This is something local resident Blake Collins can relate to.

In October 2021 Mr Collins' mental health had deteriorated to the point where he considered taking his own life.

"I was more than scared to speak out. I was scared of what people would think, how they would judge me. I was scared, embarrassed and sad. It was a whole mix of emotions," he said.

Without proper promotion of mental health services for residents in the Lithgow region, Mr Collins is one of many who have first hand experience of what can happen when there is no support.

"In all honesty, I didn't even know there were any services in town that you could go to for help," he said.

"I had been to a couple of the 'Walk N' Talks' but other than that, I wasn't aware of any services in the Lithgow area."

Even if Mr Collins had been aware of any services in Lithgow, he doubted he would've spoken up.

He said his journey with mental health has been up and down and it was difficult when he didn't know services were available to him.

In a report conducted in 2018 by The Centre for Rural and Remote Mental Health for the Nepean Blue Mountains Local Health District, Mental Health Services, it indicated that there was a 'strong commitment to addressing mental health and wellbeing in the Lithgow community with many initiatives underway' because the levels of mental illness and suicide risks were higher than other communities.

"There are a diverse range of programs and services in the area to address mental health and wellbeing but access to appropriate clinical and support services was less than optimal with many of these services being unknown to the service providers and the community, resulting in problems with referral and service gaps," the report stated.

"It was acknowledged that it was essential to address the contributing factors to mental health and wellbeing in order to achieve longer terms gains."

Professor Keith Harris, PhD from the School of Psychology at Charles Sturt University explained that "awareness is key" given most people don't look into mental health providers until there is a serious or even urgent need.

"So, building awareness helps the general public become more aware of the available resources," he said.

"Similarly, many people are reluctant to seek help, even when they know getting professional mental health help is a good idea."

This is why mental health systems must be promoted properly in small towns such as Lithgow.

"Awareness, particularly when it helps people understand how to make use of the service, can help reduce the help-seeking reluctance barrier," Mr Harris said.

He said that services need to promote themselves like a retail brand because developing good reputations can help increase service use.

"For example, beyondblue and Lifeline both have good reputations here, and many people will readily use them," he said.

According to Mr Harris, the evidence shows that rural and remote areas need more human resources for all areas of mental health.

"Fortunately, if general mental health resources, such as psychologists and counsellors, are available and affordable, that can lead to real improvements in community wellbeing, and direct and indirect reductions in suicidal behaviours," he said.

The reason why mental health services and not just hospitals and GP's are important in a small town community is because "they are part of a system, and these services need each other to function well".

Mr Harris said hospitals and GPs are well suited for identifying some mental health problems, but they generally perform triage and referrals.

"Mental health professionals are specialists trained to to treat mental health problems, which typically take months or longer to treat," he said.

The Lithgow Community Mental Health Service team includes two registered nurses, three social workers, a part-time occupational therapist and two community psychiatrists.

In additional to providing individualised social and clinical interventions, including promotion of mental health wellbeing, psychical health, counselling, education, and care coordination, the team also work with communication organisations to provide group work programs.

"The 2022 Lithgow Community Mental Health Service group work program includes a Men talking to Men group, a Hearing Voices network group, a Women's Group, and a trauma-informed yoga program," Nepean Blue Mountains Local Health District Health Service Director, Matthew Russell said.

"Whilst the majority of support for consumers is provided in the health centre or in a person's own home, the team also has the capacity to provide telehealth support."

Mr Russel said their Lithgow Community Mental Health Service has expanded to include a Rural Adversity Mental Health Program (RAMHP coordinator) worker.

This is a full-time community development position to promote health and wellbeing, education and support access for the rural community into mental health services.

"In addition, we also have a clinical psychologist as our Farmgate Rural Counsellor and our Disaster Recovery Clinician is a senior mental health nurse," he said.

Mr Russell explained these positions work within community to provide outreach and coordination of support with local services. They work closely with primary health initiatives and community and welfare agencies to provide direct care, supporting access to health services for all those impacted by natural disasters, including the recent drought and fires.

"As part of providing an integrated, recovery-based and trauma-informed community mental health service, additional mental health assessment and outreach services are provided to children and young people, families and older populations," he said.

"Crisis assessment and support services can be accessed through the Blue Mountains Mental Health Access Team.

"There is also a wellbeing nurse based in local schools in Lithgow who helps students and their families access care and assistance for health and wellbeing issues, including mental health support and services."

In response to high demand for mental health services due to the impact of COVID-19 on the NSW population, NSW Health is expanding access to time-limited psychology and counselling services as part of the NSW Government's Mental Health Recovery Package.

"The aim is to prevent the emergence of serious mental illnesses for people whose wellbeing has been significantly undermined during the pandemic. The Package also includes funding to train 275,000 community members across NSW in suicide prevention training," Mr Russell said.

NSW Health is trialling a range of innovative suicide prevention initiatives and services as part of the NSW Government's work on Towards Zero Suicides (which pre-dates the pandemic).

Many of these support people who are in distress or suicidal crisis before they require emergency care. Some of the services include:

For mental health support, call the 24-hour Mental Health Line on 1800 011 511 or contact the Lithgow Community Mental Health Service direct on 6350 2555 during business hours.

The Lithgow Community Mental Health Service is located at Lithgow Hospital, Cnr Col Drewe Drive and Great Western Highway, Lithgow.

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