Collaboration and local networks for rural and remote primary mental healthcare in South Australia
Corresponding Author
Jeffrey Fuller RN RPN MSc(PHC) PhD
Department of Public Health, University of Adelaide, Adelaide,
Spencer Gulf Rural Health School, University of South Australia and University of Adelaide, Whyalla, and
Correspondence Dr Jeffrey FullerDepartment of Public HealthUniversity of AdelaideAdelaideSouth AustraliaAustralia 5005E-mail: [email protected]Search for more papers by this authorJane Edwards BA(Hons)
Spencer Gulf Rural Health School, University of South Australia and University of Adelaide, Whyalla, and
Search for more papers by this authorLee Martinez RN BN
Northern and Far Western Regional Health Service, Pt Augusta, South Australia
Search for more papers by this authorBruce Edwards RN RM BHAdmin MEd
Northern and Far Western Regional Health Service, Pt Augusta, South Australia
Search for more papers by this authorKaryn Reid RN
Northern and Far Western Regional Health Service, Pt Augusta, South Australia
Search for more papers by this authorCorresponding Author
Jeffrey Fuller RN RPN MSc(PHC) PhD
Department of Public Health, University of Adelaide, Adelaide,
Spencer Gulf Rural Health School, University of South Australia and University of Adelaide, Whyalla, and
Correspondence Dr Jeffrey FullerDepartment of Public HealthUniversity of AdelaideAdelaideSouth AustraliaAustralia 5005E-mail: [email protected]Search for more papers by this authorJane Edwards BA(Hons)
Spencer Gulf Rural Health School, University of South Australia and University of Adelaide, Whyalla, and
Search for more papers by this authorLee Martinez RN BN
Northern and Far Western Regional Health Service, Pt Augusta, South Australia
Search for more papers by this authorBruce Edwards RN RM BHAdmin MEd
Northern and Far Western Regional Health Service, Pt Augusta, South Australia
Search for more papers by this authorKaryn Reid RN
Northern and Far Western Regional Health Service, Pt Augusta, South Australia
Search for more papers by this authorAbstract
This paper draws on a consultation with 200 stakeholders about a mental health plan in the most remote region of South Australia to discuss primary mental healthcare improvement strategies. In rural and remote environments, a lack of services means that it is more difficult to deal with a mental illness or provide assistance for circumstantial life problems. The authors’ consultations revealed difficulties with service access, acceptability and teamwork. They also found that the availability of local human service workers leads to their use as first-level mental health contacts, but these workers are neither skilled nor supported for this. These difficulties will require attention to the boundaries between different service providers which can otherwise create inflexibility and service gaps. The regional mental health plan that is being rolled out will develop collaboration through regional interagency task groups, networking groups for local human service workers and the position of a regional mental health coordinator in order to overcome these difficulties and to operationalise service partnerships.
References
- Australian Institute of Health and Welfare (2003) Mental Health Services in Australia 2000–2001. Australian Institute of Health and Welfare, Canberra.
-
Bond M. (1997) A learning team in the making.
Journal of Interprofessional Care
11, 89–97.
10.3109/13561829709040247 Google Scholar
- Brown B., Crawford P. & Darongkamas J. (2000) Blurred roles and permeable boundaries: the experience of multidisciplinary working in community mental health. Health and Social Care in the Community 8, 425–435.
- Caplan G. & Caplan R. (2002) Principles of community psychiatry. Community Mental Health Journal 36 (1), 7–24.
- Commonwealth Department of Health and Aged Care (2000) National Action Plan for Promotion, Prevention and Early Intervention in Mental Health. Mental Health and Special Programs Branch, Commonwealth Department of Health and Aged Care, Canberra.
- Commonwealth Department of Health and Ageing (2002) Better outcomes in mental health initiative.[WWW document.] URL http://www.mentalhealth.gov.au/boimh/index.htm
- Corney R. (1994) Developing mental health services in the community: current evidence of the role of general practice teams. Journal of the Royal Society of Medicine 87, 408–410.
- Denzin N. (1994) The art and politics of interpretation. In: N. Denzin & Y. Linoln (Eds) Handbook of Qualitative Research, pp. 500–515. Sage, Thousand Oaks, CA.
