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Ali AK, Barua A, Mehta R, Chandra-Mouli V. Nimble adaptations to sexual and reproductive health service provision to adolescents and young people in the early phase of the COVID-19 pandemic. Sex Reprod Health Matters 2024; 32:2372165. [PMID: 39046452 PMCID: PMC11271125 DOI: 10.1080/26410397.2024.2372165] [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] [Indexed: 07/25/2024] Open
Abstract
Early in the COVID-19 pandemic, emerging evidence showed that the provision and use of a range of health services, including sexual and reproductive health (SRH) services, were affected. Otherwise, there was little evidence on whether and how they were adapted to maintain the access of different population groups, including adolescents. The study aims to provide an overview of adaptations to adolescent sexual and reproductive health (ASRH) services carried out during the early phases of the pandemic in low- and middle-income countries (LMICs). The Human Reproduction Program (HRP) at the World Health Organization (WHO) called upon WHO and United Nations Populations Fund (UNFPA) regional offices to reach out to organisations that provided ASRH services to submit analytic case studies using a short-form survey. The study team charted information from 36 case studies and performed a content analysis. Results show that the adaptations covered a wide array of SRH services that were provided to a diverse group of adolescents. Most adaptations focused on SRH education and access to contraception in comparison to other SRH services. Over half of the case studies included mental health services, most of which were not provided before the pandemic. The adaptations varied between being face-to-face, remote, digital, and non-digital. Most adaptations complemented a pre-existing service and were nimble, feasible, and acceptable to the targeted adolescents. Lessons learned from this study could be extrapolated into other humanitarian settings and rapid responses for future public health emergencies, provided that rigorous evaluation takes place.
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Affiliation(s)
- Ahmed K Ali
- Adolescent Sexual and Reproductive Health Consultant, Department of Sexual and Reproductive Health Research which includes the UNDP, UNICEF, UNFPA, WHO and World Bank cosponsored Human Reproduction Programme, Cairo, Egypt. Correspondence:
| | | | - Rajesh Mehta
- Formerly, Regional Adviser, Adolescent Health, WHO South East Asia Regional Office; Currently Independent Expert, New Delhi, India
| | - Venkatraman Chandra-Mouli
- Formerly, Scientist, Department of Sexual and Reproductive Health Research which includes the UNDP, UNICEF, UNFPA, WHO and World Bank cosponsored Human Reproduction Programme; Currently Independent Expert, Switzerland
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Mallise C, Wall L, Paolucci F, Davies K, La Hera Fuentes G, Wilson J, Tickner C, Kay-Lambkin F, Heinsch M. Virtual Service Delivery in Mental Health and Substance Use Care: A Systematic Review of Preference Elicitation Studies. Community Ment Health J 2024:10.1007/s10597-024-01350-y. [PMID: 39269570 DOI: 10.1007/s10597-024-01350-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2024] [Accepted: 08/19/2024] [Indexed: 09/15/2024]
Abstract
Mental health and substance use disorders affect the lives of many people worldwide. Prevention and treatment of these conditions is important for optimal health and wellbeing, yet service access barriers are common. Virtual models of care may help to reduce barriers to receiving care. However, to facilitate uptake and use of virtual services, they need to appeal to patients and clinicians. This systematic review aimed to synthesise preference elicitation studies to determine what features of virtual mental health and substance use care are preferred by service users and service providers. Following the PRISMA guidelines for systematic reviews, we searched PubMed, PsycINFO, EconLit, MEDLINE, CINAHL, Academic Search Ultimate, and ProQuest Central for all available studies from database inception until May 2023. The Mixed Methods Appraisal Tool was used to assess the methodological quality of included studies. Nineteen studies met the eligibility criteria. However, none examined preferences for elements of different models of virtual care. Across the included studies, we identified 41 unique features that mapped to four themes of mental health and substance use care ('service', 'treatment', 'clinician' and 'additional supports'). Participant preferences were for individual, in-person, effective, flexible, and low-cost treatment. These preferences varied based on demographic factors, such as culture, gender, and participant type (e.g., patients, clinicians, general population). A user-centred approach should be adopted when designing and implementing mental health and substance use services. While preferences for features of mental health and substance use services more broadly are known, preferences for different models of virtual care remain unexplored. Future research should examine what features of virtual services would lead to optimal uptake and use across different users and stakeholders.
