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Help-seeking by rural residents for mental health problems: The importance of agrarian values

- Judd, Fiona, Jackson, Henry, Komiti, Angela, Murray, Greg, Fraser, Caitlin, Grieve, Aaron, Gomez, Rapson

Authors: Judd, Fiona , Jackson, Henry , Komiti, Angela , Murray, Greg , Fraser, Caitlin , Grieve, Aaron , Gomez, Rapson
Date: 2006
Type: Text , Journal article
Relation: Australian and New Zealand Journal of Psychiatry Vol. 40, no. 9 (2006), p. 769-776
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Description: Objective: To examine the role of stoicism, self-efficacy and perceived stigma in predicting help-seeking by rural residents, for mental health problems. Method: A cross-sectional community survey was conducted with a sample of 467 rural residents (58% female), who completed self-report questionnaires assessing current levels of symptomatology, disability, perceived stigma, self-efficacy, stoicism, attitudes towards and experience of seeking help for psychological problems. Results: Overall, 7.6% (n = 129) of respondents had sought help from a general practitioner and/or mental health professional for psychological problems or a mental health issue. More women than men reported having sought such help. Lifetime help-seeking for a psychological problem or mental health issue was positively associated with higher levels of distress and lower levels of stoicism and, to a lesser extent, lower levels of self-efficacy. Conclusions: Efforts to improve help-seeking by rural residents for mental health problems should focus on understanding and addressing attitudes, such as stoicism which act as barriers to help-seeking. © 2006 The Authors; Journal compilation © 2006 The Royal Australian and New Zealand College of Psychiatrists.
Description: C1
Description: 2003002045

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Going beyond CSF II to nurture the head and heart of students in Victorian schools

- Fisher, John

Authors: Fisher, John
Date: 2001
Type: Text , Journal article
Relation: Health Education Australia Vol. 1, no. 1 (2001), p. 6-9
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Description: The foreword to the Victorian Curriculum and Standards Framework II notes the skills and knowledge that students now need to prepare them to work. The preface states that the curriculum standards framework (CSF) makes it clear what students should know and be able to do. Focusing on the essentials provides a rationalistic approach to humans doing, rather than humans being. At this point, one could well ask about attitudes, values and beliefs which lie at the heart of nurturing people. [Author abstract, ed]

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"Drugs on the mind" : dual diagnosis : the experience of mental health professionals

- Soar, Rod

Authors: Soar, Rod
Date: 2003
Type: Text , Thesis , Masters
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Description: Recent publicity has focused on the problems created by the usage of illicit drugs in the community. The growing use of illicit drugs throughout the Grampians region and the lack of resources and professional services available to regional and rural areas raise many questions as to treatment options and the accessibility and appropriateness of drug and alcohol and mental health services. Despite the fact that mental health professionals in rural/regional areas are expected to deliver the most appropriate care to individuals with a comorbid drug and alcohol and psychiatric disorder, a number of these rural/regional mental health professionals have limited preparation and experience in dealing with dual diagnosis issues. This phenomenological study focuses on the area of dual diagnosis, specifically the experiences of health professionals who care for clients diagnosed with a serious mental illness and a coexisting drug and alcohol disorder. Results are described in the form of four themes, which emerged from data collected during in-depth interviews with 13 mental health professionals who care for clients with a dual diagnosis. The themes captured in this research will be described using metaphors as headings. The first theme Sink or swim represents mental health professionals’ initial preparation to care for this group of complex clientele. Treading water symbolises mental health professionals’ endeavours to keep their head above water and reflects on their feelings while endeavouring to do so. Rowing against the tide describes mental health professionals’ understanding of clients’ drug misuse, which impacts greatly on the level of care.
Description: Master of Nursing

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Internet tool box for rural GPs to access mental health services information

