Journal articles: 'Rural mental health services – Western Australia'

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van Spijker, Bregje A., Jose A. Salinas-Perez, John Mendoza, Tanya Bell, Nasser Bagheri, Mary Anne Furst, Julia Reynolds, et al. "Service availability and capacity in rural mental health in Australia: Analysing gaps using an Integrated Mental Health Atlas." Australian & New Zealand Journal of Psychiatry 53, no. 10 (June 28, 2019): 1000–1012. http://dx.doi.org/10.1177/0004867419857809.

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Objective: Access to services and workforce shortages are major challenges in rural areas worldwide. In order to improve access to mental health care, it is imperative to understand what services are available, what their capacity is and where existing funds might be spent to increase availability and accessibility. The aim of this study is to investigate mental health service provision in a selection of rural and remote areas across Australia by analysing service availability, placement capacity and diversity. Method: This research studies the health regions of Western New South Wales and Country Western Australia and their nine health areas. Service provision was analysed using the DESDE-LTC system for long-term care service description and classification that allows international comparison. Rates per 100,000 inhabitants were calculated to compare the care availability and placement capacity for children and adolescents, adults and older adults. Results: The lowest diversity was found in northern Western Australia. Overall, Western New South Wales had a higher availability of non-acute outpatient services for adults, but hardly any acute outpatient services. In Country Western Australia, substantially fewer non-acute outpatient services were found, while acute services were much more common. Acute inpatient care services were more common in Western New South Wales, while sub-acute inpatient services and non-acute day care services were only found in Western New South Wales. Conclusion: The number and span of services in the two regions showed discrepancies both within and between regions, raising issues on the equity of access to mental health care in Australia. The standard description of the local pattern of rural mental health care and its comparison across jurisdictions is critical for evidence-informed policy planning and resource allocation.

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Tennant, Chris, and Derrick Silove. "The development of a mental health service in East Timor: an Australian mental health relief project." International Psychiatry 2, no. 8 (April 2005): 17–19. http://dx.doi.org/10.1192/s1749367600007232.

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East Timor (the Democratic Republic of Timor-Leste) occupies the eastern half of the island of Timor, which lies between North Western Australia and the Indonesian archipelago. East Timor has a population of around 860 000. It is predominantly rural and there are few large towns. The country has a largely subsistence agricultural economy; coffee is the principal cash crop. The population is extremely poor, and transport and communications are primitive.

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Burmeister, Oliver K., and Edwina Marks. "Rural and remote communities, technology and mental health recovery." Journal of Information, Communication and Ethics in Society 14, no. 2 (May 9, 2016): 170–81. http://dx.doi.org/10.1108/jices-10-2015-0033.

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Purpose This study aims to explore how health informatics can underpin the successful delivery of recovery-orientated healthcare, in rural and remote regions, to achieve better mental health outcomes. Recovery is an extremely social process that involves being with others and reconnecting with the world. Design/methodology/approach An interpretivist study involving 27 clinicians and 13 clients sought to determine how future expenditure on ehealth could improve mental health treatment and service provision in the western Murray Darling Basin of New South Wales, Australia. Findings Through the use of targeted ehealth strategies, it is possible to increase both the accessibility of information and the quality of service provision. In small communities, the challenges of distance, access to healthcare and the ease of isolating oneself are best overcome through a combination of technology and communal social responsibility. Technology supplements but cannot completely replace face-to-face interaction in the mental health recovery process. Originality/value The recovery model provides a conceptual framework for health informatics in rural and remote regions that is socially responsible. Service providers can affect better recovery for clients through infrastructure that enables timely and responsive remote access whilst driving between appointments. This could include interactive referral services, telehealth access to specialist clinicians, GPS for locating clients in remote areas and mobile coverage for counselling sessions in “real time”. Thus, the technology not only provides better connections but also adds to the responsiveness (and success) of any treatment available.

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Doyle, Kerrie. "Measuring cultural appropriateness of mental health services for Australian Aboriginal peoples in rural and remote Western Australia: a client/clinician's journey." International Journal of Culture and Mental Health 5, no. 1 (April 2012): 40–53. http://dx.doi.org/10.1080/17542863.2010.548915.

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Haythornthwaite, Sarah. "Videoconferencing training for those working with at-risk young people in rural areas of Western Australia." Journal of Telemedicine and Telecare 8, no. 3_suppl (December 2002): 29–33. http://dx.doi.org/10.1258/13576330260440772.

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summary Rural Links is a videoconference training initiative developed for those who work with at-risk young people in remote and rural regions of Western Australia. The training programme was run twice (in parallel) for two groups of participants: 17 workers from the Great Southern and South West regions of Western Australia and 15 workers from the Wheatbelt, Pilbara and Kimberley regions of Western Australia. The programme consisted of seven 2 h sessions presented over 12 weeks. Objectives of the training programme centred on increasing participants’ knowledge and confidence in relation to the training topics. The initiative also aimed to enhance consultation between rural youth networks and a metropolitan-based youth mental health service (YouthLink). Analyses indicated that there were improvements in workers’ knowledge and confidence in relation to training topics following participation in the programme. Comparisons of the improvements made by these rural participants, who accessed training via videoconferencing, and metropolitan participants, who accessed training face to face, revealed few significant differences. Rural participants reported high levels of satisfaction, decreased feelings of professional isolation and an increased likelihood of accessing YouthLink for consultative support as a result of completing the Rural Links training programme.

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Green, Lelia. "Imagining Rural Audiences in Remote Western Australia." Culture Unbound 2, no. 2 (June 11, 2010): 131–52. http://dx.doi.org/10.3384/cu.2000.1525.1029131.

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In 1979, Australia’s then-Communication Minister Tony Staley commented that the introduction of satellite communications to the bush would “dispel the distance – mental as well as geographical – between urban and regional dwellers, between the haves and the have-nots in a communication society” (Staley 1979: 2225, 2228-9). In saying this, Staley imagined a marginalised and disadvantaged audience of “have-nots”, paying for their isolation in terms of their mental distance from the networked communications of the core. This paper uses ethnographic audience studies surveys and interviews (1986-9) to examine the validity of Staley’s imaginations in terms of four communication technologies: the telephone, broadcast radio, 2-way radio and the satellite. The notion of a mental difference is highly problematic for the remote audience. Inso-far as a perception of lack and of difference is accepted, it is taken to reflect the perspective and the product of the urban policy-maker. Far from accepting the “distance” promulgated from the core, remote audiences see such statements as indicating an ignorance of the complexity and sophistication of communications in an environment where the stakes are higher and the options fewer. This is not to say that remote people were not keen to acquire satellite services – they were – it is to say that when they imagined such services it was in terms of equity and interconnections, rather than the “dispelling of distance”.

