However, from 65 general recommendations, only two are specific to the provision of rural mental health services.

It is well-known regional and rural patients experience difficulty in accessing mental health services. Patients are faced with either staying locally and utilising more limited mental health services, or to leave behind support networks and travel.

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While considerable consultation occurred during the Royal Commission, the challenge for mental health service delivery remains implementation. In the words of National Rural Health Commissioner Dr Ruth Stewart: if you've been to one rural community, then you've been to one rural community. As such, it's imperative that solutions are developed in ongoing collaboration with those who understand each regional and rural community best, including local clinicians, consumers, and their families and carers.

However, there are a number of considerations relevant to the provision of mental health services for all regional and rural communities: Firstly, there has been a continuing lack of attention on the urgent need to increase psychiatry training pathways in rural areas despite significant evidence doctors are more likely to work in locations where they undertake their training. The best way to attract more psychiatrists to the regions in Victoria is to make it easier for them to train there in the first place.

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Secondly, the Royal Commission has recommended an extension of telehealth services for rural areas. While telehealth is undoubtedly a vital service, it should not be relied upon as the only means of service provision for rural patients as it does not address underlying workforce shortages. Thirdly, it is critical rural communities classified as Modified Monash Model 3-7 locations are prioritised when it comes to measures to improve the distribution of mental health services, not just our large regional cities.

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So, as we await the upcoming state budget, it is time for rural communities to demand their dues. We have an opportunity to set a precedent across the nation, becoming leaders for long-awaited change. And while it will be costly, we can't afford not to do it; because currently, it is regional and rural Victorians who are paying the price.

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