- Ollerenshaw, Alison

Authors: Ollerenshaw, Alison
Date: 2009
Type: Text , Journal article
Relation: Rural and Remote Health Vol. 9, no. (2009), p.
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Description: Introduction: Rural GPs play a significant role in the mental health care of their patients. It is therefore crucial that they have access to reputable support and advice that enhances their existing knowledge. This article outlines a recent project initiated by the Australian rural Ballarat and District Division of General Practice (BDDGP) to develop and implement an online resource to facilitate local implementation and delivery of the ‘Better Access to Mental Health Care’ (BAMHC) program. This 12 month project was initiated in response to a request from local GPs for additional information about and support in using the BAMHC program. The project is the culmination of significant collaboration among key stakeholders that includes local GPs, GP advisors from BDDGP, BDDGP staff, and two University of Ballarat research centres (the Centre for Health Research and Practice, and the Centre for Electronic Commerce and Communication). This article documents the key stages involved in the project from initiation to implementation, and reports on the use of this resource 12 months after its launch. Method: The BDDGP represents 107 GPs and six GP registrars and covers a large rural/semi-rural area of 7300 km2 and a catchment population of more than 120 000. The format and design of the project entailed four distinct but interrelated stages of development: (1) developing the program specifications and localising it to the BDDGP catchment; (2) constructing a decision-making support tool with 7 sequential steps comprising key questions and links to detailed answers; (3) developing and populating an online service directory of local allied health professionals; and (4) constructing the website for easy access and navigation for GPs and other service providers. Results: The website was publicly launched in December 2007 and is hosted by BDDGP. Since then it has received strong support. In the 12 months since its launch the website received regular and continuous visits (2847 visits/11 500 pages accessed). In addition, anecdotal evidence and other feedback (positive comments; requested changes to entries in the service directory from allied mental health professionals) indicate that the website is being recognised as an important resource of and hub for local information relating to the BAMHC program for GPs and allied health professionals. Conclusions: Integral to the website’s success and sustainability is the close and continued monitoring and updating of the information provided. A formal, longitudinal evaluation 18 months to 2 years after the website’s launch is recommended to provide a more rigorous assessment of the tool, and examine possible improvements. While the project does not address the problem of the supply of allied mental health providers in rural areas, it does provide assistance with responsive service system expansion and the provision of a localized tool for accessing appropriate information about mental health services.

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Mental health problems in rural contexts : A broader perspective

- Boyd, Candice, Hayes, Louise, Sewell, Jessica, Caldwell, Kirra, Kemp, Evan, Harvie, Lisa, Aisbett, Damon, Nurse, Sarah

Authors: Boyd, Candice , Hayes, Louise , Sewell, Jessica , Caldwell, Kirra , Kemp, Evan , Harvie, Lisa , Aisbett, Damon , Nurse, Sarah
Date: 2008
Type: Text , Journal article
Relation: Australian Psychologist Vol. 43, no. 1 (2008), p. 2-6
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Description: The objectives of this article are to expand and comment upon a recent review in Australian Psychologist of the literature in relation to mental health problems in rural contexts by Jackson et al. (2007). In the present article we review recently published qualitative research on the help-seeking attitudes and experiences of rural Australian adolescents. While we agree on the utility of the Macintyre, Ellaway, and Cummins (2002) conceptual framework based on notions of health and place, we note that this framework specifically emphasises the importance of the collective dimension. We present a broader perspective on health and place than Jackson et al. (2007) by incorporating social geographic research. We argue that rural mental health research has been hampered by a simplistic view of social stigma of mental illness and that a more thorough conceptualisation of the phenomenon is needed. Finally, we make some further recommendations based on a broader perspective of mental health in rural contexts: one that incorporates an in-depth understanding of the help-seeking attitudes and experiences of rural adolescents as well as an appreciation of the collective social functioning of rural communities.
Description: C1

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The longitudinal effects of midwife-led postnatal debriefing on the psychological health of mothers

- Selkirk, Rosemary, McLaren, Suzanne, Ollerenshaw, Alison, McLachlan, Angus, Moten, Julie