- Department of Human Services (2001) Mental Health in South Australia. Action Plan for Reform of Mental Health Services. Country Mental Health Commitment 2001– 2005. Department of Human Services, Adelaide.
-
Dey I. (1993) Qualitative Data Analysis: A User-friendly Guide for Social Scientists. Routledge, London.
10.4324/9780203412497 Google Scholar
-
Double D. (1999) What do GPs want from mental health services?
Journal of Mental Health
8, 385–389.
10.1080/09638239917300 Google Scholar
- Fuller J., Edwards J., Procter N. & Moss J. (2000) How definition of mental health problems can influence help seeking in rural and remote communities. Australian Journal of Rural Health 8, 148–153.
-
Galvin S. &
McCarthy S. (1994) Multidisciplinary community teams: clinging to the wreckage.
Journal of Mental Health
3, 157–166.
10.3109/09638239409003796 Google Scholar
-
Gask L. &
Croft J. (2000) Methods of working with primary care.
Advances in Psychiatric Treatment
6, 442–449.
10.1192/apt.6.6.442 Google Scholar
- Gask L., Sibbald B. & Creed F. (1997) Evaluating models of working at the interface between mental health services and primary care. British Journal of Psychiatry 170, 6–11.
- General Practice Strategy Review Group (1998) General Practice: Changing the Future Through Partnerships. Report of the General Practice Review Group. Commonwealth Department of Health and Family Services, Canberra.
-
Gibb C.,
Morrow M.,
Clarke C.,
Cook G.,
Gertig P. &
Ramprogas V. (2002) Transdisciplinary working: evaluating the development of health and social care provision in mental health.
Journal of Mental Health
11, 339–350.
10.1080/09638230020023714 Google Scholar
- Glover J., Harris K. & Tennant S. (1999) A Social Health Atlas of Australia, Vol. 5: South Australia, 2nd edn. Public Health Information Development Unit, University of Adelaide, Adelaide.
- Goldberg D. & Jackson G. (1992) Interface between primary care and specialist mental health care. British Journal of General Practice 42, 267–268.
- Hannigan B. (1999) Joint working in community mental health: prospects and challenges. Health and Social Care in the Community 7, 25–31.
- Hassett S. & Austin M. (1997) Service integration: something old and something new. Administration in Social Work 21 (3–4), 9–29.
- Hoge M. & Howenstine R. (1997) Organizational development strategies for integrating mental health services. Community Mental Health Journal 33, 175–188.
- Hoyt D., Conger R., Valde J. & Weihs K. (1997) Psychological distress and help seeking in rural America. American Journal of Community Psychology 25, 449–470.
- Hull S., Jones C., Tissier J., Eldridge S. & Maclaren D. (2002) Relationship style between GPs and community mental health teams affects referral rates. British Journal of General Practice 52, 101–107.
- Humphreys J., Hegney D., Lipscombe J., Gregory G. & Chater B. (2002) Whither rural health? Reviewing a decade of progress in rural health. Australian Journal of Rural Health 10, 2–14.
- Jones J. & Hunter D. (1995) Qualitative research: consensus methods for medical and health research. British Medical Journal 311, 376–380.
- Judd F., Murray G., Fraser C., Humphries J., Hodgins G. & Jackson H. (2002) The mental health of rural Australians: developing a framework for strategic research. Australian Journal of Rural Health 10, 296–301.
- Katon W. & Gonzales J. (1994) A review of randomised trials of psychiatric consultation-liaison studies in primary care. Psychosomatics 35, 268–278.
- Kendrick T., Burns T. & Freeling P. (1995) Randomised controlled trials of teaching general practitioners to carry out structured assessments of their long term mentally ill clients. British Medical Journal 311, 93–98.
- Kirmayer L., Robbins J., Dworkind M. & Yaffe M. (1993) Somatisation and recognition of depression and anxiety in primary care. American Journal of Psychiatry 150, 734–741.
- Martin C., De-Caestecker L., Hunter R., Gilloran A., Allsobrook D. & Jones L. (1999) Developing community mental health services: an evaluation of Glasgow's mental health resource centres. Health and Social Care in the Community 7, 51–60.
