Investigating and enhancing rural communities’ existing mental health service networks.

Mental illness is a growing concern throughout the world. The burden of mental illness is increasing globally, currently representing 7.4% of the total years of life either lost due to premature mortality or lived with disability. In New Zealand, the estimated life-time risk of meeting the criteria for one or more mental illnesses is 46.6%. It is therefore essential to have a secure and effective mental healthcare system throughout the country. This can be particularly challenging to deliver in rural communities due to the unique circumstances that they face. Previous studies have found that rural residents have decreased access to mental health specialist services, and increased exposure to mental health risk factors. However, there is ongoing dispute as to rurality’s overall effects on mental health status. Further research is required. Despite the urgent need to better understand the interactions between rurality and mental health, there is a severe paucity of research in the area on a national and global scale. This action research project helped investigate the impact of rurality on mental health within New Zealand by interviewing mental health and wellbeing service providers operating in Wanaka and Balclutha. The information gathered from these rural providers included their difficulties with interagency collaboration, the effects caused by rural providers working beyond their role descriptions, rural community characteristics that impact on service access, and service deficits within rural communities. This data was used in conjunction with established literature in order to help understand several of the issues that are important to mental healthcare in rural New Zealand communities. From this background, attempts were made to help improve Balclutha’s existing mental health service network. These attempts included facilitating networking between services, creating a community-specific service information package, and encouraging the use of minimal-contact guided self-help therapies in a community-appropriate manner. By investigating issues that are pertinent to rural mental health in New Zealand, this project helps address a major gap in current knowledge. The feasibility testing and process evaluation of enhancing an existing mental health service network will also serve to greatly benefit ongoing research and action in rural New Zealand