Written Evidence submitted by The Countryside Alliance (MH0031)

 

 

1              Introduction

 

As a campaigning organisation working for everyone who loves the countryside and the rural way of life, one of whose priorities is protecting rural services and promoting sustainable rural communities, the Countryside Alliance was keen to assist the Committee with this important inquiry. With over 100,000 supporters, we know that mental health is an unspoken illness that is common in rural communities, as it is in wider society.

 

In addition to promoting the inquiry and encouraging personal responses to the call for evidence, we also surveyed our members and supporters on their own experiences of mental health and healthcare in rural communities. By doing so we have provided a forum for views to be submitted to us and, by proxy, to the Committee in complete anonymity, which we felt was important given the sensitive nature of the issue.

 

Our survey ran from 8 December 2021 to 4 January 2022 and that it attracted a total of 717 responses serves to underscore the importance of the issue. It posed a range of questions gathering both quantitative and qualitative information. We designed the survey to address those among the issues the inquiry is seeking evidence about that we thought our supporters would be best positioned to comment on, and we also incorporated some questions relating to specific challenges to rural mental health that our previous work has highlighted to us.

 

Comments from respondents have been quoted verbatim.

 

2              What specific mental health challenges are faced by those living and working in rural communities?

 

We opened the survey with two questions that would determine whether respondents would primarily be asked about their personal experiences of mental health challenge or their expectations if they were to face it.

 

 

 

We then invited those who had answered ‘yes’ to both questions to give details of the issues they had faced. Responses to this question most commonly focused on the symptoms experienced. The most raised issue was loneliness, closely followed by depression, anxiety and stress.

 

“Not having anyone to talk too to express how you feel or what you’re feeling or people not understanding how you feel about managing the countryside, life in a rural place can be lonely”

 

“Depression, mood swings, feelings of being overwhelmed”

 

“Loneliness, mental fatigue.”

 

“Loneliness, anxiety, depression.”

 

“Nobody to talk to who really understands”

 

Another broad theme was a feeling among respondents that the Government, and society in general, does not fully appreciate the rural way of life and that this lack of understanding has led to hostility.

 

“Very difficult to stay positive when you're constantly bashed and verbally abused both online and in person for your profession. We used to be seen as the custodians of the countryside and are now treated like the scum of the earth thanks to celebrity hate campaigns”

 

“Stress at members of the public leaving gates open, dogs off leads, trespassing. Total ignorance shown when trying to explain or educate them, so now constantly worried about safety of our animals.”

 

“I Feal my life as a country man is being taken away be people who don't understand the countryside.”

 

“Feeling of being constantly derided and that the government and media not only don’t understand me but seem to go out of their way to make things harder. Constant issues with trespass, fear of crime, ‘sneering’ at rural lifestyles and legislating against farming and rural culture. It can get one down.”

 

“The future of the countryside. How can country people keep their identity and country traditions without being over ruled by those with different values to ours.”

 

Among respondents who indicated they worked in farming, a relatively common complaint was stress and depression caused by bureaucracy within the farming industry.

 

“Difficulties working long hours on a farm and facing beaurocratic problems and feeling that Government has no interest in agriculture”

 

“Being thought of as a second class citizen. The weight of overbearing bureaucracy and paperwork after a full day in the fields. Having to suffer while the backbone of life, the food industry, is belittled, demeanoured and devalued. having to deal with 'clever business' that renegades on contracts because they can, when a gentleman's agreement used to mean what it said and a handshake sealed the deal both ways, now even paper contracts can be overturned and the little man has no power to combat it.”

 

“Isolation,political rules and regulations on farms which create so much red tape. The phasing out of the RPA payments will destroy farming in. Britain as politicians do not understand they subsidise British food prices so that the general public can eat subsidised food . The taking away of the payments and rewilding of the countryside will destroy food production and farming in general. This new wilding project was tried in Chile and the countryside was devastated with the results. Re wilding means no food will be produced and all food will be imported ( food produced abroad has not been produce to health standards therefore more stress on the NHS when will policitians understand good food results in good health !!!!”