- Meadows G. (1998) Establishing a collaborative service model for primary mental health care. Medical Journal of Australia 168, 162–165.
-
Murphy F.,
James H. &
Lloyd K. (2002) Closer working with primary care is associated with a sharp increase in referrals to community mental health services.
Journal of Mental Health
11, 605–610.
10.1080/09638230020023804 Google Scholar
- Norman I. & Peck E. (1999) Working together in adult community mental health services: an inter-professional dialogue. Journal of Mental Health 8, 217–230.
-
Onyett S. &
Ford R. (1996) Multidisciplinary community mental health teams: Where is the wreckage?
Journal of Mental Health
5, 47–55.
10.1080/09638239650037180 Google Scholar
-
Onyett S.,
Pillinger T. &
Muijen M. (1997) Job satisfaction and burnout among members of community mental health teams.
Journal of Mental Health
6, 55–66.
10.1080/09638239719049 Google Scholar
- Padgin F. (1998) Strategic Plan for Staff Development and Support. Rural and Remote Mental Health Service of South Australia, Adelaide.
- Palmer G. & Short S. (2000) Health Care and Public Policy: An Australian Analysis, 3rd edn. Macmillan Education Australia, Melbourne.
- Primary Mental Health Care Service Delivery Models Working Group (2001) Primary Mental Health Care. Future Directions for Better Integration Between Mental Health Services, General Practice, and Other Primary Care Providers in South Australia. South Australian Divisions Incorporated and Department of Human Services, Adelaide.
- Renouf N. & Meadows G. (2001) Teamwork. In: G. Meadows & B. Singh (Eds) Mental Health in Australia: Collaborative Community Practice, pp. 163–173. Oxford University Press, Oxford.
-
Roberts L.,
Battaglia J. &
Epstein R. (1999) Frontier ethics: mental health care needs and ethical dilemmas in rural communities.
Psychiatric Services
51, 497–503.
10.1176/ps.50.4.497 Google Scholar
- Rost K., Smith R. & Lynn-Taylor J. (1993) Rural-urban differences in stigma and the use of care for depressive disorders. Journal of Rural Health 9 (1), 57–62.
- Royal Australian College of General Practitioners & Royal Australian and New Zealand College of Psychiatrists. Primary Care Psychiatry. The Last Fontier. A Report of the Joint Consultative Committee in Psychiatry. Royal Australian College of General Practitioners, Royal Australian and New Zealand College of Psychiatrists, Melbourne.
- Sanson-Fisher R. & Hendrikus D. (1988) Why do primary care physicians often fail to detect psychological disturbances in their clients? In: A. Henderson & G. Burrows (Eds) Handbook of Social Psychiatry, pp. 245–256. Elsevier, Amsterdam.
- South Australian Mental Health Services (1992) A Consultation Paper on Country Mental Health Services. A Proposed Model of Service delivery. South Australian Health Commission, Adelaide.
- South Australian Mental Health Services (1993) A Strategic Plan for the South Australian Mental Health Service. South Australian Health Commission, Adelaide.
- South Australian Department of Human Services (2000) Regional profiles. [WWW document.] URL http://www.dhs.sa.gov.au/dhs_profiles/
- Strasser R. (1995) Rural general practice: Is it a distinct discipline? Australian Family Physician 24, 870–876.
- Tissier J., Hull S. & Jones C. (2002) Working relationship between GPs and community mental health teams: a qualitative study. Primary Care Psychiatry 8 (1), 21–25.
- Tyrer P. (1984) Psychiatric clinics in general practice – an extension of community care. British Journal of Psychiatry 145, 9–14.
- Walker R. (2000) Collaboration and alliances: a review for VicHealth. [WWW document.] URL http://www.vichealth. vic.gov.au/default.asp?artid=353&tmid=406&level=3
- Warner R., Gater R., Jackson M. & Goldberg D. (1993) Effects of a community mental health service on the practice and attitudes of general practitioners. British Journal of General Practice 43, 507–511.
- Woodhouse D. & Pengelly P. (1991) Anxiety and the Dynamics of Collaboration. Aberdeen University Press, Aberdeen.