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Zirnsak T, Elwyn R, McLoughlan G, Le Couteur E, Green C, Hill N, Roberts R, Maylea C. "I have to fight for them to investigate things": a qualitative exploration of physical and mental healthcare for women diagnosed with mental illness. Front Public Health 2024; 12:1360561. [PMID: 38751585 PMCID: PMC11095107 DOI: 10.3389/fpubh.2024.1360561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Accepted: 04/12/2024] [Indexed: 05/18/2024] Open
Abstract
Introduction Women play a significant role in the management of their own healthcare and that of others, however women diagnosed with mental illness and physical health concerns experience significant health inequalities as compared to people living without mental health concerns. Methods In this paper, we reflect on the experiences of 20 cis women diagnosed with mental and physical health concerns who agreed to be a part of this research. This qualitative study is part of the larger Healthtalk Australia research project which was not gender specific. Female participants shared many experiences of mental and physical healthcare in interviews with researchers that pointed to the need for a gendered approach to addressing health inequalities. Consequently, we iteratively consolidated transcripts of interviews with participants into thematic categories facilitated by NVIVO 12. Results We identified two broad themes and a set of subthemes: in the doctor's office - experience of labelling; negotiating medications; and interactions with physical and mental health, and outside the doctor's office - responses to trauma, financial concerns, and reliance on participant's internal resources to get healthcare needs met. Discussion We conclude that participants in this study undertook significant work to manage their own healthcare needs, despite being challenged by clinicians and systems that failed to see them as whole people with expertise regarding their own health.
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Affiliation(s)
- Tessa Zirnsak
- Social Work and Social Policy, Department Clinical and Community Health, La Trobe University, Bundoora, VIC, Australia
| | - Rosiel Elwyn
- Neuroscience and Psychiatry, Thompson Institute, University of the Sunshine Coast, Birtinya, QLD, Australia
| | | | - Esther Le Couteur
- School of Global, Urban and Social Studies, RMIT University, Melbourne, VIC, Australia
| | - Chloe Green
- Department of English, Drama and Film, University College Dublin, Dublin, Ireland
| | - Nicholas Hill
- School of Global, Urban and Social Studies, RMIT University, Melbourne, VIC, Australia
- School of Social and Political Sciences, University of Melbourne, Melbourne, VIC, Australia
| | - Russell Roberts
- School of Business, Charles Sturt University, Bathurst, NSW, Australia
| | - Chris Maylea
- School of Law, La Trobe University, Melbourne, VIC, Australia
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Mutsvairo B, Terry D, Peck B. This Bloke Who Helps Me With My Tractor, He's Been the Best Psychologist: The Experience of Seeking Mental Health Support in Rural Australia. Am J Mens Health 2024; 18:15579883241249103. [PMID: 38686846 PMCID: PMC11062228 DOI: 10.1177/15579883241249103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Revised: 03/06/2024] [Accepted: 04/04/2024] [Indexed: 05/02/2024] Open
Abstract
Mental illness is difficult to discuss among men due to notions of remaining tough, being a man, and societal expectations. In rural communities this is particularly evident which is further exacerbated by poor health care access. The aim of this study is to understand the lived experiences of men and their significant others when seeking mental health support in rural areas. A qualitative study was conducted using purposeful sampling. Data were collected using semi-structured interviews in rural or regional areas of Australia. Open-ended questions were asked but more questions were developed from the responses given. Data analysis was conducted using thematic analysis. Four key themes emerged. These encompassed triggers and help-seeking caused by stressors such as work, family, and poor physical health, with support seeking from professional or informal supports. The second theme included challenges securing professional support appointments, while the third was centered on access to medication and travel time. Finally, the final theme encompassed relationships being impacted by poor mental health or created insights into the need to seek help. The experiences explored throughout this study highlight that as men are impacted, so too are married or romantic partners and children; however, they are the catalyst for help-seeking. The study further highlights even when men are psychologically prepared to seek help, it may be difficult to do so. Improving access goes beyond mere medical professionals in rural areas and must focus on supporting families and loved ones to support men.
