A call to action to address rural mental health disparities

Morales, Dawn A.; Barksdale, Crystal L.; Beckel-Mitchener, Andrea

doi:10.1017/cts.2020.42

Cited by 209 publications

(190 citation statements)

References 39 publications

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“…A study found that there used to be a treatment disparity between rural and urban settings when it comes to provision of mental health services (Morales et al, 2020). Individuals living in rural area tend to receive mental health check-ups and treatments less frequently that too from less trained personnel mostly (Morales et al, 2020).…”

Section: Relationship Between Schizophrenia Related Variables Of the ...mentioning

confidence: 99%

Relationship between the caregiver burden and the resilience among primary caregivers of individuals suffering from schizophrenia attending tertiary care rural hospital from central India: A cross-sectional observational study

Shukla¹,

Ghogare²,

Patil³

2022

Medical Science

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Introduction: Schizophrenia is a chronic mental disorder prevalent across the globe. Because of its chronic course, most of the individuals with schizophrenia require lifelong treatment which may pose financial, physical, and mental burden over the primary caregivers. So, while taking care of the individuals with schizophrenia over a prolonged period, caregivers themselves can suffer from the burden in the form of depression, anxiety, and stress. Objective: To study the relationship between caregiver burden in the form of depression, anxiety and stress, and the resilience among the primary caregivers of individuals with schizophrenia. Methodology: Present crosssectional study was carried out by the department of Psychiatry of a tertiary care rural teaching hospital from Maharashtra, India. Data were collected from 80 primary caregivers by using standard questionnaires like Depression, Anxiety and Stress -21 item (DASS-21) scale to measure the caregiver burden and Brief Resilience Scale (BRS) to measure the levels of resilience. Results:Prevalence of depression, anxiety, and stress were 55%, 35%, and 48.7% respectively. Significant negative correlation was observed between resilience levels and depression (r= -0.23), anxiety (r= -0.35), and stress (r= -0.24), suggesting that the probability of the caregiver burden increases with decline in the level of resilience. Conclusion: Based on the findings, we recommend that regular individual as well as group sessions should be conducted for the primary caregivers to strengthen their resilience so that they can not only

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Section: Relationship Between Schizophrenia Related Variables Of the ...mentioning

confidence: 99%

Relationship between the caregiver burden and the resilience among primary caregivers of individuals suffering from schizophrenia attending tertiary care rural hospital from central India: A cross-sectional observational study

Shukla¹,

Ghogare²,

Patil³

2022

Medical Science

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“…Adults residing in rural geographic locations may receive mental health treatment less frequently, often with providers with less specialized training compared to those residing in metropolitan locations [22]. The reasons underlying this mental health treatment disparity include paucity of mental health services, reduced access and underutilization of available services, and professional staffing shortages [22]. The utilization of mental health services is affected by distance as well; the longer the distance, the less the service is used [23].…”

Section: The Case Of Rural Areasmentioning

confidence: 99%

The Greek Hybrid Version of the Assertive Community Treatment Model: A Perspective View between Challenges and Limitations

Peritogiannis¹,

Tsoli²

2021

Psych

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The Assertive Community Treatment (ACT) model of care has been long considered to be effective in the management of patients with severe mental illness (SMI) in most Western countries. The implementation of the original ACT model may be particularly challenging in rural and remote communities with small and dispersed populations and lack of adequate mental health services. Rural programs may have to adapt the model and modify the ACT fidelity standards to accommodate these limitations, and this is the rationale for the introduction of more flexible, hybrid ACT models. In rural Greece, the so called Mobile Mental Health Units (MMHUs) are well-established community mental health services. For patients with SMI that have difficulties engaging with treatment services, the new hybrid ACT model has been recently launched. The objective of this manuscript is to present the recently launched hybrid ACT model in rural areas in Greece and to explore the challenges and limitations in its implementation from the experience of a team of mental health professionals with ACT experience. Referral criteria have not been strictly set, but the number of previous relapses and hospitalizations is taken under consideration, as well as the history of poor treatment adherence and disengagement from mental health services. The main limitation in the implementation of the hybrid ACT service is that it has been introduced in several areas in the absence of a pre-existing community mental health service. This may impact referrals and limit focus on the difficult cases of patients with SMI, thus making the evaluation of the model inapplicable.