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Affiliation(s)
- Carly Mallise
- Population Health, Hunter New England Local Health District, Wallsend, NSW, 2287, Australia.
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, 2308, Australia.
- Hunter New England Population Health, Longworth Avenue, Wallsend, NSW, 2287, Australia.
| | - Laura Wall
- School of Psychological Sciences, University of Newcastle, Callaghan, NSW, 2308, Australia
| | - Francesco Paolucci
- Newcastle Business School, University of Newcastle, Callaghan, NSW, 2308, Australia
- Department of Sociology and Business Law, University of Bologna, Bologna, BO, 40126, Italy
| | - Kate Davies
- Homelessness NSW, Woolloomooloo, NSW, 2011, Australia
- School of Humanities, Creative Industries and Social Sciences, University of Newcastle, Callaghan, NSW, 2308, Australia
| | - Gina La Hera Fuentes
- Newcastle Business School, University of Newcastle, Callaghan, NSW, 2308, Australia
| | - Jessica Wilson
- Brain and Mind, Murdoch Children's Research Institute, Parkville, VIC, 3052, Australia
- School of Social Work, University of Tasmania, Hobart, TAS, 7005, Australia
| | - Campbell Tickner
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, 2308, Australia
| | - Frances Kay-Lambkin
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, 2308, Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW, 2305, Australia
| | - Milena Heinsch
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, 2308, Australia
- School of Social Work, University of Tasmania, Hobart, TAS, 7005, Australia
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Prior K, Baillie AJ, Newton N, Lee YY, Deady M, Guckel T, Wade L, Rapee RM, Hudson JL, Kay-Lambkin F, Slade T, Chatterton ML, Mihalopoulos C, Teesson MR, Stapinski LA. Web-based intervention for young adults experiencing anxiety and hazardous alcohol use: Study protocol for an 18-month randomized controlled trial. Addiction 2024; 119:1635-1647. [PMID: 38725272 DOI: 10.1111/add.16522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Accepted: 04/08/2024] [Indexed: 08/03/2024]
Abstract
BACKGROUND AND AIMS Alcohol use and anxiety often co-occur, causing increased severity impairment. This protocol describes a randomized controlled trial (RCT) that aims to test the efficacy and cost-effectiveness of a web-based, self-guided alcohol and anxiety-focused program, compared with a web-based brief alcohol-focused program, for young adults who drink at hazardous levels and experience anxiety. It will also test moderators and mechanisms of change underlying the intervention effects. DESIGN This RCT will be conducted with a 1:1 parallel group. SETTING The study will be a web-based trial in Australia. PARTICIPANTS Individuals aged 17-30 years who drink alcohol at hazardous or greater levels and experience at least mild anxiety (n = 500) will be recruited through social media, media (TV, print) and community networks. INTERVENTION AND COMPARATOR Participants will be randomly allocated to receive a web-based, integrated alcohol-anxiety program plus technical and motivational telephone/e-mail support (intervention) or a web-based brief alcohol-feedback program (control). MEASUREMENTS Clinical measures will be assessed at baseline, post-intervention (2 months), 6 months (primary end-point), 12 months and 18 months. Co-primary outcomes are hazardous alcohol consumption and anxiety symptom severity. Secondary outcomes are binge-drinking frequency; alcohol-related consequences; depression symptoms; clinical diagnoses of alcohol use or anxiety disorder (at 6 months post-intervention), health-care service use, educational and employment outcomes; and quality of life. Mediators and moderators will also be assessed. Efficacy will be tested using mixed models for repeated measures within an intention-to-treat framework. The economic evaluation will analyze individual-level health and societal costs and outcomes of participants between each trial arm, while mediation models will test for mechanisms of change. COMMENTS This will be the first trial to test whether a developmentally targeted, web-based, integrated alcohol-anxiety intervention is effective in reducing hazardous alcohol use and anxiety severity among young adults. If successful, the integrated alcohol-anxiety program will provide an accessible intervention that can be widely disseminated to improve wellbeing of young adults, at minimal cost.
