S.TRUEMAN PhD THESIS 2016

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They [mental health patients] stay overnight until the chopper comes in the morning, because it is quite dangerous. Flying out at night time. [p. 24] Another participant stated in relation to a night time road evacuation of a mental health patient to a community 200 km away: You [remote nurses] can’t drive at night because it’s too dangerous … Then its unfenced cattle at night on the road … Unsealed roads at night you can’t see the next dust bowl and they’ll flip your car. [T28, p. 7] We don’t drive at night up here because of the risk of animal strike, with big cows and roos. [T4, p. 7] Accordingly, if a mental health patient can only be evacuated during daylight, then the hours of night time result in a degree of isolation. The difference between a daytime and nighttime mental health patient presentation requiring evacuation, in a practical sense, results in the community with the night time presentation being more ‘isolated’. Perversely, if the two presentations were to occur in the same community the degree of isolation becomes temporal, as the distance to the evacuation destination does not change. Weather is included in the ‘geographical elements’ section because weather patterns can be localised. In Far North Queensland, Northern Territory (the ‘Top End’) and Western Australia, there are annual periods (months) referred to as the ‘wet season’ (November to April). During this season, the annual level of precipitation is concentrated in tropical downpours and rainstorms which deluge communities, and combined with unpredictable cyclonic activity, results in communities being inaccessible, as roads (usually unsealed) become untraversable. As one nurse participant stated: