Network
• BLUEPRINT – 22 Key Action Areas
Pathways to
Breakdown
External Factors
Isolation / loneliness
Alcohol misuse
Family Breakdown
Suicide
Pathways to
Health
Advocacy for Farm Support
Building Social Networks
Raise Awareness = Reduce
Stigma
Access to Counselling
Mental Health First Aid Training
NSW Farmers
Mental Health
Network
Farmers mental health
– collaborating organisations
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•
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•
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NSW Farmers Association MH
Network
Anglicare
Australian Centre for Agricultural
Health and Safety
Australian Rotary Health Research
Fund
beyondblue
Black Dog Institute
Centre for Mental Health Research,
Australian National University
Centrelink
Centre for Social Research, Charles
Sturt University
Country Women’s Association of
NSW
•
•
•
•
•
•
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•
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Department of Primary Industries:
Drought Support Workers
NSW Association of Rural Financial
Counselling Groups
NSW Farmers’ Association
Presentation Sisters Rural Outreach
Service
Rural Doctors Association of
Australia
St Vincent de Paul Society
Suicide Safety Network
Salvation Army
Wesley Life Counselling/LifeForce
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• Building confidence and capacity
– Mental Health First Aid Training
• Building collaboration between local
services across health, welfare and
financial support sectors
Local Mental Health Networks
• Planning workshops with wide range of agencies
• Banks, accountants, RFCs
• Vets, stock and station agents
• GPs, community nurses
• Mental health services
• What are the needs?
• what resources do we have?
• What are our experiences and roles?
• How can we work effectively together?
Challenges
• Financial Sector
• Confidence in knowing what to say and/or do
• Role definition ..”but I am not a counsellor”
• Understanding roles and pathways through health system
• Personal strain of the role
• Health sector
• Confidence in working with sectors outside health
• Understanding of roles of workers in financial sector
• Less accustomed to considering the importance of this “first
contact” role
Mental health help is wider than
mental health services
• Local helpers will be used as first
points of contact
• Local helpers are best included in
the local system
• Inclusion by networks, training and
protocols (guide)