Citation

De Silva T, Prakash A, Yarlagadda S, Johns MD, Sandy K, Hansen V, Phelan S, Pit S. Int. J. Ment. Health Syst. 2017; 11: e54.

Affiliation

University Centre for Rural Health, Western Sydney University, University of Sydney, Lismore, NSW Australia.

Copyright

(Copyright © 2017, Holtzbrinck Springer Nature Publishing Group - BMC)

DOI

10.1186/s13033-017-0159-x

PMID

28936233

PMCID

PMC5604408

Abstract

BACKGROUND: Rural communities in Australia face significant disadvantages relating to geographical isolation and limited access to mental health services. Documenting general practitioners' (GP) experiences and perception of mental health services in rural Australia may be useful to gain insight into rural GP management of mild to moderate depression. AIMS: To explore GPs' experience and views on which factors influence access to mental health services for mild to moderate depression.

METHOD: This qualitative study was conducted in 2014 in the Northern Rivers, NSW, Australia. Data were obtained from semi-structured in-depth face-to-face interviews with ten GPs, and analyses were performed using a general inductive method of thematic analysis.

RESULTS: Most GPs believed that the current services for managing mild-moderate depression were adequate, however they also identified the need for better access and more services that were free for patients. GPs had a positive perception of management of depression in a rural setting, identifying advantages including better doctor-patient relationships, continuity of care and the proximity of services. However, GPs also identified several barriers to access to mental health services in a rural setting, including long waiting-times, inadequate patient rapport with referred professionals, cost of treatment, transportation, geographical location, stigma, and lack of education about available mental health services. As a result, GPs frequently self-managed patients in addition to referring them to other community mental health service providers where possible.

CONCLUSION: Overall, GPs appeared relatively satisfied with the resources available in their communities but also identified numerous barriers to access and room for improvement. Rural GPs often self-managed patients in addition to referring patients to other mental health services providers. This should be taken into account when designing mental health policies, developing new services or re-designing current services in rural communities.

Language: en

Keywords

Depression; General practice; Mental health; Mental health services; Primary healthcare; Rural health; Rural health services; Social determinants of health