Rethinking Accessibility in Light of the Orange Declaration: Applying a Socio-Ecological Lens to Rural Mental Health Commissioning

Access to urban community mental health services: does geographical distance play a role?

PURPOSE

Mental health challenges are a pressing concern in Australia, which account for a significant portion of the disease burden and economic costs, yet a substantial number of those affected do not utilise necessary professional support. This study evaluates distance decay effect on adults' community mental health services in North Metropolitan Western Australia and explores factors influencing service use.

METHODS

Data were extracted from the Mental Health Information Data Collections including the records of consumers receiving face-to-face services from the Community Mental Health Clinics in the North Metro Health Service during March 2022 to March 2023. Additionally, socio-demographic information for each suburb and population data were obtained from the Australian Bureau of Statistics. The distance between residential suburbs and clinic locations was calculated. Descriptive statistics were used to describe the characteristics of the study population. A hierarchical linear regression analysis was used to explore whether the distance of suburb to the nearest community clinic was related to service utilisation.

RESULTS

A total of 3,453 consumers received direct services across the North Metro Health Service Community Mental Health Clinics. Findings highlighted the impact of proximity to clinics on service utilisation, with suburbs closer to clinics exhibiting higher visit rates (p = 0.004). The data also showed a strong positive correlation between gender (percentage of females in the suburb) and living in socially and economically disadvantaged areas with consumer visits per thousand residents.

CONCLUSIONS

These findings underscore the importance of addressing accessibility barriers and tailoring mental health services to meet the diverse needs of the community.

Local Men Local Communities: A rural placed-based approach to increase men's engagement with mental health training and events

ISSUE ADDRESSED

Suicide is the leading cause of death for Australians aged 15-49 (Department of Health and Aged Care Suicide in Australia, https://www.health.gov.au/health-topics/mental-health-and-suicide-prevention/suicide-in-australia, 2021). With the loss of one community member impacting the individual's family, friends, and wider community. The aim of the article is to showcase a process evaluation of a place-based approach to suicide prevention, exploring the elements of mental health training and events that can be tailored to increase engagement with the men living in a rural Local Government Area in Gippsland, Victoria, Australia.

METHODS

Participation records and promotional material for the Local Men Local Communities project was utilised to explore similarities and differences between the training and events offered.

RESULTS

Results indicated that men living in rural areas engaged best with events that included a social element such as food or an activity, highlighting that men may find it easier to talk and connect when they have something to do.

CONCLUSION

Mental health training and events need to be tailored to meet the needs of the target population. Key details to consider include location, time, promotional material, content, and inclusion of a social element. SO WHAT?: When rural men were provided ownership of their conversations, they were more likely to have them. This challenges the stereotype that men do not talk and creates the opportunity for social connection within the community.

GP perspectives on a psychiatry phone line in Western Australia's Great Southern region: implications for addressing rural GP workload

BACKGROUND

Mental illness is a public health challenge disproportionately affecting rural Australians. GPs provide most of the mental health care, and they report increasing levels of burnout and unsustainable workload in the context of increased patient complexity. This may be more salient in rural settings characterised by resource constraints. In this paper, we use evaluation data from a GP psychiatry phone line established in Western Australia's Great Southern region in 2021 to describe GPs' perspectives on the service and reflect on how it may help alleviate rural GP workload.

METHODS

The sample was recruited among GPs practicing in the region. Data were collected through an online survey and semistructured interviews. Descriptive statistics were used to analyse the survey data. Interview data were subjected to thematic analysis; qualitative survey data were used for triangulation.

RESULTS

A total of 45GPs completed the survey and 14 were interviewed. Interview data yielded three themes: the criticality of timeliness; the building blocks of confidence; and trust. GPs were highly satisfied with the service, and timeliness and trust were the characteristics underpinning its effectiveness. The service built GPs' confidence in managing mental health and alcohol and other drug use issues through strengthening knowledge and providing reassurance.

CONCLUSIONS

Our results suggest that a telephone line operated by trusted, local psychiatrists with knowledge of the local mental health ecosystem of support can reduce rural GP workload through building confidence and strengthening personal agency, helping GPs navigate the ethical and clinical labyrinth of managing patient complexity in rural settings.