 

Numerous respondents noted a connection between their feelings of loneliness and lockdown policies that have been enacted over the past couple of years. Some raised concerns related to the coronavirus pandemic in general, but of those comments that referenced the overall situation the overwhelming majority focused on lockdown.

 

“Loneliness during lockdown as was not allowed to meet friends”

 

“Cant put my finger on it age 76 or the last shutdown 2020 but since i feel my brain is slightly different during shut down living alone I missed social interaction local pub and other activities.”

 

“2020 lockdown was difficult for me because I am single living with my parents on the farm I missed going out to meet my friends and not seeing anyone all day made me so lonely.”

 

“Working in retail throughout the lockdowns ping home to parents isolating as they are both high risk. Worrying about taking the coronavirus home to them. Public not wearing masks and flouting the restrictions or guidelines, no thanks for the job you do. Travelling to and from work the price of fuel rising rapidly no alternative to driving to work as little or no public transport.”

 

“100% brought about by govt covid restrictions. I am 74, alone and in good health. To be told to stay in, how l do I do my shopping? My son was ill in Feb 2020 (lung infection - prob covid), so I did his shopping. My daughter said I should 'stay home', so I said she would have to do his shopping.I wrote to MP about restrictions. I wrote to doctor asking to be counted as someone affected by mental health due to covid. He did not reply.”

 

“Long-standing depressive symptoms, presumably somehow made worse by CV19 restrictions and general doom-mongering by State bureaucrats”

 

 

Some respondents indicated that difficulties they were having with local services were negatively impacting on their mental health.

 

“Isolation, particularly during lockdown and challenges with mobile phone and internet connection leading to significantly reduced contact with others. Stress of rural crime in the area without adequate police support. Having to go out at all times of night to try and observe and report poaching and other more serious activities, knowing that if you report the crime either nothing will happen or the police will be unable to take action. Inability to report concerns about mental health and depression for fear of the consequences.”

 

“Coping with other peoples denial of what is happening to our rural way of life being dismantled. The escalation of inner city crime moving to rural areas and the Police force displaying nonchalant attitude towards the escalation.”

 

“I found coping with our upcoming retirement from a busy working farm, plus helping my husband cope, so stressful that by the time we had moved to our smaller farm I was almost devoid of all emotion. Had no energy or will power for doing anything. Paperwork, walking or indeed any outside activity. Then my Father's mental health has been slowly deteriorating. Trying to find help for him has been impossible. Persuading him to live with us, impossible. I feel isolated but having to cope with my husbands stress, financial and peronal, my son and his family and business problems and now also my Father's slow decline with dementia and his insistence that he still live at his home, which is over 25 miles away from us.”

 

“Suffer from clinically diagnosed depression associated with chronic condition. Even prior to covid it was difficult to get continuing help, since covid it is non existent, I am at the lowest I have been for years and there is no help”

 

Multiple respondents indicated that the impact of local development, specifically HS2, on their own properties was a particular driver of difficulties with mental health.

 

“I am on the verge of a nervous breakdown & have suicidal thoughts - due to HS2 and the impact on our farm and business built up over 3 generations. My husband has major heart issues and is above retirement age - our property was our pension & is now unsaleable. We are trapped”

 

Later in the survey we asked respondents about the extent to which they believed rural communities show adequate awareness of, and offer adequate support for, mental health challenges. Those who gave positive responses focused on the strength of their community and of institutions within it.

 

“I think people in a close knit rural community can be very helpful.”

 

“Having lived in both rural & urban settings I have found that Rural communities often support each other far better than any other”

 

“The rural village community were excellent”

 

“Fortunately our local church, which I’m a member of, has good pastoral support network and has elders who have engaged in training re mental health.”

 

Those offering less positive assessments coalesced around two themes. The first was the lack of awareness of mental health issues within their community:

 

“Not enough awareness and maybe 'too resilient' attitudes etc.”

 

“There is not enough promotion of how people can obtain help if they are struggling with their mental health”

 

“Mental health issues are generally hidden in rural communities. The more awareness that there is, like this survey and the work that Yellow Wellies have done, the better able people will feel to be more open about them.”

