Feasibility of internet-delivered mental health treatments for rural populations

Handley, Tonelle; Kay‐Lambkin, Frances; Inder, Kerry; Attia, John; Lewin, Terry J.; Kelly, Brian

doi:10.1007/s00127-013-0708-9

Cited by 26 publications

(27 citation statements)

References 36 publications

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“…Preparedness to use the internet was higher among those reporting MH problems and other service contacts, which is consistent with earlier findings [26,43]. However, while internet-delivered treatments may eventually improve rural residents’ access to MH resources [20], at present they are subject to many of the same barriers as traditional MH services.…”

Section: Discussionsupporting

confidence: 87%

“…8.1%), which may largely reflect the older age of the ARMHS sample. Selected data from the ARMHS 3-year follow-up have also been examined [26] to try to better understand the feasibility of using internet-delivered MH treatments among rural populations, together with relevant barriers (e.g., internet availability, treatment acceptability, previous exposure).…”

Section: Introductionmentioning

confidence: 99%

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Self-reported contacts for mental health problems by rural residents: predicted service needs, facilitators and barriers

et al. 2014

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BackgroundRural and remote Australians face a range of barriers to mental health care, potentially limiting the extent to which current services and support networks may provide assistance. This paper examines self-reported mental health problems and contacts during the last 12 months, and explores cross-sectional associations between potential facilitators/barriers and professional and non-professional help-seeking, while taking into account expected associations with socio-demographic and health-related factors.MethodsDuring the 3-year follow-up of the Australian Rural Mental Health Study (ARMHS) a self-report survey was completed by adult rural residents (N = 1,231; 61% female; 77% married; 22% remote location; mean age = 59 years), which examined socio-demographic characteristics, current health status factors, predicted service needs, self-reported professional and non-professional contacts for mental health problems in the last 12 months, other aspects of help-seeking, and perceived barriers.ResultsProfessional contacts for mental health problems were reported by 18% of the sample (including 14% reporting General Practitioner contacts), while non-professional contacts were reported by 16% (including 14% reporting discussions with family/friends). Perceived barriers to health care fell under the domains of structural (e.g., costs, distance), attitudinal (e.g., stigma concerns, confidentiality), and time commitments. Participants with 12-month mental health problems who reported their needs as met had the highest levels of service use. Hierarchical logistic regressions revealed a dose-response relationship between the level of predicted need and the likelihood of reporting professional and non-professional contacts, together with associations with socio-demographic characteristics (e.g., gender, relationships, and financial circumstances), suicidal ideation, and attitudinal factors, but not geographical remoteness.ConclusionsRates of self-reported mental health problems were consistent with baseline findings, including higher rural contact rates with General Practitioners. Structural barriers displayed mixed associations with help-seeking, while attitudinal barriers were consistently associated with lower service contacts. Developing appropriate interventions that address perceptions of mental illness and attitudes towards help-seeking is likely to be vital in optimising treatment access and mental health outcomes in rural areas.Electronic supplementary materialThe online version of this article (doi:10.1186/s12888-014-0249-0) contains supplementary material, which is available to authorized users.

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Section: Discussionsupporting

confidence: 87%

Section: Introductionmentioning

confidence: 99%

Self-reported contacts for mental health problems by rural residents: predicted service needs, facilitators and barriers

et al. 2014

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“…There is also access to isolation; hence it is easier not to be found in rural areas until it is too late, following potentially less lethal means such as hanging or overdose. There are also issues around help-seeking behaviours and rural culture [58, 59]. …”

Section: Discussionmentioning

confidence: 99%

Determinants of suicidal ideation and suicide attempts: parallel cross-sectional analyses examining geographical location

et al. 2014

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BackgroundSuicide death rates in Australia are higher in rural than urban communities however the contributors to this difference remain unclear. Geographical differences in suicidal ideation and attempts were explored using two datasets encompassing urban and rural community residents to examine associations between socioeconomic, demographic and mental health factors. Differing patterns of association between psychiatric disorder and suicidal ideation and attempts as geographical remoteness increased were investigated.MethodsParallel cross-sectional analyses were undertaken using data from the 2007 National Survey of Mental Health and Wellbeing (2007-NSMHWB, n = 8,463), under-representative of remote and very remote residents, and selected participants from the Australian Rural Mental Health Study (ARMHS, n = 634), over-representative of remote and very remote residents. Uniform measures of suicidal ideation and attempts and mental disorder using the World Mental Health Composite International Diagnostic Interview (WMH-CIDI-3.0) were used in both datasets. Geographic region was classified into major cities, inner regional and other. A series of logistic regressions were undertaken for the outcomes of 12-month and lifetime suicidal ideation and lifetime suicide attempts, adjusting for age, gender and psychological distress. A sub-analysis of the ARMHS sample was undertaken with additional variables not available in the 2007-NSMHWB dataset.ResultsRates and determinants of suicidal ideation and suicide attempts across geographical region were similar. Psychiatric disorder was the main determinant of 12-month and lifetime suicidal ideation and lifetime suicide attempts across all geographical regions. For lifetime suicidal ideation and attempts, marital status, employment status, perceived financial adversity and mental health service use were also important determinants. In the ARMHS sub-analysis, higher optimism and better perceived infrastructure and service accessibility tended to be associated with a lower likelihood of lifetime suicidal ideation, when age, gender, psychological distress, marital status and mental health service use were taken into account.ConclusionsRates and determinants of suicidal ideation and attempts did not differ according to geographical location. Psychiatric disorder, current distress, employment and financial adversity remain important factors associated with suicidal ideation and attempts across all regions in Australia. Regional characteristics that influence availability of services and lower personal optimism may also be associated with suicidal ideation in rural communities.Electronic supplementary materialThe online version of this article (doi:10.1186/1471-244X-14-208) contains supplementary material, which is available to authorized users.

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“…For example, recent research has indicated the efficacy of a clinicianassisted computerised treatment program for depression and alcohol/ other drug use problems, with equivalent benefits reported for both depression and alcohol use as an entirely therapist-delivered treatment [42,44]. The Internet (and related technologies) show promise as a means of closing the gap between evidence and clinical practice in this context [42,45,46].…”

Section: Discussionmentioning

confidence: 99%

Lifetime Affective and Alcohol Use Disorder: Impact of Comorbidity on Current Functioning and Service Use in a Rural Population

Lambkin¹

2014

J Addict Res Ther

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Feasibility of internet-delivered mental health treatments for rural populations

Cited by 26 publications

References 36 publications

Self-reported contacts for mental health problems by rural residents: predicted service needs, facilitators and barriers

Self-reported contacts for mental health problems by rural residents: predicted service needs, facilitators and barriers

Determinants of suicidal ideation and suicide attempts: parallel cross-sectional analyses examining geographical location

Lifetime Affective and Alcohol Use Disorder: Impact of Comorbidity on Current Functioning and Service Use in a Rural Population

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