Addressing the barriers to accessing therapy services in rural and remote areas

Abstract

Purpose: Throughout the world, people with a disability who live in rural and remote areas experience difficulty accessing a range of community-based services including speech-, physioand occupational therapy. This paper draws on information gathered from carers and adults with a disability living in a rural area in New South Wales (NSW), Australia to determine the extent to which people living in rural areas may receive a person-centred therapy service. Methods: As part of a larger study in rural NSW into the delivery of therapy services, focus groups and individual interviews were conducted with 78 carers and 10 adults with a disability. Data were analysed using constant comparison and thematic analysis. Results: Three related themes emerged: (i) travelling to access therapy; (ii) waiting a long time to get therapy; and (iii) limited access to therapy past early childhood. The themes overlaid the problems of recruiting and retaining sufficient therapists to work in rural areas. Conclusions: Community-based rehabilitation principles offer possibilities for increasing person-centred therapy services. We propose a person-centred and place-based approach that builds on existing service delivery models in the region and involves four inter-related strategies aimed at reducing travel and waiting times and with applicability across the life course.ä Implications for Rehabilitation Therapy service delivery in rural and remote areas requires:Place-based and person centred strategies to build local capacity in communities. Responsive outreach programs working with individuals and local communities. Recognition of the need to support families who must travel to access remotely located specialist services. Innovative use of technology to supplement and enhance service delivery.

The provision of brain injury rehabilitation services for people living in rural and remote New South Wales, Australia

“…Solutions of mentoring and outreach services to build local capacity are supported in the literature, along with other strategies such as telehealth [32,45,50,62]. Increasing support through community-based workers has been shown to lower caregiver stress, thus improving family functioning, impacting positively on future outcomes [63].…”

“…This can result in people with ABI living in crisis and confusion and receiving very limited assistance [48,49]. In addition to this, disability studies in NSW have also identified that many people with a disability living in rural and remote areas experience difficulties accessing therapy services, with problematic consequences for people [50].…”

Parental perceptions of information needs and service provision for children with developmental disabilities in rural Australia

“…Access to specialist services for people with developmental disabilities is also a big challenge in most rural regions of Australia, particularly in respect to initial diagnosis. There are only a limited number of specialists who provide service(s) outside of metropolitan areas and it is very costly for specialists to visit rural and remote areas [24,25]. There is a lack of choice when it comes to rural service provision, in some cases, there is only one or even no professional representatives in an area, forcing families to travel, sometimes large distances [26].…”

Speech–language pathology telehealth in rural and remote schools: the experience of school executive and therapy assistants

“…In regional and remote regions of NSW, people with disabilities and their carers were found 11 to greatly value speech pathology and other allied health services while highlighting the levels of unmet need, long waiting lists, lack of continuity and consistency in services, and difficulties in accessing therapy. The major causes of these difficulties were identified 11 as workforce shortages, and distances travelled by the family or the AHP.…”

“…In 2011, NSW had 24 percent fewer AHP positions per head of population in rural and remote areas than the state's average 10 . Rural AHPs in NSW may travel thousands of kilometres in a year 11 , a factor in low retention rates and recruitment difficulties 12,13 . In regional and remote regions of NSW, people with disabilities and their carers were found 11 to greatly value speech pathology and other allied health services while highlighting the levels of unmet need, long waiting lists, lack of continuity and consistency in services, and difficulties in accessing therapy.…”