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Hurley J, Longbottom P, Bennett B, Yoxall J, Hutchinson M, Foley KR, Happell B, Parkes J, Currey K. Workforce strategies to address children's mental health and behavioural needs in rural, regional and remote areas: A scoping review. Aust J Rural Health 2024. [PMID: 38572866 DOI: 10.1111/ajr.13119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Revised: 02/22/2024] [Accepted: 03/21/2024] [Indexed: 04/05/2024] Open
Abstract
INTRODUCTION Children living in rural, regional and remote locations experience challenges to receiving services for mental illness and challenging behaviours. Additionally, there is a lack of clarity about the workforce characteristics to address the needs of this population. OBJECTIVE To scope the literature on the rural, regional and remote child mental health and behavioural workforce and identify barriers and enabling mechanisms to mental health service provision. DESIGN A scoping review utilising the Joanna Briggs Institute methodology. A database search was undertaken using Medline, CINAHL, PsycINFO, ProQuest and Scopus to identify papers published 2010-2023. Research articles reporting data on mental health workforce characteristics for children aged under 12 years, in rural, regional or remote locations were reviewed for inclusion. FINDINGS Seven hundred and fifty-four papers were imported into Covidence with 22 studies being retained. Retained studies confirmed that providing services to meet the needs of children's mental health is an international challenge. DISCUSSION The thematic analysis of the review findings highlighted four workforce strategies to potentially mitigate some of these challenges. These were: (1) The use of telehealth for clinical services and workforce upskilling; (2) Role shifting where non mental health professionals assumed mental health workforce roles; (3) Service structure strategies, and (4) Indigenous and rural cultural factors. CONCLUSION A range of potential strategies exists to better meet the needs of children with mental health and behavioural issues. Adapting these to specific community contexts through co-design and production may enhance their efficacy.
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Affiliation(s)
- John Hurley
- Faculty of Health, Southern Cross University, Coffs Harbour, New South Wales, Australia
| | - Paula Longbottom
- Faculty of Health, Southern Cross University, Coffs Harbour, New South Wales, Australia
| | - Bindi Bennett
- Federation University, Ballarat, Victoria, Australia
| | - Jacqui Yoxall
- Faculty of Health, Southern Cross University, Coffs Harbour, New South Wales, Australia
| | - Marie Hutchinson
- Faculty of Health, Southern Cross University, Coffs Harbour, New South Wales, Australia
| | - Kitty-Rose Foley
- Faculty of Health, Southern Cross University, Coffs Harbour, New South Wales, Australia
| | - Brenda Happell
- Faculty of Health, Southern Cross University, Coffs Harbour, New South Wales, Australia
| | - Jill Parkes
- Faculty of Health, Southern Cross University, Coffs Harbour, New South Wales, Australia
| | - Kate Currey
- Faculty of Health, Southern Cross University, Coffs Harbour, New South Wales, Australia
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Robinson T, Govan L, Bradley C, Rossiter R. Transforming health care delivery: The role of primary health care nurses in rural and remote Australia. Aust J Rural Health 2024. [PMID: 38572893 DOI: 10.1111/ajr.13120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2023] [Revised: 02/29/2024] [Accepted: 03/21/2024] [Indexed: 04/05/2024] Open
Abstract
AIM This paper describes the policy context and approaches taken to improve access to primary health care in Australia by supporting nurses to deliver improved integrated care meeting community needs. CONTEXT In Primary Health Care (PHC), the nursing workforce are predominantly employed in the general practice sector. Despite evidence that nurse-led models of care can bridge traditional treatment silos in the provision of specialised and coordinated care, PHC nurses' scope of practice varies dramatically. Nurse-led models of care are imperative for rural and remote populations that experience workforce shortages and barriers to accessing health care. Existing barriers include policy constraints, limited organisational structures, education and financing models. APPROACH The Australian Primary Health Care Nurses Association (APNA) received funding to implement nurse-led clinics as demonstration projects. The clinics enable PHC nurses to work to their full scope of practice, improve continuity of care and increase access to health care in under serviced locations. We reviewed a range of peer-reviewed literature, policy documents, grey literature and APNA provided sources, particularly those relevant to rural and remote populations. We argue more focus is needed on how to address variations in the scope of practice of the rural and remote PHC nursing workforce. CONCLUSION Despite growing evidence for the effectiveness of nurse-led models of care, significant policy and financial barriers continue to inhibit PHC nurses working to their full scope of practice. If their potential to transform health care and increase access to health services is to be realised these barriers must be addressed.