 

“They don’t show adequate awareness. I am not aware of any specific support for, for example, members of the farming community. My husband and his family were farmers and he often tells me of young farmers who committed suicide. He is not aware of any support available”

 

Secondly several respondents pointed to a perceived stigma around mental ill-health:

 

“It's the age old comment Men keep far to much to themselves for fear of being classed as "weak "”

 

“Very location specific as to how good this is. The stigma in older age groups is still too high”

 

“Not enough awareness and there is still a stereotypical view of mental health.”

 

“Very poor. Tabo subject, which carries a lot of judgement. It can be a temporary illness like many others with the correct support”

 

Owing to our longstanding concern about the issue, we asked respondents about their experiences of bullying, including online bullying, prompted by their participation in or support for country sports.

 

 

The following is a selection of responses to our request to those who reported experiencing it to share details.

 

“Constant name calling, in real life. Slogans scrawled on the side of the car with a metal object, windows smashed on the house, eggs thrown, online campaigns of hatred and untruths being circulated.”

 

“Many friends and family have been subjected to offensive comments online or in person by people who don't understand what we do. My wife in particular has had to block people from social media to prevent retaliation. We've also had to increase security at our house following the leak of our personal information from guntrader. I am also unable to speak about my involvement in country sports and work and have to keep my personal life and social media accounts totally separate from anything to do with work.”

 

“Constant pressure. Constantly hiding your thoughts and views from others in case of backlash. My son is a keeper and I seriously worry for his wellbeing and safety. People avoiding me in case they are deemed to be condoning what I do. Constant surveillance. Very stressful.”

 

“My Facebook account was once targeted by anti hunt supporters, following a comment I put on a very obviously fake photo of a fox that had apparently been murdered by the hunt . When in fact you could clearly see it had been hit by a vehicle on a road. I merely stated this and I started receiving abusive and threatening messages. I blocked all and removed the supposed friend responsible. But for a long time it made my anxiety and panic attacks significantly worse, as my ex friend knew my address.”

 

The survey concluded by asking respondents for any further comments they would like to make about mental health in rural communities. The themes that emerged from these responses were also instructive as to the general picture of mental health in rural communities. On the positive side, some expressed optimism:

 

“I'm sure my mental health is better living in the countryside, compared with living in a town.”

 

“I have found my community to be outstandingly supportive, on a person to person level, of those with mental health problems. Some of these problems can be transient and some more permanent but all are generally treated with compassion and attempts to understand.”

 

“It is easier today to admit to it and also it is talked about in a non perjorative way”

 

Numerous respondents emphasised the importance of raising awareness of mental health and promoting empathy.

 

“The issue needs normalising. Mental wellbeing should be talked in the same way as physical fitness etc. The rural community also needs to make more of an effort so that the subject is able to be dealt with, without the stigma that is attached to it.”

 

“It is important to listen to and help those who need it”

 

“I would like an initiative in all walks of life, to teach people how to ask others how they are without it sounding disingenuous.”

 

“In a rural community it is easy to hide away. The more people talk about mental health the better. However there is a huge difference between poor mental health and severe depression.”

 

Some drew a link between mental health and the accessibility of general services within rural areas.

 

“It is not just mental health but many issues like rural poverty, poor housing, under-developed amenities, roads and facilities are often overlooked by parliamentarians. These issues cause mental stress.”

 

“Public transport is essential. Reliable landline phone that is not dependent on electric supply is crucial. Internet service at useable speeds is only helpful if rural families can afford the computing equipment. This government policies allow child poverty at an obscene level. We should all be ashamed and change local and national policies”

 

Some took the opportunity to reiterate their concerns about online abuse.

 

“There needs to be far more action by the big tech company's to tackle the abuse online. I personally have reported hundreds of abusive comments with no action taken. As well as reporting the various animal extremist pages that are raising money to commit hundreds of thousands of pounds worth of criminal damage, again with no action taken from either the social media sites or PayPal ect.”

 

“It's about time something was done to support Rural community mental health and to stop online bullying.”

 

“The bullying you talk about is a major blot on our way of life. THe amount of ignorance of country matters has to be experienced to be believed.”

 

Lastly we received a number of thoughtful comments expressing concern about a perceived lack of understanding throughout the country, and especially in the media, of the rural way of life. The respondents felt this to be deleterious to mental health without necessarily having to be conveyed in the form of abuse or bullying.