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Aoun, Samar, and Lyn Johnson. "CAPACITY BUILDING IN RURAL MENTAL HEALTH IN WESTERN AUSTRALIA." Australian Journal of Rural Health 10, no. 1 (June 28, 2008): 39–44. http://dx.doi.org/10.1111/j.1440-1584.2002.tb00007.x.

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Aoun, Samar, and Lyn Johnson. "CAPACITY BUILDING IN RURAL MENTAL HEALTH IN WESTERN AUSTRALIA." Australian Journal of Rural Health 10, no. 1 (February 2002): 39–44. http://dx.doi.org/10.1046/j.1440-1584.2002.00407.x.

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Lessing, Kate, and Ilse Blignault. "Mental health telemedicine programmes in Australia." Journal of Telemedicine and Telecare 7, no. 6 (December 1, 2001): 317–23. http://dx.doi.org/10.1258/1357633011936949.

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A national survey of mental health telemedicine programmes was conducted and data collected on their catchment areas, organizational structure, equipment, clinical and non-clinical activity, and use by populations who traditionally have been poorly served by mental health services in Australia. Of 25 programmes surveyed, information was obtained for 23. Sixteen programmes had dealt with a total of 526 clients during the preceding three months. Of these, 397 (75%) were resident in rural or remote locations at the time of consultation. Thirty-seven (7%) were Aboriginals or Torres Strait Islanders. Only 19 (4%) were migrants from non-English-speaking backgrounds. The programmes provided both direct clinical and secondary support services. Overall, the number of videoconferencing sessions devoted to clinical activity was low, the average being 123 sessions of direct clinical care per programme per year. Videoconferencing was also used for professional education, peer support, professional supervision, administration and linking families. The results of the study suggest that telehealth can increase access to mental health services for people in rural and remote areas, particularly those who have hitherto been poorly served by mental health services in Australia.

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McKinstry, Carol, and Anne Cusick. "Australia needs more occupational therapists in rural mental health services." Australian Occupational Therapy Journal 62, no. 5 (October 2015): 275–76. http://dx.doi.org/10.1111/1440-1630.12229.

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Martyr, Philippa. "A brief history of forensic mental health services in Western Australia." Australasian Psychiatry 25, no. 3 (January 31, 2017): 297–99. http://dx.doi.org/10.1177/1039856217689914.

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Objective: To scope the history of forensic mental health services in Western Australia since colonisation. Method: A range of primary sources, including archives, reports, and oral histories was consulted. Results: Forensic mental health services were identified as historically poorly managed, under-resourced, and inconsistently delivered. Conclusions: Current problems with forensic mental health services may be linked to historical factors.

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Tobin, Margaret J. "Rural Psychiatric Services." Australian & New Zealand Journal of Psychiatry 30, no. 1 (February 1996): 114–23. http://dx.doi.org/10.3109/00048679609076079.

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Objective: The objective was to describe and evaluate a community mental health service developed during 1991–1992 in an attempt to meet the mental illness needs of an isolated rural community. The setting was the Grampians health region in Western Victoria: this region has an area of 45,000 square kilo-metres and a population of 182,000. Method: The method involved firstly describing the evolution of the service delivery model. This comprised a team of travelling psychiatrists and community psychiatric nurses which succeeded in providing a combined inpatient and outpatient service which was integrated with general practitioners. Secondly, diagnostic and case load descriptions of patients receiving service were compared for both the inpatient and outpatient settings. Results: The results were that reduced reliance on inpatient beds and increased consumer satisfaction were achieved. Conclusion: It was concluded that on initial evaluation of the service it was seen to be meeting its objective of treating the seriously mentally ill in an isolated rural community based setting.

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Collins, Joanne E., Helen Winefield, Lynn Ward, and Deborah Turnbull. "Understanding help seeking for mental health in rural South Australia: thematic analytical study." Australian Journal of Primary Health 15, no. 2 (2009): 159. http://dx.doi.org/10.1071/py09019.

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This study investigated barriers to help seeking for mental health concerns and explored the role of psychological mindedness using semistructured interviews with sixteen adults in a South Australian rural centre. Prior research-driven thematic analysis identified themes of stigma, self-reliance and lack of services. Additional emergent themes were awareness of mental illness and mental health services, the role of general practitioners and the need for change. Lack of psychological mindedness was related to reluctance to seek help. Campaigns, interventions and services promoting mental health in rural communities need to be compatible with rural cultural context, and presented in a way that is congruent with rural values.

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Speldewinde, Peter C., Angus Cook, Peter Davies, and Philip Weinstein. "A relationship between environmental degradation and mental health in rural Western Australia." Health & Place 15, no. 3 (September 2009): 880–87. http://dx.doi.org/10.1016/j.healthplace.2009.02.011.

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Kruger, Estie, Irosha Perera, and Marc Tennant. "Primary oral health service provision in Aboriginal Medical Services-based dental clinics in Western Australia." Australian Journal of Primary Health 16, no. 4 (2010): 291. http://dx.doi.org/10.1071/py10028.

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Australians living in rural and remote areas have poorer access to dental care. This situation is attributed to workforce shortages, limited facilities and large distances to care centres. Against this backdrop, rural and remote Indigenous (Aboriginal) communities in Western Australia seem to be more disadvantaged because evidence suggests they have poorer oral health than non-Indigenous people. Hence, provision of dental care for Aboriginal populations in culturally appropriate settings in rural and remote Western Australia is an important public health issue. The aim of this research was to compare services between the Aboriginal Medical Services (AMS)-based clinics and a typical rural community clinic. A retrospective analysis of patient demographics and clinical treatment data was undertaken among patients who attended the dental clinics over a period of 6 years from 1999 to 2004. The majority of patients who received dental care at AMS dental clinics were Aboriginal (95.3%), compared with 8% at the non-AMS clinic. The rate of emergency at the non-AMS clinic was 33.5%, compared with 79.2% at the AMS clinics. The present study confirmed that more Indigenous patients were treated in AMS dental clinics and the mix of dental care provided was dominated by emergency care and oral surgery. This indicated a higher burden of oral disease and late utilisation of dental care services (more focus on tooth extraction) among rural and remote Indigenous people in Western Australia.

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Zeng, Grace, Donna Chung, and Beverley McNamara. "Organisational contexts and practice developments in mental health peer provision in Western Australia." Journal of Health Organization and Management 34, no. 5 (June 8, 2020): 569–85. http://dx.doi.org/10.1108/jhom-09-2019-0281.

