S.TRUEMAN PhD THESIS 2016

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all the communities are remote; what matters is the degree of isolation. As demonstrated by one nurse participant describing the handling of a mental health patient at night: We treated people in the community, or they were taken to the nearest hospital, which was … 200 kilometres away. [T3, p. 6] Distance is not the sole determining factor. It also depends on the local topography between the communities and time of day or night. For example, the distance between Horn Island and Thursday Island in the Torres Strait is 3.6 km, but if a boat is not available, or the sea becomes untravelable, then distance becomes irrelevant in evacuating a mental health patient to the Thursday Island hospital. One remote nurse participant who works on an island in the Torres Strait, in addressing the topography between island communities—in this case, sea water—referred to evacuating mental health patients using ‘the chopper’ (helicopter) [T5, p. 18]. Hence the seawater topography between the island communities determines the means of transportation, namely a helicopter (or boat) and not a motor vehicle. Thus the degree of isolation is related to whether the means of transport is available and which among alternatives is the quickest. For example, the distance from Coober Pedy to Adelaide is 845.3 kilometres. If we consider evacuating a mental health patient to Adelaide in 1899 by horse and buggy, or by motor vehicle in 1980, or by aircraft in 2015, in this sense the time taken dictates the degree of isolation, despite the distance remaining a constant. Time of day or night is also a relevant consideration. Travelling at night in remote Australia is extremely hazardous due to nocturnal wildlife and stock, and conditions such as quality of roads and weather. As participant T5 stated: