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Carlisle K, Kamstra P, Carlisle E, McCosker A, De Cotta T, Kilpatrick S, Steiner A, Kahl B, Farmer J. A qualitative exploration of online forums to support resilience of rural young people in Australia. Front Public Health 2024; 12:1335476. [PMID: 38841668 PMCID: PMC11150697 DOI: 10.3389/fpubh.2024.1335476] [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: 11/09/2023] [Accepted: 05/07/2024] [Indexed: 06/07/2024] Open
Abstract
Introduction Prevention and early intervention are crucial strategies for improving young people's mental health and well-being. Building resilience is a key component of these strategies, especially among young individuals in rural areas who face well-documented mental health disparities. This study aimed to investigate how online mental health forums can contribute to enhancing individual resilience in young rural users. Methods A sample of forum posts (n = 1,000) made by Australian rural users (18-25 years) on an online peer support mental health forum were qualitatively analyzed. The analysis was guided by themes derived from the literature on indicators of rural resilience. Results Analysis of forum posts showed evidence of rural resilience in forum users. Online peer support forums offered a virtual space for individuals to establish social connections, experience a sense of belonging, share information, acquire knowledge, and offer mutual support. There were indications of increased self-efficacy among forum users, as they demonstrated their ability to implement strategies for better managing their mental health. Discussion These findings significantly contribute to our understanding of how online forums can enhance resilience factors that are beneficial for young people living in rural communities. In the context of prevention and early intervention, this study illustrates the intricate connections between forum design and user activity with resilience outcomes, providing valuable insights into the underlying causal mechanisms. Consequently, it emphasizes the importance of incorporating such digital interventions as integral components of mental health service ecosystems.
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Affiliation(s)
- Karen Carlisle
- College of Medicine and Dentistry, James Cook University, Douglas, QLD, Australia
| | | | - Emily Carlisle
- College of Medicine and Dentistry, James Cook University, Douglas, QLD, Australia
| | - Anthony McCosker
- Department of Media and Communications, Swinburne University of Technology, Melbourne, VIC, Australia
| | - Tracy De Cotta
- Social Innovation Research Unit, Swinburne University of Technology, Melbourne, VIC, Australia
| | | | - Artur Steiner
- Glasgow Caledonian University, Yunus Centre, Glasgow, United Kingdom
| | | | - Jane Farmer
- Social Innovation Research Unit, Swinburne University of Technology, Melbourne, VIC, 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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Hawkins G, Malatzky C, Wilson S, Dingle K. Exploring the gap between refugee-background communities' needs and existing community-based physical activity programs in Australia. Health Promot Int 2023; 38:7162646. [PMID: 37184580 PMCID: PMC10184685 DOI: 10.1093/heapro/daad039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2023] Open
Abstract
Physical activity programs run by local government, public health and not-for-profit sectors are a key public health strategy for improving rates of physical activity within local communities. However, these programs are underutilized. This is especially the case among members of refugee-background communities whose participation could have far-ranging and multilevel benefits. To explore how greater engagement among refugee-background communities with these programs could be fostered in Brisbane, Queensland, Australia, a qualitative study was undertaken from the perspectives of both community-based physical activity program providers and agencies involved in delivering services to refugee-background communities. This study involved a series of semi-structured interviews with a purposive sample of personnel from agencies that work with individuals and families from refugee-background communities and organizations that provide low-cost or no-cost physical activity programs and initiatives. Reflexive thematic analysis was used to interpret meaning from these data. Three themes relating to how participation in community-based physical activity programs could be improved among refugee-background communities were identified: improving cultural safety through intersectoral collaboration; confronting constraints imposed by the broader public health policy environment; and building capacity and empowering the community to diversify the sector. The findings highlight the importance of localized, deep-level intersectoral collaborations in bridging the gap between the health and social care needs of refugee-background communities and existing physical activity programs. However, a range of systems-produced barriers to the creation of such collaborations must be addressed to enable local actors to help mitigate and address the systemic exclusion of marginalized populations from participation in broader society.
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Affiliation(s)
- Georgia Hawkins
- School of Public Health and Social Work, Queensland University of Technology, Kelvin Grove 4059, Australia
| | - Christina Malatzky
- School of Public Health and Social Work, Queensland University of Technology, Kelvin Grove 4059, Australia
| | - Susan Wilson
- School of Public Health and Social Work, Queensland University of Technology, Kelvin Grove 4059, Australia
| | - Kaeleen Dingle
- School of Public Health and Social Work, Queensland University of Technology, Kelvin Grove 4059, Australia
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Bourke L, Mitchell O, Mohamed Shaburdin Z, Malatzky C, Anam M, Farmer J. Building readiness for inclusive practice in mainstream health services: A pre-inclusion framework to deconstruct exclusion. Soc Sci Med 2021; 289:114449. [PMID: 34626883 DOI: 10.1016/j.socscimed.2021.114449] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 09/07/2021] [Accepted: 09/29/2021] [Indexed: 10/20/2022]
Abstract
Across the globe, people are not equitably included or respected by health services. This results in some people being 'hardly reached' and having less access to safe and appropriate care. While some health services have adopted specific agendas to increase inclusion, these services can struggle to implement such strategies because the underlying reasons for exclusion have not been addressed. This calls for preparation prior to implementation of inclusion approaches that deconstructs discourses and practices of exclusion. This paper presents a pre-inclusion framework that seeks to deconstruct exclusion in health services. Authors developed this framework from action research in four 'mainstream' regional health services in southeast Australia over five years. Research identified dominant discourses of exclusion among staff in these services. The study also identified common experiences of residents hardly reached by these services. Following, a range of change activities were undertaken within these services to deconstruct exclusion. Researchers also kept journals, reflected on their impact, and identified lessons learned from trying to deconstruct exclusion. Triangulating these analyses, researchers developed an interdisciplinary framework that weaves together Foucauldian theory on power/discourse with continuous quality improvement processes to embed cultural humility and voices of the hardly reached in health care. The framework outlines five foundational concepts (power as productive, deconstruction, use of continuous quality improvement processes, cultural humility and voices of service users), followed by six principles (a journey, expect resistance, whole of service approach, make visible the reasons for change, we are all cultural beings and people centred care) and six actions undertaken within health services (commitment, assessment of exclusion, action plans, structural change, reflective discussions and engagement). Until such approaches to deconstruct exclusion are implemented, inclusive agendas are likely to be ineffective.
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Affiliation(s)
- Lisa Bourke
- Department of Rural Health, The University of Melbourne, 49 Graham St Shepparton, Vic, 3630, Australia.
| | - Olivia Mitchell
- Department of Rural Health, The University of Melbourne, 49 Graham St Shepparton, Vic, 3630, Australia.
| | | | - Christina Malatzky
- School of Public Health and Social Work, Queensland University of Technology, Kelvin Grove Campus, Kelvin Grove, Brisbane, Qld, 4059, Australia.
| | - Mujibul Anam
- Department of Rural Health, The University of Melbourne, 49 Graham St Shepparton, Vic, 3630, Australia
| | - Jane Farmer
- Social Innovation Research Institute, Swinburne University of Technology, John Street, Hawthorn, Vic, 3122, Australia.
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