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Affiliation(s)
- Brenda Mutsvairo
- School of Nursing and Midwifery, University of Southern Queensland, Ipswich, Queensland, Australia
| | - Daniel Terry
- School of Nursing and Midwifery, University of Southern Queensland, Ipswich, Queensland, Australia
- Institute of Health and Wellbeing, Federation University, Mt Helen, Victoria, Australia
- Centre for Health Research, University of Southern Queensland, Ipswich, Queensland, Australia
| | - Blake Peck
- Institute of Health and Wellbeing, Federation University, Mt Helen, Victoria, Australia
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Green CR, Elwyn R, Hill N, Johnston-Ataata K, Kokanović R, Maylea C, McLoughlan G, Roberts R, Thomas SDM. A critical review of research into mental health consumers' perspectives on their physical health: Is there an absence of consumers in the design, conduct, analysis and reporting of this research? Front Public Health 2023; 10:982339. [PMID: 36814954 PMCID: PMC9939465 DOI: 10.3389/fpubh.2022.982339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 12/28/2022] [Indexed: 02/08/2023] Open
Abstract
We conducted a critical review, using systematic methods, of the literature examining mental health consumer perspectives on their physical and mental health in academic research published between 2005 and 2021. This review examined the inclusion, extent, type and centrality of consumer perspectives regarding their mental and physical health. The search produced 1,865 papers from which 116 met the inclusion criteria. Studies predominantly focused on consumers' individual experiences of their physical and mental health, including but not limited to their understandings and experiences of medication and associated risk factors. They also captured some social aspects of mental health consumers' physical health, including factors that impacted individual agency, stigma, and social and interpersonal factors. Structural factors affecting physical and mental health, such as accessibility of services and financial constraints, were also identified. The review revealed that in comparison to clinician perspectives, the direct representation of consumer perspectives was lacking. Similarly, while clinician and carer perspectives on structural factors were investigated, the consumer perspective in this area was missing. The review also found few genuine codesigned or coproduced research studies. To better identify and respond to the health needs as prioritized by consumers, this paper argues it is imperative that future studies prioritize codesigned and coproduced research. It is argued that a focus on "services as provided" rather than "services as received" has contributed to a lack of progress in addressing the life expectancy gap for consumers. It is recommended that journals, ethics committees and research policy organizations develop guidelines and standards to inform best practice in research on consumer perspectives and experience and to support the implementation of codesigned and/or coproduced approaches in future research. Respecting and including consumers as equal partners in the research process will lead to more meaningful insights to inform policy and practice and reduce the life expectancy gap for people living with mental health concerns.
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Affiliation(s)
- Chloe R. Green
- School of Law, La Trobe University, Melbourne, VIC, Australia
| | - Rosiel Elwyn
- Psychology and Social Sciences, University of the Sunshine Coast, Maroochydore, QLD, Australia
| | - Nicholas Hill
- School of Social and Political Sciences, The University of Melbourne, Parkville, VIC, Australia
| | - Kate Johnston-Ataata
- School of Global, Urban and Social Studies, RMIT University, Melbourne, VIC, Australia
| | - Renata Kokanović
- School of Global, Urban and Social Studies, RMIT University, Melbourne, VIC, Australia
| | - Chris Maylea
- School of Law, La Trobe University, Melbourne, VIC, Australia
| | - Grace McLoughlan
- School of Global, Urban and Social Studies, RMIT University, Melbourne, VIC, Australia
| | - Russell Roberts
- School of Business, Charles Sturt University, Bathurst, NSW, Australia
| | - Stuart D. M. Thomas
- School of Global, Urban and Social Studies, RMIT University, Melbourne, VIC, Australia
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Doan T, Ha V, Strazdins L, Chateau D. Healthy minds live in healthy bodies – effect of physical health on mental health: Evidence from Australian longitudinal data. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-022-03053-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
AbstractIt is well known that physical and mental health are closely related, with growing evidence for biological and behavioural pathways. Mostly the research has focussed on mental health as the key driver of this inter-connection; the extent physical health shapes mental health has received less attention. We aim to derive robust estimates of the unique role physical health may play in shaping mental health outcomes. To do so we use a novel approach, incorporating longitudinal and instrumental variable methods which can address the reciprocal relationship between physical and mental health, and the endogeneity of physical health, before estimating the physical to mental health pathway. A sample of 209,442 observations (or 24,966 unique individuals) aged 15 and over spanning 18 years (2002–2019) was extracted from the Household Income and Labour Dynamics in Australian Survey (HILDA). We find that physical activity and health shocks erode mental health via their impact on physical health with a one point improvement (or worsening) in physical health scores (0–100) resulting in a rise (or decline) of 0.43 points (or 43%) in mental health score.