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Affiliation(s)
- Katrina Prior
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | | | - Nicola Newton
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | - Yong Yi Lee
- Monash University Health Economics Group, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
- School of Public Health, The University of Queensland, Brisbane, Australia
- Queensland Centre for Mental Health Research, Brisbane, Australia
| | - Mark Deady
- Black Dog Institute, University of New South Wales, Sydney, Australia
| | - Tara Guckel
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | - Laura Wade
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | - Ronald M Rapee
- Centre for Lifespan Health and Wellbeing, Macquarie University, Sydney, Australia
| | - Jennifer L Hudson
- Black Dog Institute, University of New South Wales, Sydney, Australia
| | - Frances Kay-Lambkin
- University of Newcastle and Hunter Medical Research Institute, Newcastle, Australia
| | - Tim Slade
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | - Mary Lou Chatterton
- Monash University Health Economics Group, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Cathrine Mihalopoulos
- Monash University Health Economics Group, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Maree R Teesson
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | - Lexine A Stapinski
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
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Chiccarelli E, North S, Pasternak RH. Innovative Strategies for Addressing Adolescent Health in Primary Care Through Telehealth. Pediatr Clin North Am 2024; 71:693-706. [PMID: 39003011 DOI: 10.1016/j.pcl.2024.04.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/15/2024]
Abstract
With recent gains in telehealth access across health sectors, this editorial explores adolescent-specific health issues where innovative use of virtual care is improving outcomes and access for adolescents. These include contraception, obesity, gender-affirming care, mental health, and eating disorder care. Clinicians caring for adolescents should be aware of advances in this field to maximize opportunities for their patients to receive evidence-based care in a manner that supports health equity and confidentiality concerns while understanding the evolving regulatory landscape of telehealth.
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Affiliation(s)
- Elvira Chiccarelli
- Brooke Army Medical Center, 3100 Schofield Road, Fort Sam Houston, TX 78234, USA.
| | - Steve North
- Center for Rural Health Innovation, 167 Locust Street, Spruce Pine, NC 28777, USA
| | - Ryan H Pasternak
- Louisiana State University School of Medicine, Childrens Mercy Kansas City, 3101 Broadway Boulevard, Kansas City, MO 64111, USA
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Wittevrongel E, Kessels R, Everaert G, Vrijens M, Danckaerts M, van Winkel R. A user perspective on youth mental health services: Increasing help-seeking behaviour requires addressing service preferences and attitudinal barriers. Early Interv Psychiatry 2024. [PMID: 38853403 DOI: 10.1111/eip.13584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 05/22/2024] [Accepted: 05/28/2024] [Indexed: 06/11/2024]
Abstract
AIM Although the incidence of mental health problems is highest in young people, the majority do not seek help. Reducing the discrepancy between need for care and access to services requires an understanding of the user perspective, which is largely lacking. This study aimed to examine preferences for mental health service attributes and their relative importance among young people, as well as the potential impact on actual help-seeking intentions. METHODS Youth aged 16-24 years (N = 258) participated in a discrete choice experiment. In addition to choosing which service would suit their needs most out of two service options in nine choice sets, participants were asked whether they would consult the chosen service in the case of mental health problems. Demographic information was also collected, as well as their current mental health status, experience with and perceived barriers to care. Panel mixed logit models were estimated. RESULTS Young people's preferences were mostly driven by the attribute 'format', with a preference for individual rather than group therapy. Other attributes, in order of importance, were 'wait times' (short), 'cost' (low), 'healthcare professionals' expertise' (particular experience with working with youth aged 12 to 25 years), and 'location' (house in a city). However, a majority of young people would not consult the service they had indicated, mainly due to attitudinal barriers such as wanting to deal with problems on their own (self-reliance). CONCLUSIONS Addressing psychological barriers to access care should be a priority in mental health policies. Furthermore, entry point services, in particular, should be able to provide the option of individual treatment.
