Carers' experiences of accessing and navigating mental health care for older people in a rural area in Australia

Dawson, Suzanne; Gerace, Adam; Muir‐Cochrane, Eimear; O’Kane, Deb; Henderson, Julie; Lawn, Sharon; Fuller, Jeffrey

doi:10.1080/13607863.2015.1078283

Cited by 17 publications

(57 citation statements)

References 36 publications

(52 reference statements)

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“…11 Although there are a number of Australian studies on caregiving, many have either looked at specific health issues such as chronic heart conditions, 13 motor neuron and other similar degenerative diseases, 14 15 Alzheimer's or dementia, [16][17][18] specific cancers 19 and palliative care and/or end-of-life care issues. 20 21 Almost all studies on carers' health with the exception of a recent qualitative study 22 have been conducted in large cities and metropolitan areas. It is well established that people living in rural regions in Australia face significant challenges in relation to health and social services, and this background merits specific focused investigations.…”

Section: Strengths and Limitations Of This Studymentioning

confidence: 99%

“…24 Scores on the K-10 range from 10 to 50 with higher scores indicating higher levels of psychological distress. The designated cut-off scores for low (10)(11)(12)(13)(14)(15), moderate (16)(17)(18)(19)(20)(21), high (22)(23)(24)(25)(26)(27)(28)(29) and very high (30-50) levels of psychological distress. Australian population norms were drawn from Australian Bureau of Statistics data.…”

Section: Data Measurementmentioning

confidence: 99%

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Self-reported physical and mental health of Australian carers: a cross-sectional study

et al. 2016

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ObjectiveTo report on self-reported physical and mental health of informal carers in rural regions of New South Wales, Australia.MethodsA cross-sectional community-based sample (n=222) of carers completed a questionnaire incorporating self-reported measures of health from validated international instruments including Medical Outcomes Study Scale (SF-36), the Centre for Epidemiology-Depression (CES-D) and Kessler-10 (K-10) Psychological Distress Scales, along with information on participant demographics and other key caregiving characteristics such as health condition of care recipient.ResultsRural carers’ self-reported health was poor as evident on the SF-36 Physical and Mental Health component scores as well as each individual domain of the SF-36. Results from the CES-D and K-10 scores indicated very high rates of depressive symptoms and psychological distress. Over 70% of carers within the current study had CES-D scores indicative of depressive symptoms. Scores on the K-10 indicate almost half the carers were experiencing high levels of psychological distress, which is over 4 times the rate reported in the general Australian population.Conclusions and implicationsResults from this study were compared to Australian population normative data and were found to be significantly below Australian age-matched population norms for SF-36, CES-D and K-10. These findings illustrate the poor health profile of informal carers relative to the general Australian population, especially in terms of depressive symptoms and psychological distress. This highlights the need for additional support for rural carers in order to ease the accumulated mental and physical health burdens of this group.

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Section: Strengths and Limitations Of This Studymentioning

confidence: 99%

Section: Data Measurementmentioning

confidence: 99%

Self-reported physical and mental health of Australian carers: a cross-sectional study

et al. 2016

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“…As the percentage of older Australians in the population increases, these figures are likely to grow. Carers provide both practical and emotional support [2] and often play an important role in navigating the available services and coordination of care for the care recipients [3].…”

Section: Introductionmentioning

confidence: 99%

Psychological distress among carers and the moderating effects of social support

et al. 2020

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Background: Carers provide both practical and emotional support and often play an important role in coordination of care for recipients. The demands of caring may lead to increased levels of stress for the carer, which can affect mental health and quality of life. This study examined the relationship between being a carer and psychological distress (assessed using the Kessler Psychological Distress Scale [K10]), and explored the moderating effect of social support in that relationship using a large sample. Methods: The study used data from the 45 and Up study, a large cohort study of individuals aged 45 years and over in New South Wales, Australia, and applied multiple regression methods and moderation analysis. The sample for the current study comprised 267,041 participants drawn from the baseline dataset, with valid data on the primary outcome (carer status). Results: The mean age of participants was 62.73 (±11.18) years, and 4.23% and 7.13% were identified as full-time and part-time carers, respectively. Compared to non-carers, full-time carers had K10 scores that were on average, higher by 1.87, while part-time carers' K10 scores were on average higher by 1.60 points. A perception of social support reduced the strength of the relationship between carer status and psychological distress by 40% for fulltime carers and 60% for part-time carers. Conclusions: The findings have important implications, for both prevention and treatment of psychological problems among carers. In terms of prevention, they suggest that public health campaigns focused on increasing awareness regarding the psychological burden faced by carers would be useful. In terms of intervention, potential treatments that focus on improving social support networks may be helpful. The results are particularly important in the current context of an ageing population in Australian and other developed countries, where caregiving is likely to play an increasing role in the care and support services.

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“…Different cultures in this study result in difficulties in establishing procedures across the public and private sectors and in attracting GPs to meetings to plan collaborative activities It also creates difficulties for consumers and carers who are required to navigate a fragmented system, leading to people falling through the gaps (Dawson et al, 2017).…”

Section: Discussionmentioning

confidence: 99%

Regional responses to the challenge of delivering integrated care to older people with mental health problems in rural Australia

Henderson

Dawson

Fuller

et al. 2017

Aging & Mental Health

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Objective: Integrated care has been identified as means of managing the demands on the healthcare budget while improving access to and quality of services. It is particularly pertinent to rural health services, which face limited access to specialist and support services. This paper explores the capacity of three rural communities in South Australia to deliver integrated mental health support for older people.Methods: Thirty-one interviews were conducted with local health and social service providers from mental health, community health, general practice, residential aged care, private practice, NGOs and local government as part of a larger action research project on service integration.Results: Participants highlighted differences in service delivery between the communities related to size of the community and access to services. Three structural barriers to delivery of integrated care were identified. These are as follows: fragmentation of governmental responsibility, the current funding climate, and centralisation and standardisation of service delivery. Conclusion:We conclude that despite a focus upon integrated care in mental health policy, many features of current service delivery undermine the flexibility and informal relationships that typically underpin integration in rural communities.

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Carers' experiences of accessing and navigating mental health care for older people in a rural area in Australia

Cited by 17 publications

References 36 publications

Self-reported physical and mental health of Australian carers: a cross-sectional study

Self-reported physical and mental health of Australian carers: a cross-sectional study

Psychological distress among carers and the moderating effects of social support

Regional responses to the challenge of delivering integrated care to older people with mental health problems in rural Australia

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