 

“Constant sense that nobody understands us and our way of life. E.g. Media persecution of farming. Aggressive attitudes to meat-eating. Government and other distant authorities referring to a "small extra journey" to facilities when the nearest place that sells a pint of milk is a twenty-mile round trip etc etc”

 

“The media could help. For example, livestock farmers know that actually unlike zero-grazing in cattle yards say in California or Texas, or parts of Brazil, cattle and sheep grazing in the UK especially on the uplands on permanent grass, are fairly carbon-neutral, and if more of the now arable 'monoculture' had mixed livestock systems amongst and alongside, this too would improve soil ferrtility. The media don't, and seem not to want to, get this.”

 

“Stop pandering to vocal groups who want to change all aspects of rural life to suit their agendas. Be tolerant and kind. Help protect us against those incapable of being tolerant and kind, where necessary through legal protection. We are the most discriminated section of society from what I can see. That discrimination is permitted, even encouraged. It is having a marked and significant impact on our mental health. A farmer is bullied for farming; has legislation produced to make life every more challenging; suffers promotion of veganuary or meat free Mondays in their childrens school; is spat at and threatened by ‘lock down trespassers’; heaven forbid they shoot or trail hunt. Against all prejudice it is hard to maintain the best of mental health.”

 

3              What is the current state of mental health & suicide prevention service provision for those working in agriculture and those living in rural areas more generally? Do they meet the specific needs of that community?

 

We inquired as to whether respondents who reported having had difficulties with their mental health in the past five years, while living in a rural community, had sought help provided through the public sector, and then asked them to rate their satisfaction with the care they had received.

 

 

 

A further question asked respondents to comment on why they rated their satisfaction as they had. The commonest focus for broadly positive responses, and the positive elements within the mixed responses, was medication.

 

“Eventually got to speak to mental health nurse and prescribed medication (on going) much better at the moment.”

 

“Very helpful gp I spoke to understanding and has proscribed medicine”

 

“The GP was good and quick to prescribe medication. The other therapies e.g. counselling that were offered were difficult to access and not easy o find a suitable or accessible therapist privately.”

 

Conversely comments that focused on other forms of therapy, such as talking therapies, tended to be more negative.

 

“No support available other than drugs”

 

“All they wanted to do was give me antidepressants and put me in for group councilling”

 

“Was given telephone appointment with gp very quickly (1 day instead of usual 2 weeks) and initially very helpful. But just prescribed anti depressants and told to contact counselling service. Didn’t qualify for nhs counselling as not bad enough (come from generation that wants to hide mental health issues tho so played in down in answering questions). Think further investigations into hormone and micronutrient balance etc is appropriate but when asked for blood tests gp just increased dose of anti depressant. No monitoring of bp or physical aspects or stress etc”

 

The other key driver of a broadly negative experience revealed in the responses was difficulty with accessing services at all.

 

“Very difficult to see a dr, receptionists busy & brusk. Dr did call but the window was 4hr wait, restricting work & causing more anxiety to contact surgery.”

 

“Lack of available services, with a long wait time for an initial assessment. Was then told that I would need more help than they could provide (only 6 sessions per person and I was going to need more ongoing support than that).”

 

“It used to be okay before the pandemic but now you're lucky if you can see anyone in person.”

 

“Difficult to see one GP, was passed from pillar to post, having to re explain difficult situations each time. Then had to wait a month and demand to only see one GP. This then helped.”

 

“Long wait to get a doctors appointment but once seen good advice given”

 

“First contact with RABI was wonderful. Unfortunately at local level, the adviser was not able to fully comprehend the situation. NHS support was ok, when pushed by myself but far to much emphasise is placed on the mental health sufferer, to make contacts and ask for help. People are in such a dark, desperate place, they can not see that they need help. They only want the stress and worry going round and round in their heads, to stop.”

 

In some instances, such frustrations were linked with difficulties when accessing services from multiple providers. This suggests issues with the extent to which services are provided in a joined-up manner, which will be further considered in section 7 below.

 

Those who reported that they had experienced difficulties but had not sought support provided by the public sector were asked to comment on why they had not done so. The most common reason was a lack of awareness of or confidence in the services available.