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PurposeOver the past decade, the push for recovery-oriented services has birthed a growth in the recruitment of peer providers in mental health services: Persons who live with and manage their mental health challenges and are employed to support persons currently using mental health services. The aim of this paper is to compare the responses of government and non-government organisations to the implementation of peer provision.Design/methodology/approachEmploying a qualitative study design, 15 people who supervised peer providers or who were strategically involved in peer provision were recruited using snowball sampling. Participants completed an in-depth interview that explored how peer provision services operated at their organisation and factors that shaped the way peer provision operates. The interviews were transcribed and analysed using Moore's Strategic Triangle. Synthesised member checking and researcher triangulation ensued to establish trustworthiness.FindingsThe way in which peer provision operated sat along a continuum ranging from adoption (where practices are shaped by the recovery ethos) to co-option (where recovery work may be undertaken, but not shaped by the recovery ethos). Political and legal mandates that affected the operational capacities of each organisation shaped the way peer provision services operated.Research limitations/implicationsThe findings of the study highlight the need to reconsider where peer provision services fit in the mental health system. Research investigating the value of peer provision services may attract the support of funders, service users and policy makers alike.Originality/valueIn employing Moore's strategic triangle to evaluate the alignment of policy (the authorising environment) with the operational capacity and practice of peer provision services (the task environment), this study found that organisational response to peer provision is largely influenced by political and legal mandates externally. The successful implementation of peer provision is mediated by effective supervision of peer providers.

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Buckley, Dermot, and Tony Lower. "Factors influencing the utilisation of health services by rural men." Australian Health Review 25, no. 2 (2002): 11. http://dx.doi.org/10.1071/ah020011.

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This research identified the barriers and enablers that influence the utilisation of health services by rural men in the Midwest region of Western Australia. The methodology was based on participatory action research, including qualitative assessments to determine the issues for a larger quantitative study. Four variables were identified as predictors for the use of health services: those who attended for preventive reasons; those not affected by seasonal work;men who thought a medical telephone line was not important; and those who did not consider privacy an important issue. Modification of health service delivery to men could potentially enhance appropriate utilisation of health services in rural areas.

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Bryant, Lia, Bridget Garnham, Deirdre Tedmanson, and Sophie Diamandi. "Tele-social work and mental health in rural and remote communities in Australia." International Social Work 61, no. 1 (November 27, 2015): 143–55. http://dx.doi.org/10.1177/0020872815606794.

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Rural and remote communities often have complex and diverse mental health needs and inadequate mental health services and infrastructure. Information and communication technologies (ICTs) provide an array of potentially innovative and cost-effective means for connecting rural and remote communities to specialist mental health practitioners, services, and supports, irrespective of physical location. However, despite this potential, a review of Australian and international literature reveals that ICT has not attained widespread uptake into social work practice or implementation in rural communities. This article reviews the social work literature on ICT, draws on research on tele-psychology and tele-education, and provides suggestions on how to enhance engagement with ICT by social workers to implement and provide mental health services and supports tailored to community values, needs, and preferences that are commensurate with the values of the social work profession.

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Ramsden, Robyn, Richard Colbran, Tricia Linehan, Michael Edwards, Hilal Varinli, Carolyn Ripper, Angela Kerr, et al. "Partnering to address rural health workforce challenges in Western NSW." Journal of Integrated Care 28, no. 2 (November 4, 2019): 145–60. http://dx.doi.org/10.1108/jica-06-2019-0026.

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Purpose While one-third of Australians live outside major cities, there are ongoing challenges in providing accessible, sustainable, and appropriate primary health care services in rural and remote communities. The purpose of this paper is to explore a partnership approach to understanding and addressing complex primary health workforce issues in the western region of New South Wales (NSW), Australia. Design/methodology/approach The authors describe how a collaboration of five organisations worked together to engage a broader group of stakeholders and secure commitment and resources for a regional approach to address workforce challenges in Western NSW. A literature review and formal interviews with stakeholders gathered knowledge, identified issues and informed the overarching approach, including the development of the Western NSW Partnership Model and Primary Health Workforce Planning Framework. A stakeholder forum tested the proposed approach and gained endorsement for a collaborative priority action plan. Findings The Western NSW Partnership Model successfully engaged regional stakeholders and guided the development of a collaborative approach to building a sustainable primary health workforce for the future. Originality/value Given the scarcity of literature about effective partnerships approaches to address rural health workforce challenges, this paper contributes to an understanding of how to build sustainable partnerships to positively impact on the rural health workforce. This approach is replicable and potentially valuable elsewhere in NSW, other parts of Australia and internationally.

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Balaratnasingam, Sivasankaran. "The Wild West: Rural and Remote Psychiatry Training in North Western Australia." Australasian Psychiatry 16, no. 5 (January 1, 2008): 322–25. http://dx.doi.org/10.1080/10398560801995269.

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Objective: The author reflects on his rural psychiatric training in North Western Australia, having gained over 2 years’ experience as a basic and advanced trainee in this setting. The unique rewards and benefits of rural training are discussed along with the challenges of working in an isolated setting with resource constraints. Conclusions: Rural and remote training remains a stimulating and professionally satisfying experience that is under-utilized by many trainees. In spite of most training requirements being able to be met in this setting, trainees are reluctant to undertake this valuable and enjoyable training experience. Trainees are encouraged to consider this opportunity to be upskilled and getting involved on a more personal level with patients, families and general practitioners, thereby enhancing their clinical skills and shaping their professional identity as future psychiatrists.

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Burke, David, Ayse Burke, and Jacqueline Huber. "Psychogeriatric SOS (services-on-screen) – a unique e-health model of psychogeriatric rural and remote outreach." International Psychogeriatrics 27, no. 11 (July 29, 2015): 1751–54. http://dx.doi.org/10.1017/s1041610215001131.

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Mental health service delivery to rural and remote communities can be significantly impeded by the tyranny of distance. In Australia, rural and remote mental health services are characterized by limited resources stretched across geographically large and socio-economically disadvantaged regions (Inderet al., 2012; Thomaset al., 2012). Internationally, rural and remote area mental health workforce shortages are common, especially in relation to specialist mental health services for older people (McCarthyet al., 2012; Bascuet al., 2012).

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Lambert, Gordon, Paolo Ricci, Ross Harris, and Frank Deane. "Housing Needs of Consumers of Mental Health Services in Rural New South Wales, Australia." International Journal of Social Psychiatry 46, no. 1 (March 2000): 57–66. http://dx.doi.org/10.1177/002076400004600107.

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Fitzpatrick, Scott J., Tonelle Handley, Nic Powell, Donna Read, Kerry J. Inder, David Perkins, and Bronwyn K. Brew. "Suicide in rural Australia: A retrospective study of mental health problems, health-seeking and service utilisation." PLOS ONE 16, no. 7 (July 21, 2021): e0245271. http://dx.doi.org/10.1371/journal.pone.0245271.