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Crisan C, Van Dijk PA, Oxley J, De Silva A. Worker and manager perceptions of the utility of work-related mental health literacy programmes delivered by community organisations: a qualitative study based on the theory of planned behaviour. BMJ Open 2022; 12:e056472. [PMID: 35351719 PMCID: PMC8961141 DOI: 10.1136/bmjopen-2021-056472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVES Reluctance to seek help is a leading contributor to escalating mental injury rates in Australian workplaces. We explored the benefit of using community organisations to deliver mental health literacy programmes to overcome workplace barriers to help-seeking behaviours. DESIGN This study used a qualitative application of the theory of planned behaviour to examine underlying beliefs that may influence worker's intentions to participate in mental health literacy programmes delivered by community organisations and manager support for them. SETTING This study took place within three large white-collar organisations in the Australian state of Victoria. PARTICIPANTS Eighteen workers and 11 managers (n=29) were interviewed to explore perspectives of the benefits of such an approach. RESULTS Community organisations have six attributes that make them suitable as an alternative mental health literacy programme provider including empathy, safety, relatability, trustworthiness, social support and inclusivity. Behavioural beliefs included accessibility, understanding and objectivity. The lack of suitability and legitimacy due to poor governance and leadership was disadvantages. Normative beliefs were that family and friends would most likely approve, while line managers and colleagues were viewed as most likely to disapprove. Control beliefs indicated that endorsements from relevant bodies were facilitators of participation. Distance/time constraints and the lack of skills, training and lived experiences of coordinators/facilitators were seen as barriers. CONCLUSIONS Identifying workers' beliefs and perceptions of community organisations has significant implication for the development of effective community-based strategies to improve worker mental health literacy and help seeking. Organisations with formal governance structures, allied with government, peak bodies and work-related mental health organisations would be most suitable. Approaches should focus on lived experience and be delivered by qualified facilitators. Promoting supervisor and colleague support could improve participation. Models to guide cross-sector collaborations to equip community organisations to deliver work-related mental health literacy programmes need to be explored.
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Affiliation(s)
- Corina Crisan
- Monash Sustainable Development Institute, BehaviourWorks Australia, Monash University, Melbourne, Victoria, Australia
| | | | - Jennie Oxley
- Monash University Accident Research Centre, Monash University, Melbourne, Victoria, Australia
| | - Andrea De Silva
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
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Effectiveness and Benefits of Exercise on Older People Living With Mental Illness’ Physical and Psychological Outcomes in Regional Australia: A Mixed-Methods Study. J Aging Phys Act 2022; 31:417-429. [DOI: 10.1123/japa.2021-0514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 08/22/2022] [Accepted: 08/25/2022] [Indexed: 11/06/2022]
Abstract
Regular exercise is reported to improve depressive symptoms and quality of life for people experiencing mental illness. For older adults, including strength and balance can also decrease falls. Mental health services seldom include funding for Accredited Exercise Physiologist programs. A 9-week Accredited Exercise Physiologist-led program for older adults receiving mental health treatment with a community Older People’s Mental Health Service was trialed in regional Australia. This clinician-conceived small-scale feasibility study utilized a two-phase concurrent triangulation mixed-method design to evaluate physical and psychological program outcomes and identify factors related to engaging in physical activity. This tailored exercise program led to improvements in measures of psychological distress and physical and psychological function. These changes corresponded with participants identifying benefits of exercising as a group of adults living with mental illness. Such findings suggest a supervised, individualized program for older mental health consumers confers physical and psychological benefits; however, further research evaluating exercise interventions with this population is required.