 

“I did not feel the NHS would have sufficient resources to deal with the problem. I sought private support”

 

“Didn’t realise they were available”

 

“The attitude of the local GP service has drastically changed. They seem to have built a defensive wall around themselves and are very defensive about actually making an appointment to see a doctor. Almost as if we the patients are at fault to expect medical advice.”

“Their go to treatment is pills..... (from past experience) . I didn't want that, so chose to bear the illness and work my own way through it.”

 

“Don't have time to hold on the phone for hours trying to get an appointment, if they pick up at all. Surgeries no longer like you walking in to make appointments and my rural internet is so hit and miss it's unlikely to let me do it online.”

 

Some respondents expressed a preference for relying on their own resources.

 

“Try and fight through my problems alone”

 

“I am in my 80 th year and we think we will get over it and count your blessings instead.”

 

“I have wonderful neighbours, family & friends who are always prepared to help.”

 

“Farmers tend to hold it in and battle on”

 

Some shared concerns over stigma attached to seeking help with mental health issues.

 

“Being in the job I’m in it’s frowned on to want help”

 

“Shame”

 

“Sounds pathetic”

 

The other theme that emerged was concern from those who rely on their possession of a firearms certificate for work or leisure purposes, which they believed seeking support would jeopardise. The following is a sample of comments that were volunteered in response to the question about why people had chosen not to seek support from the public sector.

 

“I would rather deal with the issues myself and there is also a risk that if i did seek professional support from a doctor it would affect my shotgun licence”

 

“ Because the NHS will report any such discussion to other authorities and that would potentially result in my shotgun and firearm certificates being taken away. Shooting (mainly clay and target practice) is my one main recreation and losing that would have a massive impact on my life. I would trust my doctor to make an assessment of my risk to the general public but the police are massively influenced by political and public sentiment and are not the right body to make such an assessment. There is currently no way to go to a GP about mental health concerns without the police immediately taking action, irrespective of the GP's professional opinion. That is wrong.”

 

“I am a firearms holder and am very aware that it may get back to the police if I went ask for help. If there was a in confidence channel arrange for firearms holders they could go to for a consultation or just a chat and know 100 percent that it’s just for them and it’s somewhere to go with the slightest of concerns it would get used and help stop people locking the feelings away before it’s to late. Luckily the countryside is my tonic now!”

 

Since we were aware of this as an issue, later in the survey we asked about it more specifically.

 

 

 

Having then asked for any comments on the issue of medical records being shared with the authorities, the range of thoughtful responses we received does suggest that there is a perception that the authorities can be too quick to revoke or disapprove of a firearms licence in the case of individuals who have experienced mental ill-health. This is problematic because it may disincentivise people who want or need to maintain a firearms certificate from seeking treatment at an earlier (and potentially less severe) stage, and because it may remove the opportunity to pursue a leisure activity beneficial to mental health.

 

“My concern would be that without careful investigation into the severity of a condition there would be a blanket policy of simply refusing a grant or renewal.”

 

“While i feel it is very important to make the authorities aware of a serious mental health issue minor issues should be taken on their individual merit. Lets face it the majority of the population has experienced a form of anxiety and/or depression in the last couple of years but that doesnt mean to say that they are suicidal or wish other people harm. If people are worried about losing their gun licences then they wont go to the doctors and in some cases their symptoms and wellbeing will worsen”

 

“I do not trust medical authorities not to take any mental health concerns as a sign that, for example, my shotgun license, should not be resolved, despite shooting being the thing that makes me happier than anything other than my family!”

 

“There are no adequate controls in place to ensure that any action taken by the authorities is proportionate. If I were to report concerns to my GP, that GP should then make an assessment of risk, potentially with referral to a specialist and then take action. The current situation is similar to someone seeking advice for an eyesight, hearing or mobility condition and immediately having their driving licence revoked without any further tests.”

 

“I feel I’d be judged”

 

Respondents who reported that they had not experienced difficulties were asked about their confidence in the support they expected would be available were they to need it. They were asked to rate their level of confidence and then, again, to comment.