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Background Suicide rates are higher in rural Australia than in major cities, although the factors contributing to this are not well understood. This study highlights trends in suicide and examines the prevalence of mental health problems and service utilisation of non-Indigenous Australians by geographic remoteness in rural Australia. Methods A retrospective study of National Coronial Information System data of intentional self-harm deaths in rural New South Wales, Queensland, South Australia and Tasmania for 2010–2015 from the National Coronial Information System. Results There were 3163 closed cases of intentional self-harm deaths by non-Indigenous Australians for the period 2010–2015. The suicide rate of 12.7 deaths per 100,000 persons was 11% higher than the national Australian rate and increased with remoteness. Among people who died by suicide, up to 56% had a diagnosed mental illness, and a further 24% had undiagnosed symptoms. Reported diagnoses of mental illness decreased with remoteness, as did treatment for mental illness, particularly in men. The most reported diagnoses were mood disorders (70%), psychotic disorders (9%) and anxiety disorders (8%). In the six weeks before suicide, 22% of cases had visited any type of health service at least once, and 6% had visited two or more services. Medication alone accounted for 76% of all cases treated. Conclusions Higher suicide rates in rural areas, which increase with remoteness, may be attributable to decreasing diagnosis and treatment of mental disorders, particularly in men. Less availability of mental health specialists coupled with socio-demographic factors within more remote areas may contribute to lower mental health diagnoses and treatment. Despite an emphasis on improving health-seeking and service accessibility in rural Australia, research is needed to determine factors related to the under-utilisation of services and treatment by specific groups vulnerable to death by suicide.

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Aoun, Samar. "Deliberate self-harm in rural Western Australia: Results of an intervention study." Australian and New Zealand Journal of Mental Health Nursing 8, no. 2 (June 1999): 65–73. http://dx.doi.org/10.1046/j.1440-0979.1999.00133.x.

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Cord-Udy, Nigel. "The Medical Specialist Outreach Assistance Programme in South Australia." Australasian Psychiatry 11, no. 2 (June 2003): 189–94. http://dx.doi.org/10.1046/j.1039-8562.2003.00532.x.

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Objective: The present paper aims to provide an overview of the Medical Specialist Outreach Assistance Programme (MSOAP) and its implementation in South Australia with particular reference to the expansion of visiting psychiatric services to rural and remote areas. Included is a discussion of a number of the practical issues and challenges experienced by the author in the development of a visiting psychiatric service to the remote community of Coober Pedy in northern South Australia. Conclusions: There has been much success to date with the expansion of visiting psychiatric services to rural and remote areas within South Australia under MSOAP. MSOAP appears to have considerable merit, particularly for psychiatrists working in private practice. There are several practical issues to be considered in taking on this type of work. The professional rewards are substantial.

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Brett, Adam, and Lawrence Blumberg. "Video-Linked Court Liaison Services: Forging New Frontiers in Psychiatry in Western Australia." Australasian Psychiatry 14, no. 1 (March 2006): 53–56. http://dx.doi.org/10.1080/j.1440-1665.2006.02236.x.

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Leggat, Sandra G. "Mental health care: take 2." Australian Health Review 30, no. 3 (2006): 269. http://dx.doi.org/10.1071/ah060269.

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We are pleased to present our second issue on mental health care. Perhaps indicative of the needs in this sector, the original call for papers generated more interest than could be accommodated in one issue. We are also pleased to report that there has been some momentum in improving mental health care. The 2006?07 national budget delivered the government?s commitment for $1.9 billion to improve services for people with a mental illness. The largest component of the funding was allocated to Medicare rebates designed to improve access to general practitioners, psychiatrists and psychologists. Funding was also allocated to additional training places, to increase availability of mental health nurses and clinical psychologists. Funding for mental health programs included a focus on services for rural, remote and Indigenous communities of Australia, drug and alcohol, suicide prevention, early detection and social activity.

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Gelber, Harry. "The experience of the Royal Children's Hospital mental health service videoconferencing project." Journal of Telemedicine and Telecare 4, no. 1_suppl (March 1998): 71–73. http://dx.doi.org/10.1258/1357633981931542.

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In April 1995 the Royal Children's Hospital Mental Health Service in Melbourne piloted the use of videoconferencing in providing access for rural service providers and their clients to specialist child and adolescent psychiatric input. What began as a pilot project has in two years become integrated into the service-delivery system for rural Victoria. The experience of the service in piloting and integrating the use of videoconferencing to rural Victoria has been an important development for child and adolescent mental health services in Australia.

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Bates, Ann, Vivien Kemp, and Mohan Isaac. "Peer Support Shows Promise in Helping Persons Living with Mental Illness Address Their Physical Health Needs." Canadian Journal of Community Mental Health 27, no. 2 (September 1, 2008): 21–36. http://dx.doi.org/10.7870/cjcmh-2008-0015.

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The physical health of individuals with long-term mental illnesses has long been of concern. In Western Australia, the overall mortality rate from preventable causes of people living with mental illness was reported to be 2.5 times greater than that of the general population. A trial peer support service was initiated to assist people with mental illness to attend to their physical health needs. This paper presents the planning, implementation, and results of this collaborative initiative involving nongovernment agencies, the public mental health service, consumers of mental health services, and the University of Western Australia.

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Sabbioni, Daniela, Steven Feehan, Craig Nicholls, Wei Soong, Daniela Rigoli, Denise Follett, Geoff Carastathis, et al. "Providing culturally informed mental health services to Aboriginal youth: The YouthLink model in Western Australia." Early Intervention in Psychiatry 12, no. 5 (March 24, 2018): 987–94. http://dx.doi.org/10.1111/eip.12563.

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Swensen, Greg. "A Short History of Managing Problematic Users of Alcohol in Western Australia by Mental Health Services." SUCHT 66, no. 2 (April 1, 2020): 71–84. http://dx.doi.org/10.1024/0939-5911/a000649.

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Abstract. Aims: This paper examines the role that mental health services (MHS) performed in the management and provision of medical care and treatment of problematic users of alcohol in Western Australia (WA) over the period since 1900. Methods: The research involved an examination of legislative enactments and regulations, records of parliamentary debates in Hansard, administrative records in the State Records Office, and other sources of public information, such as departmental annual reports, reviews of services, studies and newspapers. Results: This research identified three eras of policy involving problematic users. The first, from 1900 to the mid 1970s, focussed on controls in inebriates and lunacy legislation to create a regime of civil commitment, designed to confine and compel ‘inebriates’, as well as ‘convicted inebriates,’ to ‘dry out’ and rehabilitate. The second, between 1975 and the late 1990s, involved the creation of a state-wide system of specialist service providers to provide treatment and recovery for problematic users. The system involved a spectrum of services that included a detoxification hospital, outpatient clinics and community-based regional services established and operated by a statutory public health agency, the Alcohol and Drug Authority (ADA). The third era, which commenced in the late 1990s, involved the transfer of all community-based services from the ADA to ‘not-for-profit’ non-government organisations (NGOs). The end result of this devolution was the ADA retained only a limited treatment role, as the operator of the inpatient detoxification facility. The balance of its functions were redefined in relation to the prevention of the use of alcohol and other drugs, primarily through support of mass public education programs, as well as oversight of funded NGO programs. The paper concludes with a consideration of a recent major development which involved administrative and legislative actions in 2015 to abolish the statutory body which had operated since 1975 and transfer administrative responsibility for drug and alcohol services into the Mental Health Commission.