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Affiliation(s)
- Eline Wittevrongel
- KU Leuven, Department of Neurosciences, Research Group Psychiatry, Centre for Clinical Psychiatry, Leuven, Belgium
- KU Leuven, University Psychiatric Centre (UPC), Leuven, Belgium
| | - Roselinde Kessels
- Department of Data Analytics and Digitalization, Maastricht University, Maastricht, The Netherlands
- Department of Economics, University of Antwerp, Antwerp, Belgium
| | - Geert Everaert
- Neuro-Psychiatric Clinic Saint Joseph V.Z.W, Pittem, Belgium
| | - May Vrijens
- Asster Psychiatric Hospital, Sint-Truiden, Belgium
| | - Marina Danckaerts
- KU Leuven, University Psychiatric Centre (UPC), Leuven, Belgium
- KU Leuven, Department of Neurosciences, Research Group Psychiatry, Centre for Developmental Psychiatry, Leuven, Belgium
| | - Ruud van Winkel
- KU Leuven, Department of Neurosciences, Research Group Psychiatry, Centre for Clinical Psychiatry, Leuven, Belgium
- KU Leuven, University Psychiatric Centre (UPC), Leuven, Belgium
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Miller-Matero LR, Knowlton G, Vagnini KM, Yeh HH, Rossom RC, Penfold RB, Simon GE, Akinyemi E, Abdole L, Hooker SA, Owen-Smith AA, Ahmedani BK. The rapid shift to virtual mental health care: Examining psychotherapy disruption by rurality status. J Rural Health 2024; 40:500-508. [PMID: 38148485 DOI: 10.1111/jrh.12818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 12/12/2023] [Accepted: 12/17/2023] [Indexed: 12/28/2023]
Abstract
BACKGROUND Given the low usage of virtual health care prior to the COVID-19 pandemic, it was unclear whether those living in rural locations would benefit from increased availability of virtual mental health care. The rapid transition to virtual services during the COVID-19 pandemic allowed for a unique opportunity to examine how the transition to virtual mental health care impacted psychotherapy disruption (i.e., 45+ days between appointments) among individuals living in rural locations compared with those living in nonrural locations. METHODS Electronic health record and insurance claims data were collected from three health care systems in the United States including rurality status and psychotherapy disruption. Psychotherapy disruption was measured before and after the COVID-19 pandemic onset. RESULTS Both the nonrural and rural cohorts had significant decreases in the rates of psychotherapy disruption from pre- to post-COVID-19 onset (32.5-16.0% and 44.7-24.8%, respectively, p < 0.001). The nonrural cohort had a greater reduction of in-person visits compared with the rural cohort (96.6-45.0 vs. 98.0-66.2%, respectively, p < 0.001). Among the rural cohort, those who were younger and those with lower education had greater reductions in psychotherapy disruption rates from pre- to post-COVID-19 onset. Several mental health disorders were associated with experiencing psychotherapy disruption. CONCLUSIONS Though the rapid transition to virtual mental health care decreased the rate of psychotherapy disruption for those living in rural locations, the reduction was less compared with nonrural locations. Other strategies are needed to improve psychotherapy disruption, especially among rural locations (i.e., telephone visits).