 

 

January 2022

 

Comments overwhelmingly focused on confidence in the local NHS as a whole. Positive answers frequently expressed confidence in the respondent’s GP, and included:

 

“Our local doctors’ surgery is truly excellent and I have no doubt that they would be able to support.”

 

“I have faith in my doctors surgery, very attentive and acailable”

 

“I would like to think my GP would be as good as one in a city.”

 

“Plenty of help both prof and vol in area”

 

“Local GP is excellent”

 

Negative responses, meanwhile, focused on perceptions that NHS care in general, and mental health support in particular, is difficult to access.

 

“I'd heard that CBT is very difficult to access.”

 

“NHS is in a mess at the moment due to Covid19”

 

“I am not sure the NHS is coping very well with physical illness never ming mental health”

 

“Very diffficukt for farmers and rural people to access help quickly.”

 

Some respondents complained specifically about being unable to see the same GP consistently between appointments.

 

“GPS difficult to access - very difficult to see the same Dr at each appointment. I know from my daughters experience and that of friends and their children that there are very long waits for mental health CAMHS and very little use when you do get an appointment. You need to be able to afford private fees to access reliable mental health treatment”

 

“Because our local health centre is under staffed and covers such a large area and number of patients. You never see same doctor and not the one you are registered to. No time to talk”

 

Lastly, we hoped to contribute to the evidence base on preferences as to the format through which mental healthcare services are delivered in rural communities, i.e. in person or online. Those who expressed one preference or the other were asked to comment on their reasoning.

 

 

Of those who preferred services delivered in person, respondents most commonly indicated it was a matter of personal preference. The second most prominent reason was the belief that services are delivered more effectively in person:

 

“The person leading the discussion and offering the help can pick up on subtleties and guide the conversation, understanding what would work best for the patient”

 

“It is much easier for the practitioner to see the real extent of someone’s true being when they can look them in the eye, see their full facial features and read the body language of the client. A client is also likely to be more relaxed if this process is done in their own home or somewhere familiar where they feel comfortable. I had a similar experience with physio over the telephone during Covid and a friend of mine who is a respiratory physio said similar to the above when giving consultations over the phone or online. You can not see if that patient has other underlying physical or mental issues going on which require a different level or approach”

 

“The internet is soulless. If I am to discuss my situation i want to be able to look into the eyes of the person the other side. Intimation, body language and tone of voice cannot be indicated on the internet, being with someone in person has a completely differnt, personal feel to filling in a lifeless, soulless computer chat or impersonal form.”

 

“It is physiologically more beneficial to gain support in person rather than online. We are a social species”

 

The third main reason for a preference for in-person services was that some respondents either disliked or expected technical difficulties in using a computer.

 

“I do not like the computer very much and feel much happier seeing someone in person.”

 

“I not that good over the Phone, r on the Internet. I wouldn't come across right on the phone, I’m a bit better in person.”

 

“Living in a rural community brings its own challenges with things like internet connection and phone service, which needs to be taken into consideration. On the other hand, it can be hard for people to get into urban areas as it takes too much time. Ideally, services need to be brought out into the rural community so people do not have to travel so far if they wish to see someone in person. An alternative must be available for those who have difficulty accessing services remotely.”

 

“Broadband and mobile phone service is hit and miss in the countryside.”

 

Meanwhile the relatively small number of respondents who expressed a preference for services delivered online also most cited their personal preference, for reasons such as ease, comfort and privacy. There was also a sense on the part of some respondents that in-person services would be difficult to access, owing to a lack of local availability:

 

“There’s not much time free to go and see someone and it’s better to keep distance due to covid- who’s going to do the work if we get ill! So best online”

 

“In person too far away. Not accessible.”

 

4              What are the causes of the higher than average rate of suicide amongst those working in agriculture? Are there other linked professions, such as vets, that have similar issues? How effective are suicide prevention services offered to these groups?

 

Although we felt that reasons of sensitivity prevented us from raising the subject of suicide in the context of a survey asking participants to reflect on their mental health, we would suggest that the evidence we have gathered as to the extent of online and other bullying experienced by those participating in or supporting country pursuits supports the inclusion of gamekeepers and allied professionals as a linked profession to agricultural workers, for the purposes of this inquiry.