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Affiliation(s)
- Tracy Robinson
- School of Nursing, Paramedicine and Healthcare Sciences, Charles Sturt University, Orange, New South Wales, Australia
| | - Linda Govan
- Latrobe University, Melbourne, Victoria, Australia
- Australian Primary Health Care Nurses Association (APNA), Melbourne, Victoria, Australia
| | - Cressida Bradley
- Australian Primary Health Care Nurses Association (APNA), Melbourne, Victoria, Australia
| | - Rachel Rossiter
- School of Rural Medicine, Charles Sturt University, Orange, New South Wales, Australia
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Puah LS, Gillam M, Walsh S, Jones M, Yisma E. Do undertaking rural placements and place of origin inform where allied health graduates work in South Australia? Aust J Rural Health 2023. [PMID: 36852747 DOI: 10.1111/ajr.12974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 02/07/2023] [Accepted: 02/15/2023] [Indexed: 03/01/2023] Open
Abstract
OBJECTIVE To examine the principal place of practice after graduation of students who participated in the Rural Health Multidisciplinary Training (RHMT) program and allied health students' place of origin. DESIGN Cross-sectional study. PARTICIPANTS Graduates who completed their degree in podiatry, occupational therapy and physiotherapy in 2019. MAIN OUTCOME MEASURES Principal place of practice at first and third years after graduation. RESULTS In 2020, 40 allied health professionals (AHPs) who graduated from the University of South Australia in 2019 were practising in rural areas but only 26 of them remained in the rural practice in 2022. The retention rate for rural practice was 65% within 2 years. However, in 2022, 25 allied health professionals left their metropolitan employment location and transitioned to rural practice. Of the 25 allied health graduates who joined the rural practice in 2022, most of them (80%, 20/25) had either rural exposure through the RMHT program or were from rural origin. CONCLUSIONS Rural exposure via the RHMT program and allied health students' rural place of origin have an important role for rural principal place of practice at first and third years after graduation.
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Affiliation(s)
- Lee San Puah
- Department of Rural Health, University of South Australia, Whyalla Norrie and Mount Barker, South Australia, Australia.,IIMPACT in Health, University of South Australia, Adelaide, South Australia, Australia
| | - Marianne Gillam
- Department of Rural Health, University of South Australia, Whyalla Norrie and Mount Barker, South Australia, Australia.,IIMPACT in Health, University of South Australia, Adelaide, South Australia, Australia
| | - Sandra Walsh
- Department of Rural Health, University of South Australia, Whyalla Norrie and Mount Barker, South Australia, Australia.,IIMPACT in Health, University of South Australia, Adelaide, South Australia, Australia
| | - Martin Jones
- Department of Rural Health, University of South Australia, Whyalla Norrie and Mount Barker, South Australia, Australia.,IIMPACT in Health, University of South Australia, Adelaide, South Australia, Australia
| | - Engida Yisma
- Department of Rural Health, University of South Australia, Whyalla Norrie and Mount Barker, South Australia, Australia.,IIMPACT in Health, University of South Australia, Adelaide, South Australia, Australia
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Hays R, Bowles S, Brown T, Lawler A, Vickers J. The impact after 50 years of a new medical education programme with a regional workforce mission. Aust J Rural Health 2017; 25:332-337. [PMID: 28677825 DOI: 10.1111/ajr.12360] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/07/2017] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Tasmania established its medical programme in 1965 to produce graduates to address medical workforce recruitment challenges. Many Tasmanian graduates work in Tasmania, but workforce problems continue. This paper reports the workforce outcomes of the first 42 graduating cohorts. METHODS A database for all University of Tasmania medical graduates from the years 1970 to 2011 was developed by combining information from university, registration and local workforce survey databases. RESULTS A total of 2012 doctors graduated from 1971 to 2011 and 1707 (85%) were registered, most commonly in general practice (45.8%), medicine (13%), anaesthetics (7.9%), surgery (7.5%), psychiatry (4.3%), emergency medicine (35, 3.5%), paediatrics (3.4%) and pathology (3.3%). While 41.9% worked in Tasmania, they comprised 35.6% of the local workforce and were clustered around the two larger cities. The proportion entering general practice has fallen since 1980s. DISCUSSION The contribution of the Tasmanian medical programme is substantial but appears less than other regional medical schools. Relatively few work in smaller communities, particularly in specialties other than general practice. Lifestyle choices and the availability of training opportunities and career positions might be contributing factors. The medical school has established clinical schools in rural communities, promoted admission of rural applicants and increased rural clinical placement opportunities, with some early signs of success. CONCLUSION The Tasmanian medical programme is important in this regional, island economy, but the rural and remote communities have not benefited as much as the two larger cities. Sustaining a regional workforce mission over time might require frequent adjustments to admissions and curriculum processes.
