Faculty Profile, People

The resiliency of rural communities

UBC Okanagan rural health researcher Nelly Oelke wants to understand how communities cope with natural disasters and provide guidance for enhancing rural mental health services

July 20, 2020

FLOODS AND FIRES HAVE BECOME COMMONPLACE IN CANADA and throughout the world, not only disfiguring idyllic landscapes, but leaving emotional scars as well. Add a pandemic threat to this mix and life may feel overwhelming for hard-hit rural communities.

Find out more about Nursing

Nelly Oelke, the daughter of an Alberta farmer, is all too familiar with how fickle Mother Nature can be and the impact she has on farming communities. Oelke recognizes that climate-driven feast or famine, combined with rural living and limited access to health services, can make rural communities vulnerable to a range of health issues.

“I spent many hours over the years caring for my elderly father, who continued living in a small town in rural Alberta,” says Oelke, an associate professor at UBCO’s School of Nursing. “Trying to access services and ensuring he was well looked-after was often a challenge. This experience fueled my interest and desire to improve the delivery of health services in rural communities.”

With this goal in mind, Oelke took a closer look at who lives in these areas and how they’re faring.

“The biggest demographic group in rural communities are individuals over the age of 50,” says Oelke. “Yet we have little information about their experiences, well-being or mental health concerns.”

To learn more, she embarked on an image and data collection process called Photovoice, in collaboration with then master’s student Lauren Airth and UBCO Associate Psychology Professor Carolyn Szostak. Rural community members with mental health concerns were the study participants and were asked to take photos that represented their outlook on life.

Common overarching themes in the photos and descriptions submitted by participants included mental well-being, loss, stigma, differing support services and personal environment.

“Photovoice allowed me to explore creative, unspoken elements of participants’ lives and analyze them in a meaningful way,” says Airth.

“These themes will help guide us in the development of future policy, education, health services and research recommendations,” says Airth. “One of our first suggestions is to provide specialized mental health care providers to the area.”

As a follow-up, Oelke, along with Master of Social Work student Ian Pryzdial, reached out to the Okanagan Men’s Shed Association (OKMSA), a non-profit society with a mandate to engage men (and women) who might otherwise be socially isolated. Pryzdial witnessed firsthand the bonding that occurs between members in the community, and noted that everyone keeps an eye on each other.

“At the shed we saw how the Okanagan’s aging population benefitted from these outreach programs. Consistent social interactions go a long way to help these individuals stay mentally, physically and emotionally fit,” he says.

“Through programs like this, we’re hopeful that rather than treating a mental health issue, we’re encouraging a proactive social environment,” adds Oelke. “We’re letting them know that it’s ok to be not ok.”

FLOODS AND FIRES

Over the last few years, back-to-back flooding combined with wildfires began changing the outlook of BC rural communities, an issue Oelke understood early on.

“It’s become harder to reach individuals. Our research participants, community members, and providers have told us that their mental health has been impacted by these events,” she says.

Wanting to support them but not knowing the best path forward, Oelke packed her bags, took a teaching leave and trekked to Orange, Australia, a small urban centre about 260 km east of Sydney. Like the Okanagan, the town experiences hot dry weather, drought and substantial fires.

During her time in Australia, Oelke met with researchers from the University of Newcastle’s Centre for Rural and Remote Mental Health, who shared their post-drought mental health insights and initiatives.

She also undertook a research review to identify community-based mental health interventions used in Canada and Australia to address mental wellbeing before, during and after natural disasters. Unfortunately, Oelke says, there aren’t many Canadian-based mental health programs specifically designed for these scenarios.

For Oelke, that means there needs to be continued advocation for greater mental health services and better understanding of the impacts of climate change in rural communities. As Scientific Director of the Rural Coordination Centre for BC (RCCbc) and in collaboration with her Australian colleagues, Oelke hopes to make strides in both areas.

“There is a great alignment with our research and the RCCbc’s mandate of improving rural health and health education,” adds Oelke. “I look forward to our joint ventures.”

PANDEMICS

If floods and fires aren’t enough of a challenge, the world was rocked by the COVID-19 pandemic in early 2020. Fighting a fire or abandoning a home due to flooding while also social distancing is almost too much to ask.

“We can’t ignore the mental health impact this pandemic will have on our rural communities,” says Oelke. “The double or triple whammy of all these events at the same time is very taxing.”

Oelke is particularly worried about the inequities experienced within these communities, which become magnified during a crisis.

“Some individuals can cope better because they have financial or social support.”

By bringing together various members of the community, including health and social care providers and community organization representatives, Oelke hopes to determine how to best address this.

“I’d like to help co-create action plans, solutions and set priorities,” she says. “The strength of rural communities is that they’re resilient; they have grit. I’m hopeful we can find ways to reinforce this foundation.”

Oelke looks forward to the day that mental health services and resources are readily available, well-used and accepted in rural communities.

“We need to work on front end to change mental wellbeing, not just during time of crises,” she says. “It’s only when this occurs that we’ll be able to say we’ve made a difference.”