Port Lincoln tragedy: Why we should be more open in talking about mental health challenges

MEN should have the courage to talk about mental health, including asking mates if they need a quiet chat instead of seeing it as a sign of weakness, SA’s chief psychiatrist Dr Aaron Groves says.

PORT LINCOLN ASSIGNMENT

• Anguish as Port Lincoln wharf tragedy revelations emerge
• MENTAL ILLNESS: ‘We saw him spiral into a dark space’
• TRAGEDY: Father drives sons off wharf in murder-suicide

AS the community grapples with the tragedy at Port Lincoln that took three lives, experts are urging men to open up and talk about mental health — and that includes having the courage to ask mates if they are OK.

Damien Little’s family have told The Advertiser they had noticed personality changes in him over the past three years, and unsuccessfully urged him to seek help as he spiralled into a “dark place”.

They also told how the 34 year-old was “too proud” to seek help despite constant pleas from his family and friends to seek professional counselling.

The outwardly healthy father’s spiral ended with shooting his two beautiful sons Koda, 4 and Hunter, nine months, driving off the town’s main wharf and shooting himself.

Police yesterday revealed the coronial inquiry was investigating issues including domestic violence and mental health.

Experts also say it may prompt families and friends to discuss what has sometimes been a taboo subject.

Not that mental illnesses are rare.

The 2007 National Survey of Mental Health and Wellbeing found almost half of the adult population had experienced an anxiety, affective or substance abuse disorder at some time while one in five people had experienced a mental disorder in the previous 12 months.

Damien and Melissa Little with sons Koda, 4, and Hunter, nine months. Picture supplied by family

The figures were slightly higher rate than a similar survey a decade earlier, but experts suggest this is due to more people seeking help rather than a rise in any mental illness prevalence.

Such problems sometimes, but not always, can play a role in the suicide rate.

Figures show that in 2013 there were 2522 suicides nationally, three quarters of them men, with a median age of 44.

The suicide rate in rural areas is almost twice the metropolitan rate, although rural residents regularly score better than their city counterparts on indicators of happiness.

Campaigns, and groups such as beyondblue and the Black Dog Institute, have endeavoured to remove any stigma associated with mood disorders such as depression and to encourage people to seek help, particularly men who may regard opening up about living with a mental illness as a sign of weakness.

South Australian Chief Psychiatrist and beyondblue board member Dr Aaron Groves has a clear message for such men.

“Real men talk about mental illness,” he says.

“A generation earlier it was a case of saying real men don’t talk about such things and if they are depressed they should pull up their socks and just get on with it.

“But that is like telling an asthmatic they should pull up their socks and just get on with breathing. Clinical depression is not just sadness, it is an illness.”

Dr Groves stresses not all people who take their own lives have a mental illness and it should not be assumed as the underlying cause in every case.

He noted common mental illnesses are anxiety disorders, where a fear builds to a point the person is crippled by it, and mood disorders such as depression.

Warning signs including behavourial, emotional and physical changes may be so subtle they may only be apparent to someone living with the person.

These can include difficulty sleeping such as waking well before dawn, appetite and weight loss, reduction in sex drive, lack of concentration, lack of enjoyment in usual things like family and hobbies, lack of motivation, withdrawal from friends and resorting to alcohol and drugs.

“People become withdrawn, difficult, irritable, not communicating and drinking more,” Dr Groves says.

“As it becomes more severe they don’t see optimism in anything. They can’t see that things will help so they don’t seek help.

“The longer it goes on the less likely they are to seek help.

“That is often what that idea of a ‘black hole’ is about — if you get them early you might convince them that seeking help will make a difference but the longer it goes on, they can’t see hope anywhere.”

Dr Groves says while some mood disorders may need medication, most involve talking therapy and a major breakthrough in recent years has been to get treatment online, anonymously, through websites such as beyondblue.org.au.

“There is better information out there now, so more people are getting treatment,” he says.

“However, about half of people with depression get no help at all which is a real worry.

“For some of these it will resolve itself, but others will end up with alcohol problems, marriage breakdowns, loss of jobs, and in a very small number of cases suicides.”

While there is more public discussion of mental illnesses including ­depression, Dr Groves says research shows men aged 35-50, particularly in rural communities, still are not getting the message to open up.

This includes having the courage to speak to a friend or colleague who may be exhibiting warning signs.

“It can be difficult to start that conversation but just gently saying to a mate: ‘You’d don’t seem like yourself, can we talk about it?’ is more likely to make people open up,” Dr Groves says.

“But we still have a lot of people reluctant to even raise the issue with friends.

“It takes courage, which is why I stress real men talk about these things, they don’t bottle it up.”

The National Rural Health Alliance says people in rural and regional area face significant barriers when dealing with a mental health challenge, in access to services and admitting there is a problem.

“In rural areas there can often be apprehension around help-seeking and a fear of the stigma sometimes associated with mental illness — particularly in smaller communities where individuals are more visible and confidentiality is less assured,” it says.

“Rural stoicism, resilient attitudes and lower educational levels also influence help-seeking behaviour, readiness to engage with mental health services, and adherence to preventive advice.

“Lower incomes and limited or non-existent public transport is also a barrier to accessing mental health care.”

The number of psychiatrists, mental health nurses and psychologists in regional areas is, respectively, 33 per cent, 82 per cent and 54 per cent compared with major cities.

There are a wide variety of mental illnesses, and the good news is in many cases with treatment people recover and get on with their lives, or can successfully manage their condition.

Mental health advocacy group SANE Australia says good mental health is the ability to manage life competently and to deal with its various challenges.

The group notes it is normal to feel sad, lonely, disappointed, or confused at times — this is part of being human.

When they persist, don’t have any cause that seems to justify them, and interfere with the ability to enjoy everyday life, then it is a good idea to talk to a health professional about any possible mental health problem that needs help.

SANE Australia says good mental health is as important as good physical health.

“It’s no surprise that both are helped by a healthy lifestyle — ensuring we get enough sleep and eat healthily; trying to keep stress to a reasonable level, and relaxing regularly, especially through physical exercise; keeping alcohol consumption to recommended safe limits, and — very importantly — staying in touch with family and friends,” the mental health charity advises.

Anyone experiencing personal difficulties can call Lifeline on 13 11 14 or visit www.lifeline.org.au

Originally published as Port Lincoln tragedy: Why we should be more open in talking about mental health challenges