Deakin Rural Health, School of Medicine, Deakin University, Princes Highway, Warrnambool, VIC, 3280, Australia.
Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Barwon Health, Geelong, VIC, Australia.
BMC Health Serv Res. 2023 Oct 4;23(1):1060. doi: 10.1186/s12913-023-10034-4.
Inadequate healthcare access and utilisation are implicated in the mental health burden experienced by those living in regional, rural, and remote Australia. Facilitators that better enable access and utilisation are also reported in the literature. To date, a synthesis on both the barriers and facilitators to accessing and utilising mental health services within the rural Australian context has not been undertaken. This scoping review aims to (1) synthesise the barriers and facilitators to accessing and utilising mental health services in regional, rural, and remote Australia, as identified using the Modified Monash Model; and (2) better understand the relationship between barriers and facilitators and their geographical context.
A systematic search of Medline Complete, EMBASE, PsycINFO, Scopus, and CINAHL was undertaken to identify peer-reviewed literature. Grey literature was collated from relevant websites. Study characteristics, including barriers and facilitators, and location were extracted. A descriptive synthesis of results was conducted.
Fifty-three articles were included in this scoping review. Prominent barriers to access and utilisation included: limited resources; system complexity and navigation; attitudinal and social matters; technological limitations; distance to services; insufficient culturally-sensitive practice; and lack of awareness. Facilitators included person-centred and collaborative care; technological facilitation; environment and ease of access; community supports; mental health literacy and culturally-sensitive practice. The variability of the included studies precluded the geographical analysis from being completed.
Both healthcare providers and service users considered a number of barriers and facilitators to mental health service access and utilisation in the regional, rural, and remote Australian context. Barriers and facilitators should be considered when re-designing services, particularly in light of the findings and recommendations from the Royal Commission into Victoria's Mental Health System, which may be relevant to other areas of Australia. Additional research generated from rural Australia is needed to better understand the geographical context in which specific barriers and facilitators occur.
在澳大利亚的偏远地区，医疗保健服务的不足和利用不足与人们的心理健康负担有关。文献中也报道了一些能够更好地促进获得和利用的促进因素。迄今为止，尚未对澳大利亚农村地区获得和利用心理健康服务的障碍和促进因素进行综合分析。本范围界定审查旨在：(1) 使用改进的蒙纳士模型综合确定澳大利亚农村地区获得和利用心理健康服务的障碍和促进因素；(2) 更好地了解障碍和促进因素之间的关系及其地理背景。
对 Medline Complete、EMBASE、PsycINFO、Scopus 和 CINAHL 进行了系统搜索，以确定同行评议文献。从相关网站收集了灰色文献。提取了研究特征，包括障碍和促进因素以及地理位置。对结果进行了描述性综合。
本范围界定审查共纳入了 53 篇文章。获得和利用的主要障碍包括：资源有限；系统复杂性和导航；态度和社会问题；技术限制；服务距离；文化敏感性实践不足；以及缺乏意识。促进因素包括以人为本和协作式护理；技术促进；环境和易于获得；社区支持；心理健康素养和文化敏感性实践。纳入研究的变异性使得无法完成地理分析。
医疗保健提供者和服务使用者都考虑了澳大利亚偏远地区获得和利用心理健康服务的一些障碍和促进因素。在重新设计服务时，应考虑到障碍和促进因素，特别是考虑到维多利亚州心理健康系统皇家委员会的调查结果和建议，这些建议可能与澳大利亚其他地区有关。需要来自澳大利亚农村地区的更多研究，以更好地了解特定障碍和促进因素发生的地理背景。