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Puskar, Kathryn, Kirsti M. H. Stark, Carl Fertman, Lisa Marie Bernardo, Richard Engberg, and Richard Barton. "School Based Mental Health Promotion." Californian Journal of Health Promotion 4, no. 4 (December 1, 2006): 13–20. http://dx.doi.org/10.32398/cjhp.v4i4.1982.

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Integrating health education and health promotion into practice is routinely done by nurses. According to a national survey, the need for mental health services has increased in over two thirds of school districts. This article describes the screening of 193 adolescents in Rural Western Pennsylvania’s 9th, 10th, and 11th graders for depressive symptoms. Ten percent (N=19) of students had depressive symptoms, the majority of which were female. These students were interviewed by the research team. The outcome themes and referrals are reported as well as the discussion of implications for nurses in screening for depression and health promotion.

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Atkinson, Jo-An, Andrew Page, Mark Heffernan, Geoff McDonnell, Ante Prodan, Bill Campos, Graham Meadows, and Ian B. Hickie. "The impact of strengthening mental health services to prevent suicidal behaviour." Australian & New Zealand Journal of Psychiatry 53, no. 7 (December 12, 2018): 642–50. http://dx.doi.org/10.1177/0004867418817381.

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Objective: Successive suicide prevention frameworks and action plans in Australia and internationally have called for improvements to mental health services and enhancement of workforce capacity. However, there is debate regarding the priorities for resource allocation and the optimal combination of mental health services to best prevent suicidal behaviour. This study investigates the potential impacts of service capacity improvements on the incidence of suicidal behaviour in the Australian context. Methods: A system dynamics model was developed to investigate the optimal combination of (1) secondary (acute) mental health service capacity, (2) non-secondary (non-acute) mental health service capacity and (3) resources to re-engage those lost to services on the incidence of suicidal behaviour over the period 2018–2028 for the Greater Western Sydney (Australia) population catchment. The model captured population and behavioural dynamics and mental health service referral pathways and was validated using population survey and administrative data, evidence syntheses and an expert stakeholder group. Results: Findings suggest that 28% of attempted suicide and 29% of suicides could be averted over the forecast period based on a combination of increases in (1) hospital staffing (with training in trauma-informed care), (2) non-secondary health service capacity, (3) expansion of mental health assessment capacity and (4) re-engagement of at least 45% of individuals lost to services. Reduction in the number of available psychiatric beds by 15% had no substantial impact on the incidence of attempted suicide and suicide over the forecast period. Conclusion: This study suggests that more than one-quarter of suicides and attempted suicides in the Greater Western Sydney population catchment could potentially be averted with a combination of increases to hospital staffing and non-secondary (non-acute) mental health care. Reductions in tertiary care services (e.g. psychiatric hospital beds) in combination with these increases would not adversely affect subsequent incidence of suicidal behaviour.

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Shanmugakumar, Sharanyaa, Denese Playford, Tessa Burkitt, Marc Tennant, and Tom Bowles. "Is Western Australia’s rural surgical workforce going to sustain the future? A quantitative and qualitative analysis." Australian Health Review 41, no. 1 (2017): 75. http://dx.doi.org/10.1071/ah15084.

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Objective Despite public interest in the rural workforce, there are few published data on the geographical distribution of Australia’s rural surgeons, their practice skill set, career stage or work-life balance (on-call burden). Similarly, there has not been a peer-reviewed skills audit of rural training opportunities for surgical trainees. The present study undertook this baseline assessment for Western Australia (WA), which has some of the most remote practice areas in Australia. Methods Hospital staff from all WA Country Health Service hospitals with surgical service (20 of 89 rural health services) were contacted by telephone. A total of 18 of 20 provided complete data. The study questionnaire explored hospital and practice locations of practicing rural surgeons, on-call rosters, career stage, practice skill set and the availability of surgical training positions. Data were tabulated in excel and geographic information system geocoded. Descriptive statistics were calculated in Excel. Results Of the seven health regions for rural Western Australia, two (28.6%) were served by resident surgeons at a ratio consistent with Royal Australasian College of Surgeons (RACS) guidelines. General surgery was offered in 16 (89%) hospitals. In total, 16 (89%) hospitals were served by fly-in, fly-out (FIFO) surgical services. Two hospitals with resident surgeons did not use FIFO services, but all hospitals without resident surgeons were served by FIFO surgical specialists. The majority of resident surgeons (62.5%) and FIFO surgeons (43.2%) were perceived to be mid-career by hospital staff members. Three hospitals (16.7%) offered all eight of the identified surgical skill sets, but 16 (89%) offered general surgery. Conclusions Relatively few resident rural surgeons are servicing large areas of WA, assisted by the widespread provision of FIFO surgical services. The present audit demonstrates strength in general surgical skills throughout regional WA, and augers well for the training of general surgeons. What is known about the topic? A paper published in 1998 suggested that Australia’s rural surgeons were soon to reach retirement age. However, there have been no published peer-reviewed papers on Australia’s surgical workforce since then. More recent workforce statistics released from the RACS suggest that the rural workforce is in crisis. What does this paper add? This paper provides up-to-date whole-of-state information for WA, showing where surgical services are being provided and by whom, giving a precise geographical spread of the workforce. It shows the skill set and on-call rosters of these practitioners. What are the implications for practitioners? The present study provides geographical workforce data, which is important to health planners, the general public and surgeons considering where to practice. In particular, these data are relevant to trainees considering their rural training options.

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Tually, Peter, John Walker, and Simon Cowell. "The effect of nuclear medicine telediagnosis on diagnostic pathways and management in rural and remote regions of Western Australia." Journal of Telemedicine and Telecare 7, no. 2_suppl (December 2001): 50–53. http://dx.doi.org/10.1258/1357633011937119.

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Limited accessibility to certain medical imaging services in regional and rural centres has led to the use of alternative modalities, which may not be best practice or which require patients to travel considerable distances for diagnosis. Data collected over three years were examined to determine the clinical effect of nuclear medicine teleradiology (NMT) and its effect on diagnostic patterns for the investigation of cardiovascular disease, radio-occult musculoskeletal injury and oncology. In comparison with two other rural, non-NMT areas of similar demographic profile, there was a significant shift in the delivery of care in terms of diagnostic work-up. NMT input led to the detection of disease and a change to therapeutic management in 122 cases and eliminated the need to transfer patients to another facility for unnecessary and expensive examinations in 38 cases. While NMT is more costly than conventional nuclear medicine services, it permits faster access to specialist consultation, provides for better management and is likely to reduce overall health costs by reducing the volume of inappropriate tests and treatment practice.

