Obstacles to the take-up of mental health care provision by adult males in rural and remote areas of Australia: a systematic review thesis

Introduction/background: Research and practice have suggested that mental health care, and mental health care practices and practitioners, along with mental health care systems, seem to be confronted with obstacles in the take-up and delivery of mental health-care services to adult males living in rural and remote areas of Australia. The aim of this systematic review thesis is to appraise and synthesise research evidence about these obstacles. These obstacles may influence the interaction between adult rural and remote dwelling males, and mental health care providers and mental health care systems. This thesis reviews and analyses health data from health systems, provider and recipient view points, through a critical analysis of the research literature published from 1995. This field of research has warranted further exploration and understanding in both qualitative and quantitative domains. Methodology The qualitative and quantitative components of this systematic review thesis have considered studies which included adult males of all racial and cultural backgrounds residing in rural and remote areas of Australia. The quantitative component has considered studies which evaluated the nature, significance, causes of and remedies to obstacles to mental health care, and the nature and significance of such obstacles from both the provider and recipient points of view. The qualitative component has considered studies which explored the meaning and experience of obstacles from similar viewpoints. Results: The outcomes of this systematic review thesis have led to the identification and description of four categories of obstacles which impact on adult males seeking mental health care in rural and remote communities of Australia. These categories are population characteristics, environment, health behaviour and health outcomes. Conclusion Quantitative and qualitative data has revealed a constellation of statistical data and themes from men’s perceptions and experiences that clarify the everyday nature of obstacles to the take-up of mental health care by rural and remote dwelling Australian adult males. Provider (supply side) and recipient (demand side) obstacles contribute to the factors involved in the demand for and supply of services and the under-use of mental health care services by adult rural and remote males in Australia. This analysis opens a fertile ground for future research in this field.Thesis (M.Clin.Sc.) -- University of Adelaide, School of Translational Health Science, 2014