One of the most traumatic results of mental health issues within the community generally is suicide. In a large metropolitan area, these may go relatively unnoticed in the overall scheme of things outside the victim's immediate sphere of family, friends, and work colleagues. However, when it happens in a small community it has the potential to impact negatively on the community as a whole. Apart from suicide, the negative coping mechanisms that often come with mental health problems (substance abuse, and antisocial behaviour like violence and disorderly conduct) can wreak havoc in communities not adequately equipped to deal with them. Such behaviours can be compounded when activities that would normally help reduce them, such as regular exercise (which reduces depression and improves mood through its activation of endorphins or 'happy' hormones), are restricted due to long working hours and fatigue. These factors all play a role in helping tip someone who is already predisposed towards suicidal tendencies over the edge.
One of the groups most prone to developing mental health problems are FIFO workers. Research consistently shows that the rate of mental health disorders within this group are at least 10% higher than they are in the rest of the community. We discussed the typical profile of a FIFO worker in this article
and how it's almost identical to the profile of the highest risk group in society generally. So what happens when large numbers of high risk FIFO workers descend on remote communities that are inadequately equipped to deal with the health problems they bring?
Unfortunately, it isn't just the communities that are often ill equipped and unprepared to deal with the influx of a transient population at high risk of mental health problems. In remote areas with large FIFO work forces, employer systems are often inadequate as well to deal with the mental health problems that arise when at risk workers spend long periods of time away from the familiar support networks provided by close family, friends and a familiar environment.
Pressure On Community Health Care Facilities – A Case Study
Community health care facilities are typically few and far between in many of these remote communities. There may be hospitals but they have limited capacity and are not always equipped to deal with mental health cases. As an example, towns in the Pilbara in Western Australia are the temporary homes for thousands of FIFO workers who live in camps within the town boundaries or nearby. They're also the home of thousands of permanent residents and as a major tourism area, they play host to tens of thousands of tourists annually. Karratha, one of the biggest towns in the Pilbara, has 2 hospitals with 50 beds in each. Those hospitals need to service 26,000+ residents, over 15,000 FIFO workers, and more than 50,000 tourists annually. Additional health care services within Karratha include an Aboriginal Health Centre, which is usually fully booked out, and a number of small clinics run by GPs.
The closest health services regional resource centre with reasonable health care facilities is 242 kilometres away in Port Hedland. The majority of mental health patients in the region however are situated closer to Karratha, where only one of the local hospitals is equipped to deal with mental health patients. This often means that anywhere up to a quarter of the available beds are being utilised by these patients, putting pressure on available resources to treat other patients. Reports indicate that invariably these mental health patients arrive at the hospital already in crisis mode, which puts the staff under pressure. Often their condition is such that they require relocation to Broome or Perth, which then puts further pressure on available resources to fly them out.
Flow On Effects Of FIFO Mental Health Problems To Local Residents
Many mine sites employ local residents as well who work alongside FIFO workers. Therefore, when a FIFO work colleague suddenly commits suicide, it has a flow on effect with that worker and his or her family and friends within the local community. It can trigger the same negative coping mechanisms, which in turn puts pressure on other community resources like law enforcement, not to mention the way it disrupts the social fabric of the community. These residents may also end up needing medical treatment. And so on.
Granted, progress has been made over the past few years, with many mining companies increasing resources to deal with mental health within their FIFO workforce and these should theoretically lighten the impact on the local communities. Better induction processes for both the workers and their families into what they can expect as a FIFO family, education around mental health to reduce the stigma attached to it, increased availability of trained personnel, and various other measures have all become more common place. Unfortunately, it still remains a fact though that whilst most mining companies do have trained counsellors available either on site or via help line support, many people with mental health issues are not comfortable discussing them in the workplace. Furthermore, surveys have shown that whilst these services are known about, it's often difficult for those in need to access them when they need them most.
Within the local communities, solutions for dealing with mental health issues include the provision of additional and specialist accommodation for mental health patients, additional respite care, drop in mental health centres, and grass roots level prevention and support.