Abstract
In 2015–2016, the Clarence Valley in Northern New South Wales, Australia, experienced an unexpectedly high number of deaths by suicide, and the resulting distress was exacerbated by unhelpful press coverage. The local response was to adopt a community-wide positive mental health and wellbeing initiative. This paper describes the process and achievements of the initiative called ‘Our Healthy Clarence’. Key stakeholders were interviewed at year two and relevant documents reviewed. Data were analysed using document and thematic analysis. Our Healthy Clarence was established following community consultation, including forums, interviews, surveys and workshops. It adopted a strengths-based approach to suicide prevention, encompassing positive health promotion, primary and secondary prevention activities, advocacy, and cross-sectoral collaboration. A stakeholder group formed to develop and enact a community mental health and wellbeing plan. Factors contributing to its successful implementation included a collective commitment to mental health and wellbeing, clarity of purpose, leadership support from key local partners, a paid independent coordinator, and inclusive and transparent governance. Stakeholders reported increased community agency, collaboration, optimism and willingness to discuss mental health, suicide and help-seeking. Our Healthy Clarence draws ideas from mental health care, community development and public health. This initiative could serve as a model for other communities to address suicide, self-harm and improve wellbeing on a whole-of-community scale.
Highlights
Rural communities in Australia are diverse, with strengths and weaknesses that influence mental health, wellbeing and suicide
In 2016, the Clarence Valley scored 926 on the Socioeconomic Indexes for Areas (SEIFA) for disadvantage, which places it in the lowest quintile in NSW [35]
The community, as represented by the Our Healthy Clarence (OHC) governance committees, was resolute in keeping the initiative focused on community mental health and wellbeing
Summary
Rural communities in Australia are diverse, with strengths and weaknesses that influence mental health, wellbeing and suicide. Rural residents have been reported to have higher social capital, community identity and life satisfaction [1,2,3,4] These strengths can be harnessed to address the challenges of rural living, one of which is the comparatively lower access to and use of health and social services [5,6,7]. This is due to there being fewer service providers per capita in rural areas, and increased distance and opportunity costs for service users. Public Health 2019, 16, 3691; doi:10.3390/ijerph16193691 www.mdpi.com/journal/ijerph
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