Within the boundary fence: an investigation into the perceptions of men’s experience of depression in rural and remote areas of Australia

Abstract

This is a study exploring perceptions of men's experience of depression in rural and remote areas of Australia. The purpose of this investigation was to generate 'new' information that can inform models of diagnosis and primary care for the treatment of depression in men in rural and remote areas. Men and women were recruited from two North Queensland sites to participate in semistructured interviews in both an individual and focus group format and completing a series of questionnaires. A combination of grounded theory and content analysis was adopted to analyse the qualitative data, and develop theory around men's experience of depression in rural and remote areas. The findings of this study suggest that men's experience of depression within a rural context is defined by a process of 'internal compound' whereupon emotional distress can represent itself in avoidant and dulling behaviours along with self-reliant attempts to 'fix' the situation. From this study a language has been provided to give explanation to the experience of depression in men in rural and remote areas. The findings of this study have implications for, and provide opportunity for reform in, how we approach the recognition, diagnosis and treatment of depression for men in rural and remote areas.

Help‐seeking experiences of older adults with a diagnosis of moderate depression

“…Issues of inadequate geographical availability of formal support were most apparent for participants who were living outside metropolitan areas, particularly those in smaller regional or rural communities. This was highlighted in a study concerning men's experience of depression in rural and remote areas of Australia (Patterson‐Kane & Quirk ). Other common help‐seeking barriers include long waiting times for appointments and difficulties establishing trusting relationships with new health professionals (Arnow et al .…”

Epistemological flaws in NICE review methodology and its impact on recommendations for psychodynamic psychotherapies for complex and persistent depression

“…Recent literature since 2009 (not reviewed by the GC) extends client experience data to under-represented groups and has been undertaken in more recent social and economic contexts (e.g. Smith & Rhodes, 2014;van Grieken et al, 2014;Oliffe et al, 2013;Corcoran et al, 2013;Patterson-Kane & Quirk, 2014;Anderson & Roy, 2013;Brown et al, 2012;Oliffe et al, 2011;Körner et al, 2011;Gask et al, 2011;Bryant-Bedell & Waite, 2010;Oliffe et al, 2012). Recent literature also includes a qualitative metasynthesis of the experiences of people caring for partners or family members with depression (Priestley & McPherson, 2015) which could have informed the current guideline.…”

The Treatment of Comorbid Anxiety in a Male With Poorly Controlled Diabetes in a Very Remote Primary Health Care Service

“…Individuals in rural and remote locations and metropolitan areas experience similar rates of mental-health disorders; however, the expression and language associated with the conditions are shown to be different (ABS, 2011; Madden, Barnard, & Owen, 2013). For example, depression experienced by men living in rural and remote locations and the language to describe their experience (e.g., “internal compound being kept within the boundary face,” “blowing up,” “nearing the edge,” and “fixing it”) was inconsistent with the language used in current assessment tools for depression in men and women living in major cities, such as the Depression, Anxiety and Stress Scale (DASS; Lovibond & Lovibond, 1995; Patterson-Kane & Quirk, 2013). Diabetes-intervention programs for individuals who reside in rural and remote locations need to understand, and respect, broader context issues specific to rural and remote locations including the use of appropriate language (Murray et al, 2004).…”

“…However, flexibility and adaptability in delivering health care is a necessity of rural and remote clinical practice. Flexibility around language use, and conscious awareness of the language used to describe experiences and issues, is also a required adaptation of rural and remote clinical practice (Fraser et al, 2002; Patterson-Kane & Quirk, 2013). For example, metaphors were used to describe Mr. Anderson’s physical health, mental health, and the relationship between the two (e.g., “weight on my shoulders,” “whipping boy,” etc) that are specific to life in rural and remote communities to ensure that Mr. Anderson remained heard, motivated, and engaged in psychological treatment.…”