In 2007, a man ended his life in the hospital's emergency department which led to an inquest in 2009.

In 2012, another inquest was conducted into the death of a patient who also committed suicide at the Wagga Base Hospital.

In 2017, the ABC reported a Riverina woman described in a public submission how she was stripped of her clothes, drugged to a dangerous level and unfairly isolated at a Wagga mental health unit during public forums into seclusion and restraint practices in NSW mental health units.

Now in 2019, how have services in the Riverina evolved? Is it enough? And, what are the next steps to ensure residents in the region can access the services they need?

Murrumbidgee Local Health District's chief executive Jill Ludford said in recent years they have focused its efforts on improving the safety and quality of care provided to acute and non-acute mental health patients across the region.

"In 2018 to 2019, MLHD invested $43.930 million to provide a range of NSW Health-funded public mental health services in hospitals (inpatient services) and in the community (specialist community mental health services)," she said.

"We have streamlined and improved follow-up care to consumers after they leave the mental health unit.

"MLHD is currently achieving 81.7 per cent of discharged patients followed-up within seven days, exceeding the NSW Health target of 70 per cent."

Ms Ludford said their ongoing challenge is to increase awareness of how people can access mental health services, particularly in a crisis.

Ms Ludford said MLHD has implemented all 19 recommendations from the 2017 NSW Health Review of seclusion, restraint and observation of consumers with a mental illness in NSW Health facilities.

One which stated that all acute mental health units and declared emergency departments should conduct a review of their facilities and implement minor capital works and equipment purchases to improve the therapeutic potential.

"We collaborate with consumers, families and carers to reduce occasions of seclusion and restraint, with a Creating Positive Cultures team formed including a peer worker and consumer and carer representatives," Ms Ludford said.

"MLHD has a full range of public psychiatry services available in the Wagga inpatient unit and communities across the district.

"These include psychiatrists who specialise in Child and Adolescent, Adult and Older Persons Mental Health issues."

Ms Ludford said technology is being used to improve access.

"MLHD uses videoconferencing widely, particularly for the Mental Health Emergency Consultation Service," she said.

"MHECS operates out of Wagga with skilled mental health clinicians providing mental health assessments to people in district hospital Emergency Departments via video conference.

"Once assessed, the clinician consults with the on-call psychiatrist about the person's ongoing needs.

Ms Ludford said video conferencing is also used for some community psychiatry clinics and for some community mental health clinical service provision.

"The new NSW Health electronic medical record system allows clinicians to have real-time access to a consumer's record when required for assessment and treatment," she said.

Ms Ludford said the Wagga Mental Health Unit, opened in 2013, has won two awards at the 2018 NSW Health Awards.

"In the 2018 Mental Health Consumer Experience of Service, MLHD's Mental Health and Drug and Alcohol Service was the only local health district to achieve a green light across the three domains of community, hospital and overall mental health care," she said.

A 28-year-old woman recently moved to Wagga for a new job and was dumbfounded by the difference in mental health faculties compared to Sydney.

Her father was diagnosed with bipolar when she was five and that had a knock-on effect to the rest of her family.

"My family saw five or six different therapists," she said.

"My family would have not coped in Wagga because there is not enough for people to avoid any crossovers.

"I would be much more frightened about people finding out. It is so much easier to be anonymous in the city."

The 28-year-old said she understood Skype could be used as a way to seek help, but that it was not the same.

"When you are trying to go at the beginning, it takes the smallest thing to put it off," she said.

"You need to feel in a safe space to feel comfortable."

Amanda Underwood, a consumer advocate for the MHLD, said the biggest issue in providing mental health treatments is the size of the local health district.

"From that, you have issues if someone presents at Lake Cargelligo emergency then their initial consult is going to be on a TV screen and then you have the issues of getting them to Wagga if it's decided they should go to the mental health unit," she said.

"Then you also have the distance of family and carers for them to distance and whether or not they have holiday leave and the finances.

"You need to have people supporting you to make that journey just that little less stressful."

Ms Underwood represents patients and their needs when it comes to shaping policies and legislation to make sure they are still treated as people.

She said for anyone in the Riverina who is more than 45 minutes away from Wagga, it is just that bit harder to have a successful and positive outcome.

"A lot of people might not also think about this, but not being able to smoke is a concern," Ms Underwood said.

"Eighty-five per cent of people who are mental health consumers are smokers and there is a no smoking policy and for some, it helps them with anxiety.

"We offer nicotine replacement therapy, which works to a degree but doesn't always cut it."

While working with patients, Ms Underwood said another common issue that arises is housing such as wanting to move from current residences, homelessness and financial issues are also common.

Ms Underwood said there restrictions on the unit, which they try to keep to a minimum, for the wellbeing of the patient.

"It is a locked unit so consumers along with their treating team discuss when it is appropriate for them to have leave from the unit," she said.

"There are also times for the TV and phones and meals which are about supporting consumers to regain healthy sleep, eating and physical habits."

Ms Underwood said sometimes people might not have clothes if they have come through the emergency.

"We do have a provision of new clothes to help alleviate that a bit," she said.

"People also are worried about their pets if they have no one to feed them, but there are some businesses who will go to homes and check on pets."

Ms Underwood said consumers have to be treated on an individual basis as it's not a one size fits all.

"Other things we do on the unit to assist consumer in their recovery are education groups run by doctors, pharmacists and psychologists," she said.

"We also have a good partnership with Wellways who support consumers to go on outings in the community and we also have a good partnership with a personal trainer who comes to the unit to assist consumers with their physical wellbeing which is connected to your mental wellbeing."

Riverina Medical Specialist Recruitment and Retention Committee chair, associate professor Nick Stephenson, said the next step is to look at ways of attracting local residents.

Dr Stephenson said at the moment, the region relies on fly in fly out psychiatrists while there is one permanent resident and another who spends a third of their time here.

"They have an overall positive effect," he said.

"We need them and they're essential because we don't have enough local residents psychiatrists workforce to provide all the services required.

"Obviously, it would be better if more, or all, could be local residents."

Dr Stephenson said building a base of more residents would take some time.

"So many people nowadays seem to fly to work, whether it be doctors or miners," he said.

"It's not unique and it's a trend that won't go away, it's a societal norm almost.

"In terms of medical services, it is always better if you can have local residents because they're able to do 24-hour a day calls."

Dr Stephenson said there is a world of difference in having local doctors.

"They can do calls, mentor students, get involved in medical education and committees as well as getting involved in the broader community such as spending money in the area," he said.

"The Riverina Medical Specialist Recruitment and Retention Committee is always looking at ways we can increase local residents.

"It's our reason for existing."

Dr Stephenson said research shows doctors will work in the same areas they study in so the next plan of action is to attract more students to regional and rural areas.

Accessline (1800 800 944) provides 24 hour/7 day per week support, advice and referral to mental health and drug and alcohol services for people anywhere within MLHD.

The Alliance is developing an interactive online map to help people, including community members and health professionals, to easily access information on services.

If you need help: beyondblue 1300 224636; Lifeline 13 11 14