Pete, 49, had been “hiding at home”  –  struggling with bi-polar illness – until the Royal Flying Doctor Service’s mental health project officer Glynis Thorp touched down in his tiny South Australian town of Yunta​, population 40, last Thursday.

“It makes the world of difference, especially today,” he said after meeting with Ms Thorp in his home for a phone consultation with a doctor in Broken Hill. “I wouldn’t go outside, I wouldn’t go anywhere else to see a doctor.”  Too sick to drive 200 kilometres from the South Australian town to Broken Hill for help, the texts and the subsequent meeting with Ms Thorp were a “lifeline”.

While Pete (last name withheld) finds the openness and the nothingness of the bush “almost uplifting”, the lack of privacy in a small town was suffocating: “Everybody knows what everyone’s doing, everybody knows what everyone’s saying.” Ms Thorp is part of a push by the Royal Flying Doctor Service to expand its mental health services to meet growing demand. In 2014, demand for mental health services grew 30 per cent, and in 2013, they jumped 28 per cent. In response, the RFDS will offer mental health services in the Central West, out of its Dubbo base, and has increased the number of mental health experts like Thorp based in Broken Hill. They visit towns like Wilcannia, White Cliffs, Packsaddle, Menindee, Tibooburra, and Wanaaring.
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To maintain patients’ privacy, discretion, decoys and improvisation are needed. Ms Thorp sees patients wherever she can: on a park bench, near a toilet block, the front seat of a hot car or in a corridor of an abandoned railway building. Another man, who has a history of depression and was angry after a heart attack, talked informally to her in the shade of an old corrugated iron wall that had become her defacto office in Yunta on a hot spring day. Later that day, the same man sent a friend over to meet Ms Thorp. Referrals like these are one reason why demand has grown, RFDS said.

“Sometimes we have to be discrete so it may mean wandering away, having a walk with someone, or if we have access to a vehicle, we may take them for a drive down the river so we are not actually seen with that person,” Ms Thorp, who is a highly experienced and credentialed nurse who has also run area hospitals, said.

To throw others off the scent, she makes a point of talking to as many as people as possible. That was not hard in Yunta where nearly half the population and some station owners and families visited the improvised clinic or dropped in for a chat. “Whether it is g’day, how are you, just to pass the time of day so you can’t necessarily put two and two together,” she said.

To gain trust in towns where newcomers are viewed with suspicion, the mental health nurses hit the streets – visiting the police, the school, roadhouses and local businesses to introduce themselves.

Problems range from depression to relationship issues, which can be a real challenge when families live and work together as closely as they do on properties and businesses in remote areas. She also visits schools to talk to children about developing healthy mental habits and building on their own strengths.

Vicki Hemley, of Packsaddle Station, about 200kms north of Broken Hill, sought counselling and advice after a young family friend killed himself.

“Mental health problems are not unique to the bush, but the uniqueness of the bush is where do we go to get help and who do we talk to now? If we can’t get an appointment for a week, that week may be the difference between someone getting help or making a rash decision.”

A 42-year-old with no children of her own, she was heartbroken by the boy’s death, and she also wanted advice on what to say to his family.

“Glynis told me to listen,” Ms Hemley, who added that Ms Thorp had also listened to her, said.

About 20 per cent of Australians suffer a mental illness each year and women are twice as likely to seek help for mental health issues as men, especially in the rural and remote areas serviced by the RFDS. Yet the amount of mental services in the bush lags behind those in the city.

This article first appeared on ‘Sydney Morning Herald’ on 15 October 2015.