Transition from Urban to Rural Mental Health Practice

Abstract

The process of adjustment, during the first year or longer, included a number of identifiable stages which could be called euphoria, depression, and adaptation

Beginning Country Practice

“…Rural practice entails different stresses to urban practice (Fenby 1979;Brummel 1985;Hamilton, Healy and Freeman 1985;Hart 1985) and some workers seem better suited to coping with these (Riggs & Kugel 1976;Hamilton et al 1985). Due to the slow pace of the changes, the worker is frequently unaware of the full picture of the adjustment process they arc experiencing, often only recognising the process when they are near to completing it.…”

“…Whatever the motivation for moving to a new job and town, it is an especially stressful event, more so if the move is a great distance from home, family and friends (Riggs and Kugel 1976;Jayaratne, Tipodi and Chess 1983;Hendrick 1988). There is a large degree of commonality in the reactions of workers to this change regardless of their experience, job descriptions or agency function.…”

“…At the same time there are increased feelings of loss for the pleasures of the city and proximity of friends and family. It can be characterised as a longing for things lost but is less severe in nature to the despair felt in the following phase which Riggs and Kugel (1976) describe as the depression stage. An apt metaphor for the Grief.and Loss Phase would be of a ship which has lost its rudder but whose crew have not yet given up hope.…”

“…Employing agencies have included local, state and federal government departments, hospitals and nongovernment welfare agencies. Riggs and Kugel (1976) identified three stages in the transition from urban to rural mental health practice. They are: Euphoria, Depression and Adaptation.…”

Those who stay: a phenomenological exploration of staying as experienced by social workers in northern communities

“…Reported factors that contribute to this reality include: an uneasy fit between urban-based practice models and the realities of northern communities (Findlay, 1980;Zapf, 1993); unique social, political and economic pressures (Carniol, 1991;Collier, 1993;McKay, 1987), limited availability of social services resources (Ingebrigtson, 1992;Millar, 1977), constant visibility, lack of privacy and anonymity (Fenby, 1978;Ingebrigtson, 1992;Whittington, 1984Whittington, , 1985Zapf, 1985b), personal and professional isolation (Ingebrigtson, 1992;Zapf, 1991Zapf, , 1993, culture shock (Zapf 1985b(Zapf , 1989(Zapf , 1993, stress and burnout (Zapf, 1985a(Zapf, , 1989(Zapf, , 1993, limited professional development opportunities (lngebrigtson, 1992;Wharf, 1985;Whittington, 1985), inter-meshed relationships between people, their communiti_ es and professionals (Abramson, 1980), multiple roles and the difficulty in separating personal and professional activities (Fenby, 1978;Whittington, 1984;Zapf, 1985b), and limited supervision (Ingebrigtson, 1992;Zapf, 1985b Riggs & Kugel (1976) support the generalist approach and suggest that the rural practice setting demands certain personal attributes for the workers' survival and effectiveness. Campbell & Findlay ( 1979) suspect that these attributes are not limited to social work but represent qualities that are essential for all professionals in these communities --be they teachers, nurses, or doctors.…”