Future of Rural, Remote, and very Remote Mental Health

Abstract

For the effects of rurality to be minimized with regard to the impact of mental health problems in RRvR locations, a number of changes need to occur. While living in nonurban locations certainly has its challenges, it has a number of unique benefits that could be emphasized in order to improve recruitment and retention of a skilled mental health workforce. Lifestyle factors, community involvement, the beauty of the natural environment, and the scope of practice are some of the common features of living and working in RRvR settings that could be promoted to mental health professionals to encourage them to consider a career away from the city. Policy changes also need to occur in a number of different areas. Recruitment and retention problems of medically trained health professionals have been addressed in Australia by successive governments developing and introducing various incentive schemes. Similar schemes could be adopted for the recruitment and retention of a diverse mental health workforce. It is also imperative that policy changes are adopted to address the lack of evaluation of programs and services that occur. Ironically, if policy required that ongoing monitoring and evaluation occurred for all mental health services and programs, mental health professionals would experience increased professional satisfaction through enhanced effectiveness of the services they offer as well as greater engagement with the people to whom they provide services. Furthermore, current training programs, generally, do not adequately prepare mental health professionals for the demands and challenges of working in RRvR places. The training of mental health professionals should be expanded to include a greater focus on areas such as primary care; the social determinants of health; ethical and professional considerations; cross-cultural service provision; and working flexibly, responsively, and a-diagnostically. Moreover, although the opportunity to undertake placements in RRvR settings is becoming more common in mental health training programs, the availability of the opportunity is still limited and needs to be expanded to more training programs. Even more important is creating the capacity to complete mental health training while remaining situated in RRvR locations. Certainly in Australia it is still almost universally the case that people must travel to urban centers for extended periods of time to train to become a mental health professional. As changes such as these begin to be introduced, residents of RRvR locations will start to enjoy the access to high-quality and effective services they require to live the lives that they would wish for themselves.