Authors: Selkirk, Rosemary , McLaren, Suzanne , Ollerenshaw, Alison , McLachlan, Angus , Moten, Julie
Date: 2006
Type: Text , Journal article
Relation: Journal of Reproductive and Infant Psychology Vol. 24, no. 2 (2006), p. 133-147
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Description: To assess the effect of midwife-led postpartum debriefing on psychological variables, 149 women were recruited in the third trimester of their pregnancy and were randomly assigned to treatment and control conditions. Women in the treatment group received midwife-led postpartum debriefing within 3 days postpartum, whereas women in the control group did not receive formalised debriefing. Background information and psychological variables were assessed in the prepartum, and birthing information was gathered 2 days postpartum. The psychological variables, plus a measure of birth trauma, were re-assessed at 1 month, and again, together with a measure of parenting stress, at 3 months postpartum. Although the majority of women reported positively on their debriefing experience, statistical analyses indicated that only on the measure of dyadic satisfaction was there some suggestion that debriefing was effective. There were no significant differences between the treatment and control groups on measures of personal information, depression, anxiety, trauma, perception of the birth, or parenting stress at any assessment points, postpartum. On the other hand, the effect of medical intervention on women's perceptions of their birthing was evident, with women who experienced more medical intervention reporting more negative perceptions of their birthing than women who had experienced less medical intervention. Surprisingly, this difference was more marked among the women who had been debriefed than among the control group. Generally, the results did not support midwife-led debriefing as an effective intervention postpartum. © 2006 Society for Reproductive and Infant Psychology.
Description: C1
Description: 2003001984

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Issues in rural adolescent mental health in Australia

- Boyd, Candice, Aisbett, Damon, Francis, Kristy, Kelly, Melinda, Newnham, Karyn, Newnham, Krystal

Authors: Boyd, Candice , Aisbett, Damon , Francis, Kristy , Kelly, Melinda , Newnham, Karyn , Newnham, Krystal
Date: 2006
Type: Text , Journal article
Relation: Rural and Remote health Vol. 6, no. 501 (2006), p. 1-9
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Description: The mental health of adolescents living in rural Australia has received little research attention. In this article, the extant literature on rural adolescent mental health in Australia is reviewed. Given the lack of literature on this topic, the review is centered on a vignette presented at the beginning of the article. The case represented by the vignette is that of a young Australian growing up in a rural area. The issues raised – including the nature of mental health issues for rural adolescents and barriers to seeking professional help – are then discussed in terms of the available literature. The article concludes with a future focus for research efforts in the area of rural adolescent mental health.
Description: C1
Description: 2003001815

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Caring for clients with dual diagnosis in rural communities in Australia : The experience of mental health professionals

- Deans, Cecil, Soar, Rod

Authors: Deans, Cecil , Soar, Rod
Date: 2005
Type: Text , Journal article
Relation: Journal of Psychiatric and Mental Health Nursing Vol. 12, no. 3 (2005), p. 268-274
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Description: This paper identifies and describes the experiences of 13 rural mental health professionals who care for clients diagnosed with a mental illness and a coexisting alcohol and other drug disorder (dual diagnosis). Dual diagnosis is a common problem which is often poorly understood and managed by mental health professionals. The effect of excessive substance use on a person's mental well-being can present as a diagnostic challenge as each condition may mask symptoms of the other. The authors utilized a phenomenological approach to discover the experiences of a group of mental health professionals working in rural communities in Victoria, Australia. Caring for clients diagnosed with dual diagnosis was found to be a complex and stressful role that involved high levels of skill and knowledge. Despite the fact that health professionals in rural areas are expected to deliver the most appropriate care to individuals with a dual diagnosis, a number of these rural health professionals have limited preparation and experience in dealing with arising clinical diagnosis issues. Clinicians experience frustration, resentment and powerlessness in their attempt to understand their clients' drug misuse whilst simultaneously endeavouring to provide a quality mental health service. © 2005 Blackwell Publishing Ltd.
Description: C1
Description: 2003001191

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Innovation and capacity growth in mental health promotion : Working with the past

- Crouch, Alan

Authors: Crouch, Alan
Date: 2006
Type: Thesis , PhD
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Description: The field of practice addressed by this Portfolio of works is mental health promotion in the context of survival of extreme, organized, armed violence and associated repression. Studies were undertaken in two historical and geo-political settings – Cambodian refugees in Australia post 1979 and Bulgarian post World War II concentration camp survivors after the fall of communism in 1989. The portfolio reports on original image-based research in mental health promotion, using discussions by focus groups composed of genocide and repression survivors. The discourse developed by each group following reflection on a set of photographs from respective conflict periods was used to explore meaning-making within that survivor group.
Description: Doctor of Health Promotion