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Lim, Adrian C., Adrian C. See, and Stephen P. Shumack. "Progress in Australian teledermatology." Journal of Telemedicine and Telecare 7, no. 2_suppl (December 2001): 55–58. http://dx.doi.org/10.1258/1357633011937146.

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Because of their remoteness, the majority of rural towns in Australia are disadvantaged in terms of access to dermatological services. Telemedicine offers one solution. Since the mid-1990s, Australian dermatologists have experimented with tele-medicine as an adjunct to clinical practice. The technical viability of teledermatology was first demonstrated in 1997. In 1999, the accuracy and reliability of teledermatology were demonstrated in a real-life urban setting. In 2001, Broken Hill (in western New South Wales), a location remote from dermatology services, served as a trial site for the institution of tele-dermatology as the primary method of accessing dermatological services. High patient and general practitioner acceptability and positive medical outcomes were demonstrated, but the study also revealed unexpected barriers and pitfalls in the effective operation of rural teledermatology.

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Chater, Alan B. "Looking after health care in the bush." Australian Health Review 32, no. 2 (2008): 313. http://dx.doi.org/10.1071/ah080313.

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LOOKING AFTER health care in rural Australia involves providing adequate services to meet the urgent and non-urgent needs of rural patients in a timely, cost-effective and safe manner. The very provision of these services requires an appropriate workforce and facilities in rural areas. This provides challenges for clinicians, administrators and medical educators. While preventive medicine has made some significant gains globally in reducing the need for acute care and hospitalisation in some areas of medicine such as infectious disease and asthma, these demands have been replaced by an increase in trauma, chronic disease and mental illness1 which, with an ageing population, eventually means presentations at an older age which can require hospitalisation. Rural patients have always had to deal with a relative undersupply of health practitioners. Rural people have coped valiantly with this. The legendary stoicism of rural people has been shown by Schrapnel2 and Davies to be a prominent feature of the rural personality. This both allowed them to cope with lack of services and to suffer in silence while their health status fell below the Australian average.3 Rural Australians use fewer Medicare services and see the doctor less per annum than the Australian average.

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Tabatabaei-Jafari, Hossein, Jose A. Salinas-Perez, Mary Anne Furst, Nasser Bagheri, John Mendoza, David Burke, Peter McGeorge, and Luis Salvador-Carulla. "Patterns of Service Provision in Older People’s Mental Health Care in Australia." International Journal of Environmental Research and Public Health 17, no. 22 (November 17, 2020): 8516. http://dx.doi.org/10.3390/ijerph17228516.

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Australia has a population of around 4 million people aged 65 years and over, many of whom are at risk of developing cognitive decline, mental illness, and/or psychological problems associated with physical illnesses. The aim of this study was to describe the pattern of specialised mental healthcare provision (availability, placement capacity, balance of care and diversity) for this age group in urban and rural health districts in Australia. The Description and Evaluation of Services and DirectoriEs for Long Term Care (DESDE-LTC) tool was used in nine urban and two rural health districts of the thirty-one Primary Health Networks across Australia. For the most part service provision was limited to hospital and outpatient care across all study areas. The latter was mainly restricted to health-related outpatient care, and there was a relative lack of social outpatient care. While both acute and non-acute hospital care were available in urban areas, in rural areas hospital care was limited to acute care. Limited access to comprehensive mental health care, and the uniformity in provision across areas in spite of differences in demographic, socioeconomic and health characteristics raises issues of equity in regard to psychogeriatric care in this country. Comparing patterns of mental health service provision across the age span using the same classification method allows for a better understanding of care provision and gap analysis for evidence-informed policy.

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Meuleners, Lynn B., Andy H. Lee, Jianhong Xia, Michelle Fraser, and Delia Hendrie. "Interpersonal violence presentations to general practitioners in Western Australia: implications for rural and community health." Australian Health Review 35, no. 1 (2011): 70. http://dx.doi.org/10.1071/ah10913.

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Objective. To estimate the incidence of interpersonal violence presentations to general practitioners (GPs). Methods. A postal survey of all GPs in Western Australia (WA) was conducted in 2009 using a structured questionnaire. Results. Among the n = 476 respondents (response rate 28%), 379 GPs treated 9572 patients for a violent incident during the past year. The rate of violent presentations in rural WA was double that of metropolitan areas (incident rate ratio (IRR) 1.9, 95% CI 1.8–2.0), whereas the rate of violent episodes in remote GP practices was 7-fold higher (IRR 7.2, 95% CI 6.8–7.6). Halls Creek in remote northern WA was found to be a ‘hot spot’ with a high cluster of violence cases, whereas metropolitan suburbs surrounding Perth had relatively low concentrations of violence presentations. Conclusions. Further understanding of the size and nature of the problem is required in view of the low response rate. High-risk groups, such as women and those living in rural and remote areas, should be targeted for special attention. What is known about the topic? Previous studies of interpersonal violence have been based on victim surveys or crime databases, which are subjected to both under- and over-reporting. Hospital admission and mortality statistics represent severe injuries resulting from violence episodes. However, victims who sought treatment from GPs are not routinely recorded. What does this paper add? Rural and remote GP practices reported a higher incident of violent presentations than their metropolitan counterparts. The finding provides a basis to further investigate the level of GP services for treating interpersonal violence injuries. What are the implications for practitioners? Sentinel surveillance of GPs is recommended. High-risk groups such as women and those living in rural and remote areas should be targeted for attention.

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Ronnau, Peggy, Arthur Papakotsias, and Glen Tobias. ""Not for" sector in community mental health care defines itself and strives for quality." Australian Journal of Primary Health 14, no. 2 (2008): 68. http://dx.doi.org/10.1071/py08025.

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This paper briefly describes the history and service context of the Psychiatric Disability Rehabilitation and Support sector (PDRSS) in Victoria, and, to a lesser extent, in New South Wales, South Australia and Western Australia. In describing the sector we will call upon the experience of a particular PDRSS - Neami - in operating and developing services, and the challenges it faced in establishing a culture of quality that directly improves consumer outcomes. Elements of this experience may serve as a guide in the development of mental health service policy at state and federal level.

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Cosgrave, Catherine, Myfanwy Maple, and Rafat Hussain. "Work challenges negatively affecting the job satisfaction of early career community mental health professionals working in rural Australia: findings from a qualitative study." Journal of Mental Health Training, Education and Practice 13, no. 3 (May 14, 2018): 173–86. http://dx.doi.org/10.1108/jmhtep-02-2017-0008.

