Nicola* and her eight‑year‑old son Henry* live in regional Victoria. When Nicola became concerned that Henry’s mental health was deteriorating, she spoke to her maternal child health nurse, who referred her to her GP.
Henry has now been diagnosed with attention deficit hyperactivity disorder, and he experiences anxiety and oppositional defiant disorder behaviour.
Nicola found it very difficult to access support in a small regional town. Limited public services meant she has incurred significant out‑of‑pocket expenses, including gap payments, to see private psychologists and paediatricians, often travelling long distances to regional centres to access them.
She noted that while she wants to support Henry as much as she can, she doesn’t always have the money to spend on services for him.
Henry’s private psychologist suggested Nicola seek support from the local child and youth mental health service when his behaviour started escalating.
I had to fight really hard to get him into the local child and youth mental health services, and for whatever reason, he struggled to engage with the worker, and there was no one else. She did persevere for quite some time but then had to close our case as they weren’t making any progress.
Nicola said the support Henry has received has been very fragmented due to circumstances such as clinicians moving away, retiring or having limited alternatives within the same service.
He’s been with six mental healthcare workers. It’s really hard because the poor guy seems to make a bit of a connection with someone and then they move on.
The consequence of this on transitioning between services is also difficult for Nicola.
I keep records and basically every time we start with a new service, I whip out all these records again and re‑tell the story. I’ve told the story so many times, it is really frustrating.
Nicola is concerned that Henry is approaching his teenage years with little support. She has been told about specialist services in Melbourne, and even Sydney, but the travel and cost are prohibitive.
My biggest concern is probably the future. We get loads of ideas we can try, for example, behavioural therapies, but they’re down in Melbourne. So depending on what type of appointment it is, that is driving three and a half hours and potentially accommodation.
Nicola feels more should be done to support access in regional communities. In her experience, Henry engages better with services face to face, so telehealth services are not always a viable option.
If you get him drawing or you play to his interest like Lego, he can be quite chatty. So that’s where phone and zoom meetings are not the same, they’re not going to have that effect on him. Face to face he knows that Mum is just outside, but whatever he wants to talk about is private.
I’d love to see more accessibility. Something to entice specialists to work in the area, even if they come to the town a few days per week. I’m sure there are probably so many families who can’t fork out any money at all, or who can’t travel for whatever reason, and I’m sure there are many children around the area that are missing out. It shouldn’t matter what your postcode is, you should be able to access these basic services.
Nicola said she has received little support herself and has focused on accessing support for Henry. Although she’s often felt that she would just deal with things by herself, Nicola would like to see an automatic referral system where when a referral is made for a child, support for parents is included to focus on how the parents are coping.
I know a lot of children’s mental health services often work with families, with for example, parenting programs, but focus on how they’re coping. I do feel really judged being in a small town, so I think having that support as well would be a great idea.
Source: RCVMHS, Interview with ‘Nicola’ (pseudonym), September 2020.
Note: * Names have been changed to protect privacy.