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Younker T, Radunovich HL. Farmer Mental Health Interventions: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 19:ijerph19010244. [PMID: 35010504 PMCID: PMC8751007 DOI: 10.3390/ijerph19010244] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 12/22/2021] [Accepted: 12/23/2021] [Indexed: 01/09/2023]
Abstract
The prevalence of mental health disorders and suicide amongst agricultural producers is a global problem. Community leaders, researchers, policymakers, and clinicians have mobilized to develop programs to address this issue. This study reviewed a wide range of mental health interventions targeting farmer mental health spanning over 50 years and examined their reported effectiveness and constraints. A total of ninety-two articles on farmer mental health were included in a final systematic review. Most articles were written concerning mental health literacy and peer and paraprofessional support interventions in the United States and Australia. Among the 56 studies reporting empirical evaluative data, 21 were mixed-method, 20 quantitative, 11 qualitative, and 5 literature synthesis. Non-experimental, self-reported, and qualitative data suggest efficacy of mental health literacy programs, peer and paraprofessional support, and community-based and agroecological interventions. However, most interventions were not subject to rigorous evaluation and only one intervention was evaluated using a control condition. The heterogeneity of existing studies and paucity of rigorous evaluation proscribes firm conclusions related to program-type efficacy. This review demonstrates that there is still a need for a stronger and broader evidence base in the field of farmer mental health interventions, which should focus on both holistic, multi-component programs and targeted approaches.
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Roberts R. A rural health governance model that is fit for purpose-It's not them and us: It's 'we'. Aust J Rural Health 2021; 29:816-820. [PMID: 34881471 DOI: 10.1111/ajr.12830] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Roberts R. Free speech costs: Public health policy and leadership matters. Aust J Rural Health 2021; 29:4-6. [PMID: 33631051 DOI: 10.1111/ajr.12729] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
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Roberts R, Jones M, Mills D, Gray R. Special issue: Enhancing physical well-being in people with mental illness living in rural and remote communities. Aust J Rural Health 2021; 28:104-106. [PMID: 32390208 DOI: 10.1111/ajr.12624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Affiliation(s)
| | - Martin Jones
- Department of Rural Health, University of South Australia, Adelaide, SA, Australia
| | - David Mills
- Adelaide Rural Clinical School, University of Adelaide, Adelaide, SA, Australia
| | - Richard Gray
- School of Nursing and Midwifery, La Trobe University, Melbourne, Vic., Australia
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11
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Lewis C. Rethinking access for minority segments in rural health: An LGBTQI+ perspective. Aust J Rural Health 2020; 28:509-513. [PMID: 32985013 DOI: 10.1111/ajr.12660] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 07/02/2020] [Accepted: 07/19/2020] [Indexed: 01/12/2023] Open
Abstract
This paper nuances the notion of access when considering minority segments and their use of health care services in rural communities. It argues that access needs to be considered as both the availability and the perceived ability to use a service without fear of retribution. By taking such a stance, this paper addresses the inequality in LGBTQI+ care in rural communities. It claims equitable care can only be achieved if the appropriate environment is created where individuals can disclose their identity and seek appropriate treatment. Given the complexity surrounding rural communities, their prevailing culture and perceptions, as well as stigmas and poor health outcome, a multilevel approach is taken to identify implications. It is argued that to address the individual and systemic barriers to equitable health care, a human rights-centred approach to health needs to be adopted considering the individual, the community and the health system.
