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Mental health in rural and remote communties: annotated bibliography

Allen, J., Inder, K. J., Lewin, T. J., Attia, J., & Kelly, B. J. (2012). Social support and age influence distress outcomes differentially across urban, regional and remote Australia: an exploratory study. BMC Public Health, 12(1), 928.
The aim of this study was to examine whether increasing remoteness had any effect on psychological distress. 4219 people over 55 years were surveyed across New South Wales about their levels of social support, demographic details, remoteness and levels of psychological distress experienced. The report concluded that remoteness could reduce the levels of psychological distress associated with a lack of social support. This may be due to people living in remote areas having a higher level of self-sufficiency. The study was limited in that it only studied older people.
Blignault, I., Haswell, M., & Pulver, L. J. (2016). The value of partnerships: lessons from a multi‐site evaluation of a national social and emotional wellbeing program for Indigenous youth. Australian and New Zealand Journal of Public Health, 40(S1).
This study provides the results of a three-year evaluation of SAM our way- a program that aimed to improve the social and emotional wellbeing of Aboriginal and Torres Strait Islander living in remote and regional areas of Australia. Five out of the 14 sites were studied, selecting from diverse locations over several states and in depth case studies were performed. The best performing sites were those where strong local partnerships had been formed with the local Indigenous community. Several lessons were learned including the importance of program design and resourcing and ways of working. It was essential to build partnerships with the local community including training and engaging members and working consistently with them, taking things slowly. Evaluation is essential and needs to be built into the programs. Activities need to be engaging and, effective integrating with other programs and services.
Carey, T. A., Wakerman, J., Humphreys, J. S., Buykx, P., & Lindeman, M. (2013). What primary health care services should residents of rural and remote Australia be able to access? A systematic review of “core” primary health care services. BMC Health Services Research, 13(1), 178.
A systematic review was performed to address which primary healthcare services should be accessible to all Australians regardless of geography. It was done in response to the inequality in access to healthcare faced by those in remote and rural communities. It concluded that defining a list of core services was difficult but that they should be an appropriate fit for service and evidence-based. Policy makers, consumers, practitioners and researchers need to work together in developing them to ensure that they are affordable and accessible to all.
Inder, K. J., Handley, T. E., Fitzgerald, M., Lewin, T. J., Coleman, C., Perkins, D., & Kelly, B. J. (2012). Individual and district-level predictors of alcohol use: cross sectional findings from a rural mental health survey in Australia. BMC Public Health, 12(1), 586.
Excessive alcohol use has been cited as a problem in rural and remote Australia and this study aimed to examine the geographical variation in rates and the potential effects of socio-economic disadvantage, population change and remoteness from services in contributing to this disparity. A survey was performed on 1981 people randomly taken from the electoral role using the Australian Rural Mental Health Study. It found that gender, age, marital status and personality status were the biggest contributors to at risk alcohol use. Financial advantage and experiencing multiple recent adverse life events also contributed to increased alcohol use. Relatively few district-level factors were linked to increased alcohol consumption after controlling for other factors.
Inder, K. J., Handley, T. E., Johnston, A., Weaver, N., Coleman, C., Lewin, T. J., & Kelly, B. J. (2014). Determinants of suicidal ideation and suicide attempts: parallel cross-sectional analyses examining geographical location. BMC Psychiatry, 14(1), 208.
Suicide rates are consistently higher in rural than urban settings so this study aimed to examine if there were any differences in determinants of suicidal ideation and attempts between the areas. The main determinants were psychological distress and mental illness. Parallel cross-sectional analyses were performed using data from the 2007 National Survey of Mental Health and Wellbeing (n=8463) and the Australian Rural and Mental Health Study (n=634). The former was under representative of rural and remote participants and the latter was over representative. Geographical location was not found to be associated with suicidal ideation or attempt, but socio-economic factors were significantly associated with higher rates of suicidality. Access to lethal means and isolation, resulting in not being found quickly may also affect the rate of suicidality. It stressed the importance of developing and evaluating targeted evidence-based intervention strategies for at risk groups.
Morandini, J. S., Blaszczynski, A., Dar‐Nimrod, I., & Ross, M. W. (2015). Minority stress and community connectedness among gay, lesbian and bisexual Australians: a comparison of rural and metropolitan localities. Australian and New Zealand Journal of Public Health, 39(3), 260-266.
The aim of this study was to examine the impact of locality on minority stress experienced by lesbian, gay and bisexual (LGB) Australians. Increased stress and lack of community connectedness experienced by LGB individuals has been associated with increased depression, drug and alcohol use and suicidality. Data was collected by survey (n=1306) to assess minority stressors, connection with community and social isolation. The results were than analysed to assess the effect of locality on these stressors independent of gender, age, ethnicity, education and income. Those living in rural and remote areas and unexpectedly outer metropolitan areas experienced higher levels of stressors and high LGB disconnection than those living in inner metropolitan areas. Reluctance to disclose sexuality, including increased concealment of sexuality from friends and internalised homophobia in men were more common in rural and remote communities. This will put them at increased risk of psychiatric morbidity. It recommends health promotion in these communities that is aimed at reducing homophobia and discrimination and support services to assist those struggling with stigma and isolation.

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May e-book of the month

The Wiley Handbook of Anxiety Disorders by Emmelcamp, P.M.G. & Ehring, T. (2014)

This is a comprehensive book which provides an overview of management and classification of anxiety disorders. It is well organised and spilt into sections covering:

  • Classification
  • Etiology
  • Specific disorders
  • Special populations
  • Prevention
  • Clinical assesment
  • Treatment
  • Clinical management of specific disorders
  • Clinical management of comorbidity
  • Approaches to improve effectiveness
  • Agenda for future research

It’s a book that can be dipped in and out of as needed or be read as a whole to provide the reader with a solid background on anxiety and its treatment and management.

This e-book is available free to access for Healthy Options staff and volunteers from the library using the organisation’s computers.