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

Abstract

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.

Perceived barriers and facilitators towards help‐seeking for eating disorders: A systematic review

“…Practical factors associated with accessing treatment, including cost, transportation, and lack of time emerged as an important barrier towards help‐seeking. Previous studies on help‐seeking for mental health problems have reported similar findings, particularly in rural areas and among people from potentially disadvantaged groups . Although the included studies in the present review did not focus on rural areas, these practical barriers were similarly important, especially among ethnically diverse samples.…”

“…Previous studies on helpseeking for mental health problems have reported similar findings, particularly in rural areas and among people from potentially disadvantaged groups. 29,32,53 Although the included studies in the present review did not focus on rural areas, these practical barriers were similarly important, especially among ethnically diverse samples. In particular, financial difficulties were endorsed as a barrier by a majority of women with eating disorders from ethnically diverse backgrounds 24 ; however, no difference in treatment seeking between women of different ethnicities was found.…”

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“…We did not identify sex differences in PDS and CDS, but differences in the manner in which men and women seek help, discuss and understand problems, and engage in support networks and services should nonetheless be considered by initiatives for relieving drought-related stress. 5 Programs of support for drought-affected communities should incorporate an understanding of the relationship between drought and mental health, and take factors into account that influence PDS and CDS.…”

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