This photo sums up something of Eyre Peninsula for me. It’s a place filled with quirky characters, shaped by isolation and sculpted by a landscape that is both harsh and beautiful in equal measure. I went there for a holiday in 1996, fell in love with the landscape and the people and didn’t leave for almost 20 years. #Homesick is something I write often on other people’s social media posts about Eyre Peninsula. Pictures of the light playing on the waters of Boston Bay, of perfect summer days at Fishery Bay and long expanses of open highway with huge empty skylines heading ever further west to the isolated sacred places of Cactus and the Head of the Bight. These images and the people who take them make me yearn for my former home in Port Lincoln.

The main reason I choose not to live there at this time is I simply grew tired of not being able to access the specialist care I needed to manage my mental health. We hear in the news about the lack of mental health beds in metropolitan hospitals, the long waits for specialist psychiatric care and the horror stories when the stresses on the system become too much and it fails individuals with catastrophic consequences. But in regional South Australia there just isn't much of a system to fail you in the first place.

When I left Eyre Peninsula a bit over three years ago, there was no psychiatrist based in the region and hadn’t been for about 15 years. My observation of psychologists in the public system is that they were often recent graduates thrown in at the deep end with complexities and caseloads that were both unfair and unsafe. The few experienced psychologists working privately had huge waiting lists. Mental health workers, often in the not-for-profit sector, are an essential part of the picture, but they too were working with enormous caseloads and lacked the essential backup of experts like psychiatrists.

I was fortunate to have a terrific GP with an interest in mental health, but she was booked up months in advance and though she did her absolute best, she couldn’t be expected to fill the void left by a psychiatrist and an experienced psychologist or counsellor. So many regional GP’s are already stretched to breaking point, being all things to all people and are simply unable to respond quickly enough to the needs of a mental health patient in crisis, or ideally before it gets to that point. A friend in Port Lincoln summed the situation up when she posted on Facebook recently 'Anyone know of a female doctor I can get an appointment with before I turn 100?'

My bipolar disorder was not diagnosed until my mid 40's. Would it have been diagnosed sooner if I was not living almost 700 km from a major city? Probably. But once I had the diagnosis, I decided that specialist care was not negotiable. I had been seriously putting my health at risk for years. In fact without being overly dramatic, I had been putting my life at risk for years. The suicide risk for people with bipolar is 17 times greater than that of the general population and life expectancy is around 10 years less than someone without a mental illness. If you live regionally you can take off another four years. Suddenly my retirement plan was starting to look pretty short.

Bipolar Disorder is a condition that responds pretty well to medication, but it’s a finely tuned and individualised process that for me has meant almost three years of trial and error and the collaborative efforts of an experienced psychiatrist and an excellent GP. A highly skilled psychologist completes the trifecta and for the last couple of years I have been mostly steady, stable and touch wood, happy. I touch wood again in the hope that with this treatment regime, I have finally said goodbye to a dangerous, debilitating and exhausting cycle of crash and burn that has followed me since I was a teenager.

I don't know if I will need the level of care I currently have for the rest of my life, but it’s quite likely I will, and if this is what it takes to be well, then this is what it takes. I like being well. In fact, I could really get used to it. With all those alarming statistics hanging there like a hammer about to fall, I’m not feeling too inclined to take any chances. I’ve taken more than enough of those over the years with an illness that was undiagnosed, then misdiagnosed and at 51, I reckon I’ve well and truly used up every one of my nine lives.

So, presuming I do need this level of care long term, that pretty much rules out moving back to my beloved Eyre Peninsula, unless there are some dramatic improvements in regional mental health services in the years to come. And I don't see that kind of investment in regional mental health being on anyone's medium or long term agenda. If the fact that a person with a mental illness who lives regionally will probably live14 years less than someone in the general population can't mobilise the politicians, I don't know what will. Eyre Peninsula will always be the place I call home in my heart, but for the sake of my health, sadly it may not be the place that I live anytime soon.

First published on ABC Open August 2014

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