Fennell Kate, Hull Melissa, Jones Martin, Dollman James
Sansom Institute for Health Research, University of South Australia
University of South Australia
Rural Remote Health. 2018 Feb;18(1):4155. doi: 10.22605/RRH4155. Epub 2018 Feb 15.
The prevalence of chronic disease, mortality and suicide rates is higher in rural Australia than in urban centres. Understanding rural Australians' barriers to accessing health services requires urgent attention. The purpose of this study was to compare barriers to help-seeking for physical and mental health issues among rural South Australian adults.
A total of 409 people from three rural and remote regions in South Australia completed a computer-assisted telephone interview. They were presented a physical or mental health scenario and rated the extent to which barriers would prevent them from seeking help for that condition. Responses ranged from 1 ('strongly disagree') to 5 ('strongly agree') and were averaged to form domain scores (higher scores representing stronger barriers to seeking support), in addition to being examined at the item level.
Men reported higher barriers for the mental compared with physical health scenario across four domains ('need for control and self-reliance', 'minimising the problem, resignation and normalisation', 'privacy' and 'emotional control'). Women reported higher barriers for the mental compared to physical health scenario in two domains ('need for control and self-reliance' and 'privacy'). Both men and women endorsed many items in the mental health context (eg 'I don't like feeling controlled by other people', 'I wouldn't want to overreact to a problem that wasn't serious', 'Problems like this are part of life; they're just something you have to deal with', 'I'd prefer just to put up with it rather than dwell on my problems', 'Privacy is important to me, and I don't want other people to know about my problems' and 'I don't like to get emotional about things') but in the physical health context, barriers were endorsed only by men (eg 'I wouldn't want to overreact to a problem that wasn't serious',' I'd prefer just to put up with it rather than dwell on my problems', 'Problems like this are part of life; they're just something you have to deal with', 'I like to make my own decisions and not be too influenced by others').
Both rural men and rural women report more barriers to help seeking for mental health issues than physical health issues across a range of domains. There is a need to educate the current and future rural health and mental health workforce about these barriers and to encourage them to test evidence-based strategies to address them, in particular to facilitate more widespread mental health help-seeking in rural Australia.
澳大利亚农村地区慢性病的患病率、死亡率和自杀率高于城市中心。了解澳大利亚农村居民获得医疗服务的障碍需要迫切关注。本研究的目的是比较南澳大利亚农村成年人在寻求身心健康问题帮助时所面临的障碍。
来自南澳大利亚三个农村和偏远地区的409人完成了一次计算机辅助电话访谈。他们面对一个身心健康情景，并对障碍在多大程度上会阻止他们针对该状况寻求帮助进行评分。回答范围从1（“强烈不同意”）到5（“强烈同意”），除了在项目层面进行检查外，还将回答平均以形成领域得分（得分越高表示寻求支持的障碍越强）。
在四个领域（“对控制和自力更生的需求”、“尽量减少问题、听天由命和正常化”、“隐私”和“情绪控制”）中，男性报告在心理健康情景下比在身体健康情景下面临更高的障碍。在两个领域（“对控制和自力更生的需求”和“隐私”）中，女性报告在心理健康情景下比在身体健康情景下面临更高的障碍。男性和女性在心理健康背景下都认可了许多项目（例如“我不喜欢被别人控制的感觉”、“我不想对一个不严重的问题反应过度”、“这样的问题是生活的一部分；它们只是你必须处理的事情”、“我宁愿忍受它也不愿纠结于我的问题”、“隐私对我很重要，我不想让别人知道我的问题”以及“我不喜欢对事情情绪化”），但在身体健康背景下，只有男性认可了一些障碍（例如“我不想对一个不严重的问题反应过度”、“我宁愿忍受它也不愿纠结于我的问题”、“这样的问题是生活的一部分；它们只是你必须处理的事情”、“我喜欢自己做决定，不太受他人影响”）。
农村男性和女性在一系列领域中报告，寻求心理健康问题帮助比寻求身体健康问题帮助面临更多障碍。有必要对当前和未来的农村卫生和心理健康工作人员进行关于这些障碍的教育，并鼓励他们测试基于证据的策略来解决这些障碍，特别是促进在澳大利亚农村地区更广泛地寻求心理健康帮助。