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Affiliation(s)
- Clifford Lewis
- School of Management and Marketing, Charles Sturt University, Bathurst, NSW, Australia
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12
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Abstract
PURPOSE OF REVIEW This review of the literature examines the most recent advances in the battle to improve the physical health of people with severe mental illness. Covering the 2018/2019 time period, the article offers a glance of future healthcare models and research directions. RECENT FINDINGS A systematic search of the PubMed and Cochrane databases, along with additional journal articles available online but not yet allocated to a journal edition, produced a total of 24 journal articles suitable for review. The review period was from January 2018 to December 2019. The four main themes of investigation, intervention, integration and training emerged. SUMMARY The uptake and integration of primary care into mental health services for people with SMI is still facing many barriers. Healthy lifestyle and physical activity interventions need to run alongside medical treatment for both mental and physical health in order to provide holistic care. To do this, clarification of professional roles and responsibility need to be defined and adhered to, along with additional training for staff and coordination of services.
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Mills D. Can we manage mental health and cardiovascular risk in rural communities? Aust J Rural Health 2020; 28:120-121. [DOI: 10.1111/ajr.12612] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Revised: 02/25/2020] [Accepted: 02/26/2020] [Indexed: 11/30/2022] Open
Affiliation(s)
- David Mills
- Discipline of Rural Health Adelaide Rural Clinical School Ringgold Standard Institution Adelaide SA Australia
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Mehmet M, Roberts R, Nayeem T. Using digital and social media for health promotion: A social marketing approach for addressing co-morbid physical and mental health. Aust J Rural Health 2020; 28:149-158. [PMID: 31970832 DOI: 10.1111/ajr.12589] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Revised: 09/17/2019] [Accepted: 09/30/2019] [Indexed: 01/20/2023] Open
Abstract
OBJECTIVE This study examines consumer engagement with a social marketing digital media strategy designed to support the implementation of Equally Well-a program to improve the physical health of people living with mental illness. DESIGN A four-stage strategic analysis and intervention mix were used as the theoretical framework to assess stakeholder needs and to evaluate the effectiveness of the intervention. SETTING Online and digital media. PARTICIPANTS Mental health consumers, carers, clinicians and service managers. INTERVENTIONS A digital media, social marketing intervention to support those seeking to improve the physical health of people living with mental illness. The strategy was developed using a co-design methodology and provided links to self-care resources, access to service providers, clinical tools for health professionals and links to existing successful rural programs. MAIN OUTCOME MEASURES The main outcome measures were the number of people from each category accessing the media, making connections and downloading resources. RESULTS The program has resulted in more than 24 500 website hits per annum, 3500 tweets and 14.5 million Twitter impressions with good bounce and download rates. The analysis suggested the materials were mostly used by clinicians and service managers using desktop computers. CONCLUSIONS Using a co-design approach, the study demonstrated the potential of a social marketing digital media strategy as a health promotion methodology. The paper has provided a framework for implementing and evaluating the effectiveness of digital social media campaigns that can help consumers, carers, clinicians and service planners address the challenges of rural health service delivery and the tyranny of distance.
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Affiliation(s)
- Michael Mehmet
- University of Wollongong, Wollongong, NSW, Australia.,Charles Sturt University, Bathurst, NSW, Australia
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Ennals P, Muchamore I, Langan V, Hall C, Wolstencroft K. Active8: Promoting health beyond the absence of mental illness. Aust J Rural Health 2020; 28:215-217. [PMID: 31943491 DOI: 10.1111/ajr.12576] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Revised: 08/13/2019] [Accepted: 09/01/2019] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVE We sought to understand and develop the critical elements of a program designed to promote physical health for people living with or experiencing mental illness. DESIGN The study used a most significant change approach. Participants provided personal accounts of change, and these were analysed in a workshop with a range of stakeholders involved in program design and delivery. Core themes were identified to inform the development of the program. SETTING The program is delivered by a community managed organisation in the South Eastern Illawarra region of New South Wales and the study took place in this setting. PARTICIPANTS Participants included people who had accessed the Active8 program, staff who delivered the program, referrers and the funder of the program. MAIN OUTCOME MEASURES Participants were invited to share stories of how the Active8 program had impacted them or the people they were supporting. RESULTS Five key themes were identified as being critical to program success and development: (a) the right start at the right time; (b) a program that fits me; (c) health literacy leads to agency, action and change; (d) a chance to explore and establish healthy connections; and (e) change requires time, focus and ongoing support. CONCLUSION Approaches that steer away from simple advice giving and towards empowering and motivating people in line with their individual needs, aspirations and social context show potential for enhancing health-behaviour change.