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Affiliation(s)
- Richard Hays
- School of Medicine, University of Tasmania, Hobart, Tasmania, Australia
| | - Sarah Bowles
- School of Medicine, University of Tasmania, Hobart, Tasmania, Australia
| | - Terry Brown
- Postgraduate Medical Council of Tasmania, Hobart, Tasmania, Australia
| | - Anthony Lawler
- Department of Health and Human Services, Tasmania, Hobart, Tasmania, Australia
| | - James Vickers
- School of Medicine, University of Tasmania, Hobart, Tasmania, Australia
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Orda U, Orda S, Sen Gupta T, Knight S. Building a sustainable workforce in a rural and remote health service: A comprehensive and innovative Rural Generalist training approach. Aust J Rural Health 2016; 25:116-119. [PMID: 27385104 DOI: 10.1111/ajr.12306] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/02/2016] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND Historically it has been challenging to recruit and retain an appropriately trained medical workforce to care for rural and remote Australians. This paper describes the Queensland North West Hospital and Health Service (NWHHS) workforce redesign, developing education strategies and pathways to practice, thereby improving service provision, recruitment and retention of staff. CONCEPT The Mount Isa-based Medical Education Unit sought accreditation for a Rural Generalist (RG) training pathway from Internship to Fellowship with the Australian College of Rural and Remote Medicine (ACRRM) and the Regional Training Provider (RTP). This approach enhanced the James Cook University (JCU) undergraduate pathway for rurally committed students while improving recruitment and retention of RMOs/Registrars. ACHIEVEMENTS Accreditation was achieved through collaboration with training providers, accreditation agencies, ACRRM and a local general practice. The whole pathway from ignore Internship to Fellowship is offered with the RG Intern intake as a primary allocation site beginning in 2016. Comprehensive supervision and excellent clinical exposure provide an interesting and rewarding experience - for staff at all levels. RESULTS Since 2013 RMO locum rates have been <1%. Registrars on the ACRRM pathway and Interns increased from 0 to 7 positions each in 2015, with similar achievements in SMO staffing. Three RMOs expressed interest in a Registrar position, CONCLUSIONS: Appropriate governance is needed to develop and advertise the program. This includes the NWHHS, the RG Pathway and JCU.
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Affiliation(s)
- Ulrich Orda
- North West Hospital and Health Service, Mount Isa, Queensland, Australia.,James Cook University, College of Medicine and Dentistry, Mount Isa, Queensland, Australia.,Mount Isa Centre for Rural and Remote Health, Mount Isa, Queensland, Australia
| | - Sabine Orda
- North West Hospital and Health Service, Mount Isa, Queensland, Australia.,James Cook University, College of Medicine and Dentistry, Mount Isa, Queensland, Australia.,Mount Isa Centre for Rural and Remote Health, Mount Isa, Queensland, Australia
| | - Tarun Sen Gupta
- James Cook University, College of Medicine and Dentistry, Mount Isa, Queensland, Australia
| | - Sabina Knight
- James Cook University, College of Medicine and Dentistry, Mount Isa, Queensland, Australia.,Mount Isa Centre for Rural and Remote Health, Mount Isa, Queensland, Australia
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