Promotion and Prevention of Mental Health Problems in Rural and Remote Context

Abstract

The imperative for targeted mental health promotion, and mental illness and suicide prevention programs in rural and remote Australian communities, can in part be validated by the high prevalence of mental ill-health, acute distress, suicidality, and suicide deaths in these communities. In addition to the impacts on those with lived experience, mental health has collective implications for rural and remote communities, workplaces, and economies. These implications support the need for systemic change and greater investment in effective program delivery and evaluation. Whether programs or services are effective will depend largely on the extent to which they engage with the target audience; utilize culturally and geographically relevant approaches; reduce stigma and improve mental health literacy; influence positive behaviors; and fill gaps in the continuity of care between clinical services, in-community supports, and informal care methods.

While “whole of community” prevention – from primary prevention through to secondary and tertiary prevention – is key, there is a definitive need to respond to particular “high-risk” cohorts as target sub-groups of rural and remote populations. This includes Aboriginal and Torres Strait Islander peoples; culturally and linguistically diverse communities; workers in certain industries such as farming, primary production, fishing, and forestry; older Australians; LGBTIQ+people; and youth cohorts – noting that these groups are not mutually exclusive and that a myriad of mitigating factors prevail depending on individual and community variables.

Several priorities will determine program suitability: delivery and content relevance, localized communication methods, level of collaboration, facilitation of stepped care pathways, practical reach and accessibility, sustainability and scalability, evidence base, evaluation method, and demonstrable impacts. Integration of high-quality programs and services, with a community-led approach that is sensitive to local needs, experiences, and strengths, is the way forward.