Self-reported contacts for mental health problems by rural residents: predicted service needs, facilitators and barriers

• Published in: BMC psychiatry 2014-09, Vol.14 (1), p.249-249, Article 249
• Main Authors: Handley, Tonelle E, Kay-Lambkin, Frances J, Inder, Kerry J, Lewin, Terry J, Attia, John R, Fuller, Jeffrey, Perkins, David, Coleman, Clare, Weaver, Natasha, Kelly, Brian J
• Format: Article
• Language: English
• Subjects: Alcohol use; Analysis; Attitude to Health; Cross-Sectional Studies; Female; Health aspects; Health Services Needs and Demand; Health Status; Humans; Internet; Male; Medical societies; Mental disorders; Mental Disorders - psychology; Mental Disorders - therapy; Mental health; Mental Health Services - utilization; Mental illness; Middle Aged; New South Wales; Patient Acceptance of Health Care - psychology; Patient Acceptance of Health Care - statistics & numerical data; Psychiatric services; Psychiatry; Residence Characteristics - statistics & numerical data; Rural areas; Rural Health - statistics & numerical data; Self Report; Sociodemographics; Stigma
• ISSN: 1471-244X; 1471-244X
• DOI: 10.1186/s12888-014-0249-0

Rural and remote Australians face a range of barriers to mental health care, potentially limiting the extent to which current services and support networks may provide assistance. This paper examines self-reported mental health problems and contacts during the last 12 months, and explores cross-sectional associations between potential facilitators/barriers and professional and non-professional help-seeking, while taking into account expected associations with socio-demographic and health-related factors. During the 3-year follow-up of the Australian Rural Mental Health Study (ARMHS) a self-report survey was completed by adult rural residents (N = 1,231; 61% female; 77% married; 22% remote location; mean age = 59 years), which examined socio-demographic characteristics, current health status factors, predicted service needs, self-reported professional and non-professional contacts for mental health problems in the last 12 months, other aspects of help-seeking, and perceived barriers. Professional contacts for mental health problems were reported by 18% of the sample (including 14% reporting General Practitioner contacts), while non-professional contacts were reported by 16% (including 14% reporting discussions with family/friends). Perceived barriers to health care fell under the domains of structural (e.g., costs, distance), attitudinal (e.g., stigma concerns, confidentiality), and time commitments. Participants with 12-month mental health problems who reported their needs as met had the highest levels of service use. Hierarchical logistic regressions revealed a dose-response relationship between the level of predicted need and the likelihood of reporting professional and non-professional contacts, together with associations with socio-demographic characteristics (e.g., gender, relationships, and financial circumstances), suicidal ideation, and attitudinal factors, but not geographical remoteness. Rates of self-reported mental health problems were consistent with baseline findings, including higher rural contact rates with General Practitioners. Structural barriers displayed mixed associations with help-seeking, while attitudinal barriers were consistently associated with lower service contacts. Developing appropriate interventions that address perceptions of mental illness and attitudes towards help-seeking is likely to be vital in optimising treatment access and mental health outcomes in rural areas.