 

The survey has not enabled us to gather statistical data as to suicide rates within this profession, but we would suggest that the Gamekeepers’ Welfare Trust, which provides advice on health and wellbeing, would be well placed to advise further. In addition, in response to the request for further comments from those who expressed that they had experienced such bullying, one respondent replied:

 

“I was very sad to hear of the passing of two young keepers this year. There was speculation this was due to the abuse received. Also know of several people who have had threats made to them and their families.”

 

5              Is sufficient mental health support made available to rural communities following “shocks” such as flooding or mass animal culls?

 

Here the Committee touches on an important point, the intent behind which other stakeholders such as the NFU will be better placed to comment on. We would note, however, that such shocks can be personal as well as regional. If an individual falls victim to a ‘Twitterstorm’ or some such campaign of targeted social media harassment, to which our survey indicates those involved in country pursuits are especially vulnerable, the shock to them is closely comparable to that experienced across a wider community from such events as the Committee describes.

 

6              Does the Government’s recent investment in mental health services adequately provide for agricultural mental health?

 

While our survey did not inquire specifically as to any recent improvements that may be accounted for by Government investment, the Countryside Alliance’s position is that while increased investment in mental healthcare provision is welcome, it remains important to ensure that the benefits are realised across the country, including in rural communities, by means of accessible services.

 

7              How joined up are key actors, such as Defra, DHSC, NHS England, Public Health England and Local Government in their approach to improving quality of, and access to, mental health service in rural and agricultural communities?

 

Although we did not question on this specific issue, some respondents did report issues when accessing services from multiple providers.

 

“My son went for help from the doctor with mental health issues she told him to register at the homeless centre in the local town where he would be referred for help quicker . I was so shocked my son who just needed counselling to get back on track had to register has homeless to receive support!”

 

“passed from pillar to post with multiple excuses”

 

“Took a long time to receive help from domestic abuse and mental health services. They did not work together and would often say the other could help with something when asked they couldn't. This was rather frustrating.”

 

8               Recommendations

 

Based on the complete set of responses received to our survey, the Countryside Alliance would like to offer the following recommendations:

 

  1.                                                                                                                                                                         The provision of local mental health support should be tailored to the needs of the community, to ensure that people living in rural areas can access services. Remote provision, whether by computer or telephone, has a role to play but our survey revealed a strong majority favouring delivery in person and indeed, several of those favouring remote services went on to suggest they did so primarily because they believed services in person would not be accessible given difficulties with long travelling distances and inadequate public transport.

 

  1.                                                                                                                                                                         Recognising the increased costs of delivering mental health support within rural communities owing to their lower population density, funding should be apportioned fairly across the country. Services are usually put in place where a need has been identified, which may suffice for urban areas whose higher population densities make this readily achievable, but it would be more difficult for rural areas to meet a similar threshold.

 

  1.                                                                                                                                                                         Improve the visibility of services to encourage people to seek help at an earlier stage. A lack of awareness of the services that are available, or a lack of confidence in their sufficiency, was a key reason we identified for people choosing not to seek support; similarly the social enterprise Rural Mental Health Matters has said that if people do not see services in their area they assume they do not exist. We believe this has contributed to a culture of self-reliance and stoicism that has prevented people from seeking support earlier and, sadly, may be a driver of elevated suicide rates among farmers and other rural occupations.

 

  1. There should be a greater degree of appreciation and respect for the rural way of life throughout the country, from policymakers to individuals. There are legitimate grounds for disagreement on divisive issues connected with animal welfare and the environment, but these cannot excuse hostility to practitioners in the fields of agriculture, wildlife management and country sports by those with an alternative ideological viewpoint. The pervasiveness of such attitudes and behaviours does impose burdens on the state of mental health within rural communities.

 

  1.                                                                                                                                                                         Where incidents of ‘cyber-bullying’ or otherwise targeted harassment are referred to the police, victims should as a matter of course be offered expedited access to mental health support.

 

  1.                                                                                                                                                                         For the purposes of this inquiry and in further analysis by the Committee, the Government and others should consider gamekeepers and allied professionals as a profession linked to agricultural workers in facing an elevated risk of suicide.