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Purpose Some of Australia’s most severe and protracted workforce shortages are in public sector community mental health (CMH) services. Research identifying the factors affecting staff turnover of this workforce has been limited. The purpose of this paper is to identify work factors negatively affecting the job satisfaction of early career health professionals working in rural Australia’s public sector CMH services. Design/methodology/approach In total, 25 health professionals working in rural and remote CMH services in New South Wales (NSW), Australia, for NSW Health participated in in-depth, semi-structured interviews. Findings The study identified five work-related challenges negatively affecting job satisfaction: developing a profession-specific identity; providing quality multidisciplinary care; working in a resource-constrained service environment; working with a demanding client group; and managing personal and professional boundaries. Practical implications These findings highlight the need to provide time-critical supports to address the challenges facing rural-based CMH professionals in their early career years in order to maximise job satisfaction and reduce avoidable turnover. Originality/value Overall, the study found that the factors negatively affecting the job satisfaction of early career rural-based CMH professionals affects all professionals working in rural CMH, and these negative effects increase with service remoteness. For those in early career, having to simultaneously deal with significant rural health and sector-specific constraints and professional challenges has a negative multiplier effect on their job satisfaction. It is this phenomenon that likely explains the high levels of job dissatisfaction and turnover found among Australia’s rural-based early career CMH professionals. By understanding these multiple and simultaneous pressures on rural-based early career CMH professionals, public health services and governments involved in addressing rural mental health workforce issues will be better able to identify and implement time-critical supports for this cohort of workers. These findings and proposed strategies potentially have relevance beyond Australia’s rural CMH workforce to Australia’s broader early career nursing and allied health rural workforce as well as internationally for other countries that have a similar physical geography and health system.

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Rossi, Alberto, Vera Morgan, Francesco Amaddeo, Marco Sandri, Michele Tansella, and Assen Jablensky. "Psychiatric Out-Patients Seen Once Only in South Verona and Western Australia: A Comparative Case-Register Study." Australian & New Zealand Journal of Psychiatry 39, no. 5 (May 2005): 414–22. http://dx.doi.org/10.1080/j.1440-1614.2005.01590.x.

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Objective: This study examined variables associated with having a once-only contact with the out-patient department of two community mental health services in Italy and Australia. Method: Two 8-year cohorts of patients, who had a new episode of care with out-patient psychiatric departments in South Verona and in Western Australia, were followed-up for 3 months after the first contact, to identify those patients who had no further contact with services. Potential determinants of once-only contact were analysed. Results: Thirty percent of new episodes of care for persons who met the inclusion criteria of the study were once-only contacts with the service in South Verona. In Western Australia, the figure was 24%. Moreover, the proportion of once-only contact patients has increased over time in South Verona whereas, in Western Australia, it has remained stable. In Western Australia, once-only contact patients were younger whereas in South Verona they tended to be older. At both research sites, patients who had a once-only contact were more likely to be male and to have a less severe mental illness. Conclusions: The results of this study suggest that only clinical characteristics were significant determinants of this pattern of contact with services consistently at both sites: the less severe the patient's diagnosis, the more likely the patient is to have a once-only contact. This may well indicate good screening at the initial point of contact by both sets of mental health service providers. Prospective studies are necessary to clarify the problem of ‘onceonly contact’ and to organize a proper psychiatric care.

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Jelinek, G. A., T. J. Weiland, C. Mackinlay, N. Hill, and M. F. Gerdtz. "Perceived Differences in the Management of Mental Health Patients in Remote and Rural Australia and Strategies for Improvement: Findings from a National Qualitative Study of Emergency Clinicians." Emergency Medicine International 2011 (2011): 1–7. http://dx.doi.org/10.1155/2011/965027.

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Introduction. We aimed to describe perceptions of Australian emergency clinicians of differences in management of mental health patients in rural and remote Australia compared with metropolitan hospitals, and what could be improved.Methods. Descriptive exploratory study using semi-structured telephone interviews of doctors and nurses in Australian emergency departments (EDs), stratified to represent states and territories and rural or metropolitan location. Content analysis of responses developed themes and sub-themes.Results. Of 39 doctors and 32 nurses responding to email invitation, 20 doctors and 16 nurses were interviewed. Major themes were resources/environment, staff and patient issues. Clinicians noted lack of access in rural areas to psychiatric support services, especially alcohol and drug services, limited referral options, and a lack of knowledge, understanding and acceptance of mental health issues. The clinicians suggested resource, education and guideline improvements, wanting better access to mental health experts in rural areas, better support networks and visiting specialist coverage, and educational courses tailored to the needs of rural clinicians.Conclusion. Clinicians managing mental health patients in rural and remote Australian EDs lack resources, support services and referral capacity, and access to appropriate education and training. Improvements would better enable access to support and referral services, and educational opportunities.

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Dragovic, Milan, Viki Pascu, Tammy Hall, Jesse Ingram, and Flavie Waters. "Emergency department mental health presentations before and during the COVID-19 outbreak in Western Australia." Australasian Psychiatry 28, no. 6 (September 22, 2020): 627–31. http://dx.doi.org/10.1177/1039856220960673.

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Objective: Coronavirus (COVID-19) has led to high levels of psychological distress in the community. This study aimed to examine whether emergency departments (EDs) also recorded a rise in mental health presentations. Method: Changes in the number, and type, of mental health presentations to Western Australia EDs were examined between January and May 2020, and compared to 2019. Results: Data showed an unexpected decrease in the number of mental health presentations, compared to 2019, which was temporally coincident with the rise in local COVID-19 cases. Presentations for anxiety and panic symptoms, and social and behavioural issues, increased by 11.1% and 6.5%, respectively, but suicidal and self-harm behaviours decreased by 26%. Conclusion: A rise in local COVID-19 cases was associated with a decrease in mental health presentations to EDs. This has important implications for the planning and provision of healthcare services in the current pandemic.

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Doessel, Darrel P., Roman W. Scheurer, David C. Chant, and Harvey A. Whiteford. "Changes in Private Sector Electroconvulsive Treatment in Australia." Australian & New Zealand Journal of Psychiatry 40, no. 4 (April 2006): 362–67. http://dx.doi.org/10.1080/j.1440-1614.2006.01803.x.

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Objectives: This paper reports on changes, over time and between states, in the use of electroconvulsive therapy (ECT) in the private psychiatric sector in Australia between 1984 and 2004. Method: Data for ECT services, and all specialist psychiatry services provided under the Medicare system, have been analysed in absolute numbers and as utilization rates. Results: Changes in the use of ECT over time are different from other services provided by private psychiatrists. As in other countries, the use of ECT initially declined in period studied but has increased in recent years. In addition, there is a clear pattern of differential use of ECT between the states and territories. Conclusions: This descriptive study cannot ‘explain’ the results obtained: other data, incorporated into an explanatory model using regression analysis, are needed to determine the factors underlying the utilization patterns obtained in this study. Thus, further work is needed. Furthermore, it is important to analyse data at a lower level of geographical aggregation than that of the state/territory: this (state/territory) aggregation conceals differences in utilization between metropolitan, minor city, rural and remote regions of the country.

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Kennedy, Alison, Jessie Adams, Jeremy Dwyer, Muhammad Aziz Rahman, and Susan Brumby. "Suicide in Rural Australia: Are Farming-Related Suicides Different?" International Journal of Environmental Research and Public Health 17, no. 6 (March 18, 2020): 2010. http://dx.doi.org/10.3390/ijerph17062010.

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Rural Australians experience a range of health inequities—including higher rates of suicide—when compared to the general population. This retrospective cohort study compares demographic characteristics and suicide death circumstances of farming- and non-farming-related suicides in rural Victoria with the aim of: (a) exploring the contributing factors to farming-related suicide in Australia’s largest agricultural producing state; and (b) examining whether farming-related suicides differ from suicide in rural communities. Farming-related suicide deaths were more likely to: (a) be employed at the time of death (52.6% vs. 37.7%, OR = 1.84, 95% CIs 1.28–2.64); and, (b) have died through use of a firearm (30.1% vs. 8.7%, OR = 4.51, 95% CIs 2.97–6.92). However, farming-related suicides were less likely to (a) have a diagnosed mental illness (36.1% vs. 46.1%, OR=0.66, 95% CIs 0.46–0.96) and, (b) have received mental health support more than six weeks prior to death (39.8% vs. 50.0%, OR = 0.66, 95% CIs 0.46–0.95). A range of suicide prevention strategies need adopting across all segments of the rural population irrespective of farming status. However, data from farming-related suicides highlight the need for targeted firearm-related suicide prevention measures and appropriate, tailored and accessible support services to support health, well-being and safety for members of farming communities.

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Crotty, Mikaila M., Julie Henderson, Lee Martinez, and Jeffrey D. Fuller. "Barriers to collaboration in mental health services for older people: external agency views." Australian Journal of Primary Health 20, no. 3 (2014): 250. http://dx.doi.org/10.1071/py12144.

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The need for mental health services for older people living in rural areas is increasing in South Australia. Providing such care requires coordination between several types of services across government, hospital and non-government sectors. The purpose of this study was to identify barriers to collaboration from the perspective of external aged care agencies. A total of 42 responses from an online survey were qualitatively analysed. Four categories emerged, within which participants had identified barriers to collaboration: (1) awareness of services and certainty about responsibilities, in particular, a lack of awareness of which services are available; (2) referral criteria and processes, including the specific criteria needed to be eligible for these services; (3) opportunities to collaborate, with a perceived lack of formal opportunities for collaboration between individuals working across agencies; and (4) education of staff, with more joint education between agencies being recognised as having the potential to increase local knowledge and provide an opportunity for networking and relationship building, with greatest barriers experienced between mental health and social care services.

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Nancarrow, Susan A., Alison Roots, Sandra Grace, and Vahid Saberi. "Models of care involving district hospitals: a rapid review to inform the Australian rural and remote context." Australian Health Review 39, no. 5 (2015): 494. http://dx.doi.org/10.1071/ah14137.

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Objectives District hospitals are important symbolic structures in rural and remote communities; however, little has been published on the role, function or models of care of district hospitals in rural and remote Australia. The aim of the present study was to identify models of care that incorporate district hospitals and have relevance to the Australian rural and remote context. Methods A systematic, rapid review was conducted of published peer-reviewed and grey literature using CINAHL, Medline, PsychInfo, APAIS-Health, ATSI health, Health Collection, Health & Society, Meditext, RURAL, PubMed and Google Scholar. Search terms included ‘rural’, ‘small general and district hospitals’, ‘rural health services organisation & administration’, ‘medically underserved area’, ‘specific conditions, interventions, monitoring and evaluation’, ‘regional, rural and remote communities’, ‘NSW’, ‘Australia’ and ‘other OECD countries’ between 2002 and 2013. Models of teaching and education, multipurpose services centres, recruitment and/or retention were excluded. Results The search yielded 1626 articles and reports. Following removal of duplicates, initial screening and full text screening, 24 data sources remained: 21 peer-reviewed publications and three from the grey literature. Identified models of care related specifically to maternal and child health, end-of-life care, cancer care services, Aboriginal health, mental health, surgery and emergency care. Conclusion District hospitals play an important role in the delivery of care, particularly at key times in a person’s life (birth, death, episodes of illness). They enable people to remain in or near their own community with support from a range of services. They also play an important role in the essential fabric of the community and the vertical integration of the health services. What is known about the topic? Little has been published on the function of small-to-medium district hospitals in rural and remote Australia, and almost nothing is known about models of care that are relevant to these settings. What does this paper add? District hospitals form an important part of vertically integrated models of care in Australia. Effective models of care aim to keep health services close to home. There is scope for networked models of care that keep health care within the community supported by hub-and-spoke models of service delivery. What are the implications for practitioners? This review found limited evidence on the skill mix required in district hospitals; however, the skill mix underpins the extent of service and speciality that can be provided locally, particularly with regard to the provision of surgery and emergency services. International evidence suggests that providing surgical services locally can help increase the sustainability of smaller hospitals because they typically provide high return, short episodes of care; however, this depends on the funding model being used. Similarly, the skill mix of staff required to sustain a functioning emergency department brings a skill base that supports a higher level of expertise across the hospital.

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Hawker, Fiona. "Telemedicine user Network: A Call for Interested Participants." Australasian Psychiatry 5, no. 6 (December 1997): 296. http://dx.doi.org/10.3109/10398569709082290.

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Telemedicine, or the use of telecommunication technologies for the delivery of medical services, has been receiving increasing attention as a possible answer to the tyranny of distance and the scarcity of specialist resources in rural and remote Australia [1,2]. While internationally teleradiology and teledermatology are the most frequent users of the technology, in Australia it is psychiatry that has been quick to recognise the potential of telemedicine and to use it for the delivery of specialist psychiatric support. In Australia telepsychiatry is one of the most common forms of telemedicine with some of the most established and successful tele-psychiatry programmes in the world.

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Samy, D. Chinna, Philip Hall, Jacquie Rounsevell, and Rodney Carr. "'Shared Care ? Shared Dream': Model of shared care in rural Australia between mental health services and general practitioners." Australian Journal of Rural Health 15, no. 1 (February 2007): 35–40. http://dx.doi.org/10.1111/j.1440-1584.2007.00847.x.

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Journal articles on the topic 'Rural mental health services – Western Australia'

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