As Hawkesbury Nepean residents dealt with the upheaval of the region's latest flood disaster in July, the third such event in the space of just four months, Monica Kaoutal (pictured right) and her colleagues were busy mobilising.
For Nepean Blue Mountains rural counsellors, based in Windsor, disaster response has become the new normal in recent times. And for Monica, a senior psychologist and rural counsellor who commenced with the Towards Zero Suicides Enhancement to Rural Counselling initiative earlier this year, it's all she's known in the role.
Floods in March this year, were followed by subsequent major flooding events in April and July.
"I started in March and the very first week, the floods hit," she recalls. "With the first floods, we formed part of that Community Emergency Response Team (CERT), so we were consumed into that whole flood recovery work - initially at the evacuation centres and the recovery centre."
The repeated natural disasters have forced the service to shift focus away from regular outreach efforts and instead adapt to the immediate mental health needs of its continually displaced community.
"We already knew what we needed to get in place, so straightaway as soon as the latest floodwaters arrived here, there were rosters put out as to who could cover things - ready for when we would be asked to be there."
Having lived in the area her whole life, supporting her community on the ongoing emotional rollercoaster of trauma and recovery is very personal for Monica. And that local knowledge and understanding gives her a great deal of insight into the mindset and needs of those affected.
Among the greatest challenges, she says, has been overcoming the stigma and anxiety that many people in smaller communities still feel toward seeking, or being seen to be seeking, mental health care.
Despite so many affected people spending time in the evacuation and recovery centres, Monica noticed that many, including those who had been identified by other recovery services present on site as likely to benefit from counselling support, were reticent to attend her service desk to talk.
"They didn't want to be coming to the 'mental health tables'," Monica explains. But after removing the signage identifying their service desk and spending more time circulating the centre to approach individuals in less exposed settings, the tide quickly shifted.
"If there's one thing that this role can do it's to start breaking down that stigma in some of these rural communities that it's okay to ask for help," she says. "And the ones that did, even though they would initially say 'no, no I'm okay', after they came and they saw it wasn't so bad, they would tell us 'Actually this is helpful'".
One of the most common issues impacting flood affected locals has been the triggering nature of wet weather forecasts or rumours of worse rain events to come.
"There's a lot of heightened anticipatory anxiety in the community… a lot of people coming in saying things like 'they're predicting there'll be another flood in August and they're saying it's going to be even higher than this one'," Monica says.
"You can't be living in it and ruminating and worrying about these things - so it's about bringing them back to the mindset of thinking 'Okay, what do we need to do today, to help focus on what's going to help you today, and what's going on for you today'.
"Being prepared if the worst does occur, but you're not living and waiting for it to happen."
Rural Counselling is a NSW Heath Towards Zero Suicides initiative.
