Enhancing access to psychologically informed mental health services in rural and northern communities.

Abstract

Access to psychologically informed mental health services has historically been a challenge for the more than 6 million Canadians residing in rural and northern (R&N) communities. However, over the past 20 years, Canada has been witness to a number of positive psychologist-led initiatives aimed at enhancing access for R&N Canadians. These can be grouped into 2 main categories, namely recruiting and retaining psychologists in R&N communities and developing and implementing technologically supported psychology services offered at a distance (telepsychology). This article provides an overview of the barriers to accessing psychologically informed mental health services and reviews some of the psychologist-led initiatives aimed at enhancing access in R&N Canada. Potential benefits and limitations of these initiatives are presented and the importance of enhanced collaboration between urban and R&N-based psychologists is discussed. Finally, psychologists are encouraged to look for and embrace opportunities to further broaden and enhance their positive presence in R&N communities.

Through our lens: Experiences of adult mental health service consumers in the Arrow Lakes Region of British Columbia

“…In Canadian literature, rural and/or remote realities of mental health are inclusive of structural and attitudinal barriers to accessing mental healthcare, as well as environmental risk factors (Bodor, 2009;Dyck & Hardy, 2013;Goodwin, MacNaughton-Doucet & Allan, 2016;Panazzola & Leipert, 2013;Ryan-Nicholls & Haggarty, 2007). Identified barriers to accessing mental healthcare in Canada include proximity of services, accessibility, provider shortages and lack of mental healthcare consumer involvement in decision-making processes (Bodor, 2009;Dyck & Hardy, 2013;Panazzola & Leipert, 2013;Ryan-Nicholls & Haggarty, 2007). Ryan-Nicholls and Haggarty (2007) identified additional systemic barriers to effective rural and remote Canadian mental health care in their research.…”

“…With an increasing realization that it is unlikely the needs of rural and remote mental health consumers will be met through mainstream services, recommendations for systemic reform are emerging (Ryan-Nicholls & Haggarty, 2007). Recommendations for reform presented in the literature include: advancements in telemedicine and alternative access to specialized mental health care, implementing interprofessional mental health teams, increased mental health promotion and educational programming, inclusion of mental healthcare consumers and their families in policy and programming decisions, development of local community resources, and the development of rural curriculum for mental healthcare providers (Dyck & Hardy, 2013;Goodwin, MacNaughton-Doucet & Allan, 2016;Panazzola & Leipert, 2013;Ryan-Nicholls & Haggarty, 2007).…”

“…Existing literature showcases the significant barriers to accessing mental health services in rural and/or remote communities (Dyck & Hardy, 2013;Fitzpatrick et al, 2017;Goodwin, MacNaughton-Doucet & Allan, 2016;Handley et al, 2014;Kelly et al, 2010;Morling & Boxall, 2014;Panazzola & Leipert, 2013;Procter & Ferguson, 2014;Robinson et al, 2012;Ryan-Nicholls & Haggarty, 2007). Although these barriers are categorized in similar ways across the My exploratory, text and image-based, qualitative research with adult mental health service consumers works to address the Arrow Lakes regions' lack of representation in existing literature, while presenting the opportunity for community-based stigma reduction, increased mental health literacy, and participant empowerment through the arts-based component of this research (Koh & Shrimpton, 2014;Quinn et al, 2011;Ryan et al, 2015).…”

“…Furthermore, standpoint theory works to create space for oppressed groups to vocalize and demonstrate the ways in which privileged institutions and populations have maintained, and implemented, harmful, disadvantageous social conditions (Harding, 2009;Intemann, 2010). In the context of rural and/or remote mental health, these disadvantageous social conditions have included community stigma and the inadequacy of urban-based healthcare models in rural healthcare settings, both of which have contributed to inequitable mental health outcomes for rural, remote residents (Dyck & Hardy, 2013;Ryan-Nicholls & Haggarty, 2007).…”

“…Contemporary health policies and discussions, such as the Rural Health Services in BC: Policy Framework to Provide A System of Quality Care, are becoming increasingly invested in including experiences of health consumers in rural and remote locations in policy decisions (Government of British Columbia, 2015). This interest is -in part -attributable to the reality that individuals living in rural communities tend to have poorer socioeconomic statuses, more barriers to accessing health care services, and inequitable health outcomes in comparison to their urban counterparts (Bodor, 2009;Dyck & Hardy, 2013; Government of British Columbia, 2015; Ryan-Nicholls & Haggarty, 2007).…”