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Affiliation(s)
- Lisa R Miller-Matero
- Henry Ford Health, Center for Health Policy & Health Services Research, Detroit, Michigan, USA
- Henry Ford Health, Behavioral Health Services, Detroit, Michigan, USA
| | - Gregory Knowlton
- Health Partners Institute, Research and Evaluation Division, Bloomington, Minnesota, USA
| | - Kaitlyn M Vagnini
- Henry Ford Health, Center for Health Policy & Health Services Research, Detroit, Michigan, USA
- Henry Ford Health, Behavioral Health Services, Detroit, Michigan, USA
| | - Hsueh-Han Yeh
- Henry Ford Health, Center for Health Policy & Health Services Research, Detroit, Michigan, USA
| | - Rebecca C Rossom
- Health Partners Institute, Research and Evaluation Division, Bloomington, Minnesota, USA
| | - Robert B Penfold
- Kaiser Permanente Washington, Health Research Institute, Seattle, Washington, USA
| | - Gregory E Simon
- Kaiser Permanente Washington, Health Research Institute, Seattle, Washington, USA
| | - Esther Akinyemi
- Henry Ford Health, Behavioral Health Services, Detroit, Michigan, USA
| | - Lana Abdole
- Henry Ford Health, Behavioral Health Services, Detroit, Michigan, USA
| | - Stephanie A Hooker
- Health Partners Institute, Research and Evaluation Division, Bloomington, Minnesota, USA
| | - Ashli A Owen-Smith
- Georgia State University, School of Public Health, Kaiser Permanente Georgia, Center for Research and Evaluation, Atlanta, Georgia, USA
| | - Brian K Ahmedani
- Henry Ford Health, Center for Health Policy & Health Services Research, Detroit, Michigan, USA
- Henry Ford Health, Behavioral Health Services, Detroit, Michigan, USA
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Fisher OJ, McGrath K, Grogan C, Cockshaw W, Leggatt-Cook C. Care navigation addresses issues of tele-mental health acceptability and uptake in rural and remote Australian communities. PLoS One 2024; 19:e0298655. [PMID: 38574110 PMCID: PMC10994303 DOI: 10.1371/journal.pone.0298655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 01/30/2024] [Indexed: 04/06/2024] Open
Abstract
INTRODUCTION People living in rural and remote areas face substantial barriers to accessing timely and appropriate mental health services. In the Bowen Basin region of Queensland, Australia, barriers include: limited local providers, long waiting lists, unreliable telecommunication, and reluctance to trial telehealth. Isaac Navicare is a new, community co-designed care navigation service which addresses these barriers by coupling care navigation with supported telehealth, and referrals to mental health providers and other supports. We aimed to understand the reach and effectiveness of Isaac Navicare in improving access to mental health services and address an evidence gap on strategies for improving telehealth acceptability. METHODS This mixed-methods implementation science evaluation used the RE-AIM Framework. It involved a client database review, survey and semi-structured interviews with service users during the 12-month pilot from November 2021. RESULTS 197 clients (128 adults, 69 minors) were referred to Navicare during the pilot. Half of adult clients were unemployed, meaning referral options were limited to low-cost or bulk-billed services. Participants described Navicare as supportive and effective in helping to access timely and appropriate mental health supports. Most clients who expressed a treatment modality preference selected face-to-face (n = 111, 85.4%), however most referrals were for telehealth (n = 103, 66.0%) due to a lack of suitable alternatives. The rapport and trust developed with the care navigator was critical for increasing willingness to trial telehealth. Barriers to telehealth included privacy issues, technical difficulties, unreliable internet/phone, and perceived difficulties developing therapeutic rapport. The supported telehealth site was under-utilised. The majority (88.3%, n = 182) of referrals to Navicare were from local health or community service providers or schools. DISCUSSION Coupling supportive, individualised care navigation with tele-mental health provider options resulted in increased uptake and acceptance of telehealth. Many barriers could be addressed through better preparation of clients and improving promotion and uptake of the supported telehealth site. CONCLUSION Attitudes towards telehealth have changed during the COVID-19 pandemic, however although the need exists, barriers remain to uptake. Telehealth alone is not enough. Coupling telehealth with other supports such as care navigation improves acceptance and uptake.
