| Project Objectives / Summary:
The aim of the project was to conduct an investigative pilot study to establish strategies to improve quality of life, overall health status and improve access to health services for unemployed people in North West Tasmania in view of establishing a much larger study subsequent to the findings of this project. On the basis of the statistical evidence from the demographic profile, non employed men aged 40 - 60 years were selected as the focus of the qualitative phase.
This project was designed to gather qualitative data on the health issues of non employed middle aged men in the Mersey-Lyell region to gain a more detailed understanding of the issues of employment, disability and health on the north west coast. The project also addressed the role of General Practice in providing care and access to health services for this disadvantaged group. For the purpose of this project, non-employed men were defined as those in receipt of a Newstart Allowance or Disability Support Pension. Middle age is defined as between the ages of 40 and 60.
The report is based on two pieces of research:
- A telephone survey of GPs in the region to ascertain their attitudes and practices in relation to their work with non employed middle aged men; and
- Focus group discussions were conducted with forty three non employed men to explore their personal experiences with General Practice, barriers to accessing health services, access and knowledge of existing support services and their awareness of preventative and health promotion programs.
Project Collaboration:
- University of Tasmania, Department of Sociology and Social Work
- Centrelink
- GPs
- Men aged 40 - 60 years
Project Outcomes:
Results from the telephone survey of General Practitioners reveal:
- General Practitioners on the North West Coast were virtually unanimous that employment status matters for the health status for all patients, including non- employed middle aged men.
- Most practitioners more commonly treat non-employed middle aged men for chronic illness and disability than acute conditions.
- The most common reasons non-employed middle aged men seek treatment are for physical health problems, psychological and interpersonal problems, and mental illness. Social problems were not widely perceived by GPs as significant factors in non-employed men's decisions to seek treatment.
- GPs believe they are most effective in advising non employed middle aged men with respect to psychological counselling, mental health and emotional support, and in relation to lifestyle and health promotion advice especially in regard to diet, exercise, alcohol consumption and smoking.
- 70% percent of GPs believe existing support services on the North West coast are inadequate.
- Over one third of GPs see a need for additional support services that would increase the employability of men in the target group. Another 15% see a need for increased psychiatric and psychological services.
- Most GPs see non-employed middle aged men as a distinct group that differs from employed men. Non-employed middle aged men are perceived to be more highly stigmatised, and to have more social problems, more risk factors, and less healthy lifestyles than employed middle aged men. Most GPs also believe that the health of non-employed men would improve if they were offered employment.
- GPs are most divided over the issue of whether Government levels of income support for non-employed middle aged men are adequate or inadequate.
Findings from the focus group reveal:
- Unemployment, poverty and loss of social identity were identified as the major causes of health problems.
- The consequent experiences of stress, anxiety and depression were the major health issues identified by non-employed middle aged men. Lifestyle issues, such as risk taking behaviours, did not emerge as a major theme in the focus group discussions.
- Effective counselling by GPs, approaches to treatment, consultation times, and cost barriers were key themes discussed in relation to general practice.
- Poor access to dental services, general practitioner knowledge of, and liaison with, agencies such as Centrelink and the Commonwealth Rehabilitation Service as well as the adequacy of support services on the north west coast were other major Issues.
Recommendations
- That the North West Tasmania Division of General Practice take on an advocacy role to raise awareness of the widespread effects of unemployment on the health of individuals and on the broader community.
- That the North West Tasmania Division of General Practice highlight to the Federal Government the need for retraining and education schemes targeted for non-employed middle aged men. Emphasis should be placed on the need for job creation so that training is undertaken with the outcome of employment.
- That the North West Tasmania Division of General Practice take up the opportunity to work with Local Government in the development of their Partnership Agreements with the Tasmanian Government to ensure that the needs of non-employed middle aged men are articulated in the Agreements. For example, this may include the promotion of affirmative action programs in local councils to employ non-employed middle aged men.
- That the North West Tasmania Division of General Practice negotiate with local councils, the Department of Sport and Recreation, and private operators to introduce reduced rates for Health Care Card holders to municipal recreational facilities such as swimming pools and privately owned gyms and health and fitness clubs.
- That the North West Tasmania Division of General Practice lobby State Government to increase access and availability of public dental health services.
- That the North West Tasmania Division of General Practice identify a GP(s) with a special interest in the issues of non-employed middle aged men to facilitate a focus group as a forum for health promotion advice and building social networks. A major consideration would be the cost of travel to and from meetings and strategies should be explored to provide financial support for middle aged men to take up this option.
- That the North West Tasmania Division of General Practice promote the use of bulk billing for holders of Health Care Cards, which would include non-employed middle aged men and their families.
- That the North West Tasmania Division of General Practice examine the possibilities for more flexible service delivery which may include extended consultation times where appropriate.
- That the North West Tasmania Division of General Practice investigate further issues identified with the counselling skills of GPs to develop appropriate professional training packages.
- That the North West Tasmania Division of General Practice explore strategies to ensure that non-employed middle aged men have access to both male and female GPs in their local areas. The "Adopt a Rural Practice" model adopted from other Divisions provides an example of this approach.
- That the North West Tasmania Division of General Practice increase awareness of GPs about the needs of non-employed middle aged men in relation to the provision of information about prescription medication.
- That the North West Tasmania Division of General Practice compile a resource list containing information about alternative health care skills of GPs in this region, for example acupuncture, hypnotherapy.
- That the North West Tasmania Division of General Practice investigate the range of non-employed middle aged men medical options that are available in the area and develop an information package for GPs.
- That the North West Tasmania Division of General Practice work with existing support agencies and services to develop decentralised service options to more remote areas in the region. This could be achieved by using approaches such as rotational outreach services.
- That the North West Tasmania Division of General Practice discuss with GPs in the region the possibility of co-locating support services, such a psychologists, within existing medical practices.
- That the North West Tasmania Division of General Practice develop professional development programs in collaboration with Centrelink, the Commonwealth Rehabilitation Service and other agencies. The purpose of this program would be to:
Increase GPs knowledge and understanding of agency functions and procedures;
- Develop professional links between GPs and agency staff;
- Provide information on policies affecting entitlements for non-employed middle aged men; and
- Formulate collaborative approaches which will better meet the needs of non-employed middle aged men.
- That the North West Tasmania Division of General Practice examines the possibility of funding a GP with specialist knowledge in the areas of disability, rehabilitation and worker's compensation legislation and procedures to act as a consultant and referral source for GPs in the region.
- That the North West Tasmania Division of General Practice develop a critical reference group comprising non-employed middle aged men. The purpose of this reference group is to provide ongoing evaluation and feedback on the issues specific to their needs.
Dissemination:
Resources:
Directory of Services
Lessons / Assessment:
The Division did not seek additional funding in Round Two. However, the evidence gained through this project would have added valuable knowledge for the Division to assist its members. |