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“…Recent research has suggested that patients with medical conditions such as heart disease or traumatic brain injury residing in rural areas were less likely to utilize specialized services and were in risk for worse outcomes, compared to urban patients (Brown et al, 2019; Field et al, 2018; Yue et al, 2020). Similarly, it has been shown that patients residing in rural geographic locations receive mental health treatment less frequently and often by professionals with less specialized training, when compared to those residing in metropolitan locations (Morales et al, 2020). The reasons underlying this mental health treatment disparity are well documented and include reduced access to services and limited availability of specialty mental health care in rural areas; lack of trained mental health personnel and care coordination in rural medical care; mental health staff shortages; and underutilization of available services (Morales et al, 2020; Thornicroft et al, 2011).…”

Section: Introductionmentioning

confidence: 99%

“…Similarly, it has been shown that patients residing in rural geographic locations receive mental health treatment less frequently and often by professionals with less specialized training, when compared to those residing in metropolitan locations (Morales et al, 2020). The reasons underlying this mental health treatment disparity are well documented and include reduced access to services and limited availability of specialty mental health care in rural areas; lack of trained mental health personnel and care coordination in rural medical care; mental health staff shortages; and underutilization of available services (Morales et al, 2020; Thornicroft et al, 2011). Family structure and socioeconomic status are also involved in mental health care utilization (Hauenstein et al, 2007).…”

Section: Introductionmentioning

confidence: 99%

Research on psychotic disorders in rural areas: Recent advances and ongoing challenges

Peritogiannis¹,

Samakouri

2021

Int J Soc Psychiatry

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Background: Research on patients with chronic psychotic disorders in rural areas is scarce. Those patients may not receive adequate mental health care. Mental health disparities among rural and urban areas have been recognized. Aims: This review aims to present the most recent research on psychotic disorders in rural areas. Method: We conducted a search in the PubMed and Scopus databases. The search involved articles published over the last decade (2011–2020). All types of research design were included, if studies had used a controlled group of urban patients and reported on the differences among rural/urban residents with psychotic disorders. The focus of the review was on outcome and treatment. Results: A total of 12 studies were included in this review. Most have been conducted in China or India. Reports from Western countries are rare. Outcome studies showed that employment rates are significantly higher in rural patients, as well as rates of marriage in women. It is not clear what is the impact of those outcomes on patients’ lives. The finding of lower cost of psychotic disorders in some rural areas, should be viewed with scepticism. Studies on treatment aspects suggested that rural patients were less likely to receive antipsychotics, antipsychotic combination or clozapine. Those results were attributed to limited access to specialized treatment. When rural patients receive specialized community care they seem to have better outcomes than urban patients. Conclusion: There is an ongoing, but still scarce research on patients with chronic psychotic disorders in rural areas. Researchers pointed out the impact of socioeconomic inequalities on outcome and treatment, and stressed the importance of minimizing mental health disparities. These findings may have potential implications for future research; for the introduction of accessible, locally based mental health services in rural areas; and for political initiatives that would address poverty and social inequalities.

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A call to action to address rural mental health disparities

Cited by 209 publications

References 39 publications

Relationship between the caregiver burden and the resilience among primary caregivers of individuals suffering from schizophrenia attending tertiary care rural hospital from central India: A cross-sectional observational study

Relationship between the caregiver burden and the resilience among primary caregivers of individuals suffering from schizophrenia attending tertiary care rural hospital from central India: A cross-sectional observational study

The Greek Hybrid Version of the Assertive Community Treatment Model: A Perspective View between Challenges and Limitations

Research on psychotic disorders in rural areas: Recent advances and ongoing challenges

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