Resilience, of individuals, is a well-established concept in the psychology/ mental health literatures, but has been little explored in relation to communities. Related theory in the community development and social impact assessment literature provides insight into qualities and assets of communities that enable them to develop effectively or to adapt to major changes. This article reports the components of community and individual resilience identified through a participatory action research study within a rural Australian community. These are social networks and support; positive outlook; learning; early experiences; environment and lifestyle; infrastructure and support services; sense of purpose; diverse and innovative economy; embracing differences; beliefs; and leadership.
Objective: A needs analysis was undertaken to determine the quality and effectiveness of mental health services to Indigenous consumers within a health district of Southern Queensland. The study focused on identifying gaps in the service provision for Indigenous consumers. Tools and methodologies were developed to achieve this.Method: Data were collected through the distribution of questionnaires to the target populations: district health service staff and Indigenous consumers. Questionnaires were developed through consultation with the community and the Steering Committee in order to achieve culturally appropriate wording. Of prime importance was the adaptation of questionnaire language so it would be fully understood by Indigenous consumers. Both questionnaires were designed to provide a balanced perspective of current mental health service needs for Indigenous people within the mental health service.Results: Results suggest that existing mental health services do not adequately meet the needs of Indigenous people.Conclusions: Recommendations arising from this study indicate a need for better communication and genuine partnerships between the mental health service and Indigenous people that reflect respect of cultural heritage and recognises the importance of including Indigenous people in the design and management of mental health services. Attention to the recommendations from this study will help ensure a culturally appropriate and effective mental health service for Indigenous consumers.
The critical shortage of the rural medical workforce in Australia continues. There is pressure on medical schools to produce not only more doctors, but to supply them in geographical areas of need. The latest policy to tackle these problems will increase medical student numbers while the supply of clinical teachers and patients for teaching remains static. This challenges the traditional apprenticeship model for learning medicine. Coupled with this is the requirement of medical schools to provide compulsory rural clinical placements for all students. The success of rural clinical schools and University Departments of Rural Health (UDRH) is increasingly apparent, but they must find new strategies to maintain a quality clinical experience and exposure to rural lifestyle for all medical students. The dilemma is providing this quality rural experience to all medical students in the immediate future. We suggest approaches to meet this challenge at a policy, organisational, student and teaching level.
Objective: In-depth exploration of the perceptions, experiences and expectations of current long-term rural GPs and medical students intent on a rural career, regarding the current and future state of rural medicine.Design: Qualitative study using semistructured interviews. Results: Despite large differences in generation and experience, medical students and rural GPs hold similar perceptions and expectations regarding the current and future state of rural practice. In particular, they cite a lack of professional support at the systems level. This includes specific support for: continuing medical education to obtain and retain the skills necessary for rural practice; dealing with the higher risks associated with procedural work; and consequences of medico-legal issues and workforce shortage issues such as long hours and availability of locums. Conclusions:Issues relating to recruitment and retention of the rural health workforce are identified by both cohorts as relating to professional support. Medical schools and institutional support systems need to join forces and work together to make rural practice a viable career in medicine.KEY WORDS: medical students' perception, recruitment and retention of general practitioner, rural general practitioner, rural workforce issue.
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