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Affiliation(s)
- Olivia J. Fisher
- Health Services Research, Wesley Research Institute, Brisbane, Queensland, Australia
- Faculty of Health, Charles Darwin University, Darwin, Northern Territory, Australia
| | - Kelly McGrath
- Health Services Research, Wesley Research Institute, Brisbane, Queensland, Australia
- Isaac Navicare Hub, Wesley Research Institute, Moranbah, Queensland, Australia
| | - Caroline Grogan
- Health Services Research, Wesley Research Institute, Brisbane, Queensland, Australia
| | - Wendell Cockshaw
- Health Services Research, Wesley Research Institute, Brisbane, Queensland, Australia
- Faculty of Health, Charles Darwin University, Darwin, Northern Territory, Australia
| | - Chez Leggatt-Cook
- Family and Disability Services, UnitingCare Queensland, Brisbane, Queensland, Australia
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Kavanagh BE, Corney KB, Beks H, Williams LJ, Quirk SE, Versace VL. A scoping review of the barriers and facilitators to accessing and utilising mental health services across regional, rural, and remote Australia. BMC Health Serv Res 2023; 23:1060. [PMID: 37794469 PMCID: PMC10552307 DOI: 10.1186/s12913-023-10034-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 09/14/2023] [Indexed: 10/06/2023] Open
Abstract
BACKGROUND Inadequate healthcare access and utilisation are implicated in the mental health burden experienced by those living in regional, rural, and remote Australia. Facilitators that better enable access and utilisation are also reported in the literature. To date, a synthesis on both the barriers and facilitators to accessing and utilising mental health services within the rural Australian context has not been undertaken. This scoping review aims to (1) synthesise the barriers and facilitators to accessing and utilising mental health services in regional, rural, and remote Australia, as identified using the Modified Monash Model; and (2) better understand the relationship between barriers and facilitators and their geographical context. METHODS A systematic search of Medline Complete, EMBASE, PsycINFO, Scopus, and CINAHL was undertaken to identify peer-reviewed literature. Grey literature was collated from relevant websites. Study characteristics, including barriers and facilitators, and location were extracted. A descriptive synthesis of results was conducted. RESULTS Fifty-three articles were included in this scoping review. Prominent barriers to access and utilisation included: limited resources; system complexity and navigation; attitudinal and social matters; technological limitations; distance to services; insufficient culturally-sensitive practice; and lack of awareness. Facilitators included person-centred and collaborative care; technological facilitation; environment and ease of access; community supports; mental health literacy and culturally-sensitive practice. The variability of the included studies precluded the geographical analysis from being completed. CONCLUSION Both healthcare providers and service users considered a number of barriers and facilitators to mental health service access and utilisation in the regional, rural, and remote Australian context. Barriers and facilitators should be considered when re-designing services, particularly in light of the findings and recommendations from the Royal Commission into Victoria's Mental Health System, which may be relevant to other areas of Australia. Additional research generated from rural Australia is needed to better understand the geographical context in which specific barriers and facilitators occur.
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Affiliation(s)
- Bianca E Kavanagh
- Deakin Rural Health, School of Medicine, Deakin University, Princes Highway, Warrnambool, VIC, 3280, Australia.
| | - Kayla B Corney
- Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Barwon Health, Geelong, VIC, Australia
| | - Hannah Beks
- Deakin Rural Health, School of Medicine, Deakin University, Princes Highway, Warrnambool, VIC, 3280, Australia
| | - Lana J Williams
- Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Barwon Health, Geelong, VIC, Australia
| | - Shae E Quirk
- Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Barwon Health, Geelong, VIC, Australia
- Institute of Clinical Medicine, Psychiatry, University of Eastern Finland, Kuopio, Finland
- Institute of Clinical Medicine, Kuopio Musculoskeletal Research Unit (KMRU), University of Eastern Finland, Kuopio, Finland
| | - Vincent L Versace
- Deakin Rural Health, School of Medicine, Deakin University, Princes Highway, Warrnambool, VIC, 3280, Australia
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