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Affiliation(s)
| | - Ian Muchamore
- Swinburne University of Technology, Hawthorn, Vic., Australia
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Roberts R. Researching for better health for regional and rural Australians? Aust J Rural Health 2019; 27:474-475. [DOI: 10.1111/ajr.12597] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Stanton R, Rebar AL, Rosenbaum S. Supporting better mental health services for rural Australians: Secondary analysis from the Australian National Social Survey. Aust J Rural Health 2019; 28:122-123. [PMID: 31621117 DOI: 10.1111/ajr.12551] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Revised: 06/14/2019] [Accepted: 06/29/2019] [Indexed: 10/25/2022] Open
Affiliation(s)
- Robert Stanton
- School of Health, Medical and Applied Sciences, Central Queensland University, Rockhampton, Queensland, Australia.,Appleton Institute, Central Queensland University, Adelaide, South Australia, Australia
| | - Amanda L Rebar
- School of Health, Medical and Applied Sciences, Central Queensland University, Rockhampton, Queensland, Australia.,Appleton Institute, Central Queensland University, Adelaide, South Australia, Australia
| | - Simon Rosenbaum
- School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia.,Black Dog Institute, Sydney, New South Wales, Australia
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Jackson K, Roberts R, McKay R. Older people's mental health in rural areas: Converting policy into service development, service access and a sustainable workforce. Aust J Rural Health 2019; 27:358-365. [PMID: 31233258 DOI: 10.1111/ajr.12529] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Revised: 03/19/2019] [Accepted: 05/07/2019] [Indexed: 01/22/2023] Open
Abstract
This paper describes the older people's mental health workforce development, policy development and implementation process and quantifies the rural service delivery and access impacts over a 15-year period in New South Wales. It highlights the factors that are considered to be critical to successful rural service development such as commitment to funding parity, investment in strong local service leadership, and development of innovative, locally adapted rural service models. Building on these foundations, the Older People's Mental Health Program in New South Wales was able to address key challenges relating to service access in rural health and develop new, sustainable specialist older people's mental health service networks. A sustained focus on policy and implementation which explicitly supports rural older people's mental health service enhancement, and development of evidence-based models of care, has significantly improved access to specialist mental health care for older people in rural areas. It has delivered 23 new rural older people's mental health community teams and a 440% increase in the number of people accessing these teams. It has also doubled the number of acute inpatient units and established new specialist mental health-residential aged care partnership services in rural New South Wales. It has resulted in increased access to services for the "older old," while not diminishing older people's rates of access to general adult mental health services. It has also supported innovative, sustainable rural service models such as "hub and spoke" models and step-up step-down inpatient services that build on existing health and hospital infrastructure and link geographically dispersed specialist clinicians and services together in rural service delivery.
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Affiliation(s)
- Kate Jackson
- Older People's Mental Health Policy Unit, NSW Ministry of Health, Orange, New South Wales, Australia
| | - Russell Roberts
- Faculty of Business, Justice and Behavioural Sciences, Charles Sturt University, Bathurst, New South Wales, Australia.,University of Sydney, School of Rural Health, Broken Hill, New South Wales, Australia
| | - Roderick McKay
- HETI Higher Education, Health Education and Training Institute, Sydney, New South Wales, Australia.,School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia
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Roberts R. Vale Bob Hawke: What impact has Medicare had on rural Australia? Aust J Rural Health 2019; 27:194-195. [DOI: 10.1111/ajr.12532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Affiliation(s)
- Russell Roberts
- Charles Sturt University; Bathurst New South Wales Australia
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Roberts R. Doing rural health collectively: Amplifying impact. Aust J Rural Health 2019; 27:116-117. [DOI: 10.1111/ajr.12515] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Roberts R. Rural health advocacy: The gaps, strategies and lessons. Aust J Rural Health 2018; 26:382-383. [PMID: 30556361 DOI: 10.1111/ajr.12492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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