By: Sajra Trto
Health research in rural communities has grown over the past few decades. It is of no surprise that in this health research, there are differences found in healthcare provision, retention and usage between rural and urban areas. One main area that has been a focus for many researchers around the world is mental health care. Mental health has become less of a stigma as more and more people are getting on board with movements such as ‘Bell #Let’sTalk’ and ‘here for you’, but is this enough to break the barrier of accessing adequate mental health care services, while living in remote communities? After researching this topic, relevant papers were found and it is safe to say, Australia and Canada have been busy trying different approaches to minimize this recurrent health problem.
Australia and Canada have similar rural-urban ratios, which is why I thought comparing their strategies and findings would be beneficial, as their rural mental health issues possess the same patterns. Most papers found during my research were based in Australia, as they are moving at a faster pace than Canada, trying to find a suitable solution to the lack of mental health care access in rural areas. This led to my research idea of exploring Australian approaches and determining how applicable they are to Canada. Can Australian methods for adequate mental health care access in rural areas be implemented in Canada? That is what my research is all about.
What I found during my research were some major common themes, which included mental health care inequalities in indigenous populations, individuals affected by farming/droughts, individuals throughout the life course (youth and aging), as well as additional topics such as suicide, care givers perspective, and addiction/substance use. Decades of research has proven there needs to be an updated mental health policy for all of these sub-populations in rural areas.
The national mental health strategy was implemented in Australia in 1992 in order to reinforce the need for improvement on this topic. The plan had three goals:
- Promote mental health and prevent the development of mental health disorders
- Reduce the impact of mental health disorders on individuals, as well as their families and the community
- Assure the rights of people with mental health disorders
Now almost 30 years later, we have moved past this general goal (while still using it as a core basis for pilot projects) and we are moving into more specific approaches, as we begin to realize different rural communities have different demands. The goal is to develop a program that can be implemented to different communities as well as different countries, catering to their needs. This is one of the biggest issues Australia is facing in the development of a new policy/program.
Australia has piloted a few projects over the years. Some of these have proven to be successful, although this success runs no further than the community in which the research had taken place in. An example of this, is the ‘GP clinic’approach, which was established in 2007. The clinic works by providing patients with monthly appointments with general practitioners, managed by the community mental health team. Mental health nurses as well as psychologists attend the appointment and together try to help the patient. This gives the patient a comprehensive team to work with, while at the same time helping the general practitioner learn how to manage patients with a mental health disorder. Unfortunately, it is stated in the research paper that implementation of the pilot project to other communities has been proven difficult. One thing the study did prove is that what is needed, is a system that implements a basic model that can be reconstructed by locally-driven methods. This approach will be much more feasible than a top-down approach that provides a generic solution to all communities.
It will take a bit more time until Australia comes up with an approach that works nation-wide, let alone something that will be able to be implemented in a different country. Despite this, a lot of progress has been made over the years, and with that, my hopes remain high that a suitable approach will come about in the near future.
Fitzpatrick, S.J., et al. Coordinating Mental and Physical Health Care in Rural Australia: An Integrated Model for Primary Care Settings. International Journal of Integrated Care, 2018; 18(2):19, 1-9. DOI: https://doi.org/10.5334/ijic.3943