Youngson Sarah A, Cuesta-Briand Beatriz, Coleman Mathew
Rural Clinical School Western Australia, University of Western Australia, Bridgetown, WA 6255, Australia.
Rural Clinical School Western Australia, University of Western Australia, QE2 Medical Centre, Nedlands, WA 6008, Australia.
Rural Remote Health. 2025 Jan;25(1):8692. doi: 10.22605/RRH8692. Epub 2025 Jan 7.
The geographic, cultural, social and economic milieu that impacts mental health in rural communities globally has been well documented. However, few studies have addressed how rural ecosystems impact specifically upon the mental health and wellbeing of young people. Furthermore, the limited explorations of factors contributing to poorer mental health outcomes in rural youth have primarily included adult voices. The study aimed to give a youth voice to the vexed problem of high rates of youth mental illness and suicide in rural and remote areas, exploring young people's experiences in a deeply contextual manner.
This study followed a phenomenological qualitative design underpinned by the principles of participatory action research. A youth-led reference group provided guidance on the study design and recruitment. A total of 29 young people aged 12-19 years were recruited from a small rural community in southern Western Australia. Individual and focus group semi-structured interviews were conducted. The interviews were transcribed and subjected to thematic analysis informed by ecological systems theory.
The findings demonstrate the impact of a rural address on youth mental health through the influence of three overarching spheres of influence, as described by ecological systems theory: 'everyone knows everyone', 'small school and beyond' and 'the place'. Most themes included both positive and negative components, as well as ambivalence, demonstrating a double-edged sword.
The study findings support the view that mental health in rural young people is best viewed through an ecosystem lens, acknowledging the complex and dynamic interplay between interpersonal, community and environmental factors on young people. The paradoxes and contradictions present in almost every interview are informative, instructive and of great value in considering the needs and desires of rural young people. Rural communities should be supported to build upon their intrinsic strengths to ameliorate the impact of rurality on mental health risk factors for young people. Building on the assets inherent in rural communities, could rural young people have better outcomes than urban youth?
全球农村社区影响心理健康的地理、文化、社会和经济环境已有充分记录。然而，很少有研究探讨农村生态系统如何具体影响年轻人的心理健康和幸福。此外，对导致农村青少年心理健康状况较差的因素的有限探索主要包括成年人的观点。该研究旨在让年轻人表达农村和偏远地区青少年精神疾病和自杀率高这一棘手问题，以深入情境化的方式探索年轻人的经历。
本研究采用基于参与式行动研究原则的现象学定性设计。一个由年轻人主导的参考小组为研究设计和招募提供指导。从西澳大利亚州南部的一个小农村社区招募了29名年龄在12至19岁之间的年轻人。进行了个人和焦点小组的半结构化访谈。访谈内容被转录，并根据生态系统理论进行了主题分析。
研究结果表明，根据生态系统理论所描述的三个总体影响领域，农村环境对青少年心理健康有影响：“人人相识”、“小学校及其他”和“地方”。大多数主题都包括积极和消极的成分，以及矛盾情绪，显示出一把双刃剑。
研究结果支持这样一种观点，即最好通过生态系统视角来看待农村年轻人的心理健康，承认人际、社区和环境因素对年轻人的复杂和动态相互作用。几乎每次访谈中出现的悖论和矛盾在考虑农村年轻人的需求和愿望方面具有启发性、指导性和巨大价值。应支持农村社区利用其内在优势来减轻农村对年轻人心理健康风险因素的影响。基于农村社区固有的资产，农村年轻人能否比城市年轻人有更好的结果？
