Where to turn?

It's been a busy week dealing with the inbound interest after CleanM8 was announced as the 2018 winner of the Regional Australia Institutes "Light Bulb Moments" challenge. In all the chats I've had, I've wanted to paint a picture of what the experience is like for rural, regional or remote area consumers wrestling with substance dependence issues. In a recent telehealth conference we presented at, when we asked of the MedTech professionals 'who here is from a town of <2000people?', there were remarkably few hands. The people designing HealthTech systems often fail to comprehend the lived experience, isolation and constraints.

As a younger man, I spent 3 years living + adventuring in Bourke - a memorable place, but one where our nearest large regional services centre was Dubbo, a 5hr drive away. Bourke is a thirsty town, having once had the highest ratio of pubs to population, in its boom years. In the time I was there, it notoriously had the highest ratio of police per head of population. Now imagine you're a mum or dad there, raising kids, and one of them gets caught up in recreational use of methamphetamine, a drug that has an instantaneous impact on dopamine reserves from the first encounter, setting someone onto a course of clinical grade depression and impaired cognition from that first hit, seeing them spiral downwards into more regular use. Then imagine seeing them get caught up in legal processes, where even in that nearest regional centre (5hrs drive away), Dubbo, local magistrates have no option but to incarcerate, for lack of local rehab facilities, with the process further compounding a complex health issue.
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It's an experience that's played out in many regional, rural and remote settings, tearing families apart and wasting years of young lives. We know from talking with lived experience advocates who visit these towns, there are few or no services to assist and that for the rehab centres that do, it's a precarious existence. Amongst them, there are varying levels of rigour in drawing on a good evidence base to guide their treatment models. The Regional Australia Institute have done great work mapping out the progressive decline of service delivery professionals in the social fabric of these towns, making it ever harder for locals to access services. We can't keep pretending that addressing workforce shortages is going to be a viable concern, as the evidence shows that retaining talent in communities is diabolically hard.

Just keep it in mind next time you ask "What's our Why"? 

We believe it's time for new ways of tackling this problem, with systems that can scale, support from the first moment of desire to change, through clinical intervention and beyond. We don't pretend it will ever be as useful as direct face to face encounters, but it has to be better than nothing. Rest assured, we're also thinking bigger about where this can go.

This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.

Author: Brian Hill

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