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Coping and resilience in farming families affected by drought

- Boyd, Candice, Caldwell, Kirra

Authors: Boyd, Candice , Caldwell, Kirra
Date: 2009
Type: Text , Journal article
Relation: Rural and Remote Health Vol. 9, no. (2009), p.
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Description: Objectives: The present study was a qualitative investigation of the impact of drought on rural families of southern New South Wales, Australia, with particular emphasis on the concept of resilience in times of stress. The aim was to provide insight, from a psychological perspective, into the experiences of rural farmers in a time of adversity, and to identify the coping resources utilized by these farming families. Method: Participants were 11 members of five families from Blighty, a small farming town in the Riverina district, experiencing drought and decreased water allocation to their local area. Family members were interviewed on two separate occasions at their farms. Results: Analysis of interview transcripts revealed that a wide range of coping strategies were being utilized by these families from problem-focussed coping, optimism and positive appraisal to less adaptive strategies such as cognitive dissonance, denial and avoidance of negative social influences. A significant finding was the discovery of a range of collective coping strategies used by the families in this study and the reliance on social capital as an adaptive resource. There were signs, however, that social cohesion of this community had become compromised due to competition for resources. Conclusion: The adaptive coping mechanisms traditionally employed by these farming families are starting to weaken and urgent work to enhance the individual coping strategies of farmers is needed. Furthermore, Government needs to recognise the importance of social capital as a coping resource that will enable farming families to adapt and survive drought conditions into the future. Providing financial assistance to support current community initiatives and collective coping strategies may prove more beneficial to farmers than allocating inadequate amounts of funding to individual farming families.
Description: 2003008039

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Development and evaluation of a pilot program to reduce stigma of mental illness among rural adolescents

- Newnham, Krystal

Authors: Newnham, Krystal
Date: 2011
Type: Text , Thesis , PhD
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Description: Two forms of stigma – social and self – represent barriers to receiving professional help for rural Australian adolescents with mental health issues. Characteristics of rural communities such as self-reliance, social proximity and social exclusion are thought to compound experiences of stigma, creating a fear of seeking professional help. The aim of this project was to design and evaluate a stigma reduction program for rural secondary school students. A two-stage quasi-experimental research design was developed. Study 1 involved working collaboratively with seven students from a rural secondary school to develop a population specific program. The curriculum development process was evaluated and the final form of the intervention documented. Study 2 involved delivering and evaluating the intervention within the same secondary school. The aim of Study 2 was to decrease adolescents‟ stigma of mental illness, as measured by social and self stigmatic attitudes, desired social distance, and help-seeking intentions. The treatment group comprised students from year 7, 8, 9, and 12, and the control comprised a delayed treatment group of comparable students from these year levels. After accounting for attrition, the treatment group comprised 31 (16 females) participants, and the delayed treatment group 36 participants (16 females). Measures of stigmatic attitudes, desired social distance and help-seeking intentions were taken at pre-, post-, and 12-week follow-up. The intervention comprised two sessions each of 90 minutes spaced one week apart. Focus-group discussions held post-intervention expanded evaluations of the program; and suggested areas for improvement. The first hypothesis, that prior to intervention, adolescent boys would have significantly higher social stigma, self stigma, desired social distance from those with mental illness, and perceived barriers to seeking help than females, was supported. The second hypothesis, that participants in the treatment group would report lower social- and self-stigma, desired social distance, and fewer perceived barriers to seeking help post-intervention than pre-intervention and compared to the control group was supported in part. The third hypothesis, that reductions in social stigma, self stigma, desired social distance, and barriers to seeking help would be maintained at follow-up also received mixed support. Qualitative data confirmed that student attitudes towards those with mental health issues improved slightly; however, it also indicated that more change was possible and provided direction for future programs. Results have implications for anti-stigma campaign development and implementation. Suggestions for developing more effective anti-stigma programs that will help to lift the burden of stigma and to increase help-seeking behaviours for rural youth are discussed.
Description: Doctor of Psychology

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