Mental health service use: Is there a difference between rural and non-rural women in service uptake?

Abstract

This study examines differences in uptake of the Medicare items rolled out in 2006 under the 'Better Access Scheme' (BAS) between rural and non-rural Australian women. It compares differences in women's uptake of the BAS services by area of residence (ARIA+) across time using the Australian Longitudinal Study of Women's Health (ALSWH) survey data linked to Medicare data. Women aged 28-33 years at the time the BAS was introduced that responded to the self-reported question on depression/anxiety and consented to linkage of their survey data with Medicare data (n=4,316). Participants were grouped by ARIA+ according to BAS use, diagnoses of anxiety/depression but no BAS use and other eligible women. Across all areas, women born 1973-1978 with a self-reported diagnosis of depression/anxiety or having treatment under the BAS had a significantly lower mean mental health score compared to other women. Significantly more women living in non-rural areas had used at least one service provided under the BAS initiative compared to women in outer regional, inner regional or remotes areas (21% versus 18% versus 13% versus 7%, respectively), and across all areas, 12% of women reported having a diagnosis of depression/anxiety but not been treated under the BAS. While there is a gradual uptake of the new BAS services, a large percentage of women who have a diagnosis of depression/anxiety have not been treated under the BAS. The data suggest that women in urban areas have been better able to take up the services compared to non-urban women.

Common mental disorders and associated factors: a study of women from a rural area

“…Moreover, people living in rural communities have limited access to health services and specialized services such as mental health services. Women living in rural areas with low education levels are less likely to seek care for mental illness compared to women living in urban areas (17) . From this perspective, we emphasize that several factors can influence the mental health of rural women.…”

Sintomas de depressão em mulheres rurais: fatores sociodemográficos, econômicos, comportamentais e reprodutivos

“…(24) Women living in rural areas and with a low educational level presented less inclination (in comparison with those living in urban areas) to seek care in face of a mental disorder, as they have limited access to health services, mainly specialized ones, such as mental disorder-related services. (25) The prevalence of mental disorders seems to be widely comparable in rural and urban areas, however there are differences between these two environments that may have different impacts and outcomes on the health of women. In general, living in a rural area limits access to health services and stigmatizes the public health within a cultural context.…”

General practitioners’ experiences and perceptions of mild moderate depression management and factors influencing effective service delivery in rural Australian communities: a qualitative study

“…The true extent of disadvantage faced by rural communities in comparison with their urban counterparts is difficult to ascertain [ 10 , 23 , 24 ], although the evidence is rising. The validity of the universal approach to mental illness in rural communities is questioned, as there is increasing evidence that there is “inequitable distribution of mental health care services across rural, remote and metropolitan areas” [ 25 ]. These discrepancies have been attributed to patient socioeconomic status, geographical location, and adequacy and availability of mental health services [ 26 ].…”

“…These discrepancies have been attributed to patient socioeconomic status, geographical location, and adequacy and availability of mental health services [ 26 ]. Indeed, a recent study [ 25 ] demonstrated that a lower proportion of women in rural and regional areas accessed an Australian government-funded mental health initiative ‘Better Access’ Scheme compared to their non-rural counterparts, potentially reflecting a shortage of services or difficulty accessing them [ 25 ].…”