Tyranny of distance impacts mental health in the bush
Researchers are calling for greater funding for rural mental health services as a new study shows patients face increasing disadvantages the further out of town they live.
James Cook University’s Dr Andrew Amos is Chair of the Queensland Section of Rural Psychiatry, RANZ College of Psychiatrists, and lead author of the study. He said Australians outside metropolitan cities face higher rates of attempted and completed suicide, worse mental health and greater barriers to accessing mental health care.
“Both community and hospital care are less available in rural locations, with private and NGO providers often operating at capacity, with limited ability to accept new patients and limited integration into public health networks.
“Our study aimed to estimate exactly how much of a barrier distance from the nearest mental health inpatient unit is to gaining access to hospital-based care and what sociodemographic factors came into play,” said Dr Amos.
He said in Australia overall the study found a 1% increase in distance from hospital was associated with a 0.37% decrease in bed days per person, and in Queensland and Western Australia a 1% increase in distance from hospital was associated with a 0.05% decreased incidence of admission.
“Our conclusion is that rural Australians face limited service provision and a reduced likelihood of admission to a mental health unit proportional to their distance from a hospital, in addition to a high mental illness burden and socioeconomic disadvantage,” said Dr Amos.
He said there were strong links between Indigenous status, preventable hospitalisations, number of admissions and length of stay, suggesting limited access to community care leads to greater reliance upon treatment after admission.
Dr Amos said overcoming these disadvantages will require increased outreach to remote areas.
“Our experience suggests that greater support for private and NGO care providers, with better integration into broader health networks focused on more effective communication between levels of the stepped care system, would make better use of existing resources.”
Dr Andrew Amos