Urban–rural differences in psychiatric rehabilitation outcomes

Srinivasan, T. N.; Conrad, Agatha M.; Frost, Barry G.; Johnston, Suzanne

doi:10.1111/j.1440-1584.2010.01127.x

Cited by 26 publications

(13 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Higher rates of suicide in rural compared to urban areas (Qi et al, 2014), despite protective factors such as higher social supports (Tirupati et al, 2010; Yoshimasu et al, 2008), in addition to differential rates of suicide by migrant, indigenous and socioeconomic status (Law et al, 2016; Page et al, 2006; Qi et al, 2012; Too et al, 2018), suggests the potential role of mental health service availability and access as an important modifiable factor in preventing suicide (Korosec Jagodic et al, 2013). Successive suicide prevention frameworks and action plans have called for improvements to the availability, quality and integration of mental health services and enhancement of workforce capacity, which continues under current mental health reforms (Department of Health, 2009, 2012, 2017).…”

Section: Introductionmentioning

confidence: 99%

The impact of strengthening mental health services to prevent suicidal behaviour

Atkinson

Page

Heffernan

et al. 2018

Aust N Z J Psychiatry

View full text Add to dashboard Cite

Objective: Successive suicide prevention frameworks and action plans in Australia and internationally have called for improvements to mental health services and enhancement of workforce capacity. However, there is debate regarding the priorities for resource allocation and the optimal combination of mental health services to best prevent suicidal behaviour. This study investigates the potential impacts of service capacity improvements on the incidence of suicidal behaviour in the Australian context. Methods: A system dynamics model was developed to investigate the optimal combination of (1) secondary (acute) mental health service capacity, (2) non-secondary (non-acute) mental health service capacity and (3) resources to re-engage those lost to services on the incidence of suicidal behaviour over the period 2018–2028 for the Greater Western Sydney (Australia) population catchment. The model captured population and behavioural dynamics and mental health service referral pathways and was validated using population survey and administrative data, evidence syntheses and an expert stakeholder group. Results: Findings suggest that 28% of attempted suicide and 29% of suicides could be averted over the forecast period based on a combination of increases in (1) hospital staffing (with training in trauma-informed care), (2) non-secondary health service capacity, (3) expansion of mental health assessment capacity and (4) re-engagement of at least 45% of individuals lost to services. Reduction in the number of available psychiatric beds by 15% had no substantial impact on the incidence of attempted suicide and suicide over the forecast period. Conclusion: This study suggests that more than one-quarter of suicides and attempted suicides in the Greater Western Sydney population catchment could potentially be averted with a combination of increases to hospital staffing and non-secondary (non-acute) mental health care. Reductions in tertiary care services (e.g. psychiatric hospital beds) in combination with these increases would not adversely affect subsequent incidence of suicidal behaviour.

show abstract

Section: Introductionmentioning

confidence: 99%

The impact of strengthening mental health services to prevent suicidal behaviour

Atkinson

Page

Heffernan

et al. 2018

Aust N Z J Psychiatry

View full text Add to dashboard Cite

show abstract

“…Suicide rates are higher in rural than in urban regions (11,12), despite higher social support (13), which is considered a protective socioeconomic factor against suicide (14). This could be explained by lower availability of psychiatric services in rural regions (15,16).…”

mentioning

confidence: 99%

Availability of mental health service providers and suicide rates in Slovenia: a nationwide ecological study

Jagodič

Rokavec²,

Agius³

et al. 2013

Croat Med J

View full text Add to dashboard Cite

AimTo investigate the influence of socioeconomic factors, mental health service availability, and prevalence of mental disorders on regional differences in the suicide rate in Slovenia.MethodsThe effects of different socioeconomic factors, mental health service availability, and mental disorders factors on suicide rates from 2000-2009 were analyzed using a general linear mixed model (GLMM). Pearson correlations were used to explore the direction and magnitude of associations.ResultsAmong socioeconomic factors, unemployment rate ranked as the most powerful predictor of suicide and an increase of one unit in the unemployment rate increased regional suicide rate by 2.21 (β = 2.21, 95% confidence intervals [CI] = 1.87-2.54, P < 0.001). On the other hand, higher marriage/divorce ratio was negatively related to the suicide rate and an increase of one unit in marriage/divorce ratio reduced regional suicide rate by 1.16 (β = -1.16, 95% CI = -2.20 to -0.13, P < 0.031). The most influential mental health service availability parameter was higher psychiatrist availability (4 psychiatrists and more working at outpatient clinics per 100 000 inhabitants), which was negatively correlated with the suicide rate and reduced regional suicide rate by 2.95 (β = -2.95, 95% CI = -4.60 to -1.31, P = 0.002). Another negatively correlated factor was the antidepressant/anxiolytic ratio higher than 0.5, which reduced the regional suicide rate by 2.32 (β = -2.32, 95% CI = -3.75 to -0.89, P = 0.003). Among mental health disorders, only the prevalence of alcohol use disorders was significantly related to the regional suicide rates and an increase of one unit in the prevalence of alcohol use disorders per 1000 inhabitants increased the regional suicide rate by 0.02 (β = 0.02, 95% CI = 0.01- 0.03, P = 0.008).ConclusionsBesides unemployment, which was a very strong predictor of suicide rates, unequal availability of mental health services and quality of depressive disorder treatment may contribute to variations in suicide rates in different regions.

show abstract

“…Presumably, the structure and habits of a rural community may allow for some patients to function quite satisfactory in this context despite the partial remitted symptomatology. Notably, it has been suggested that the availability and access to the so-called social capital in the form of family support may also play significant role in outcomes for the rural residents with psychotic disorders (Tirupati et al, 2010). Moreover, there is some evidence that rural inhabitants may have a more positive attitude towards mental illness (Mutiso et al, 2018).…”

Section: Discussionmentioning

confidence: 99%

“…Less is known about the outcome of patients with psychotic disorders in rural areas. Interestingly, in a comparative study in Australia, Tirupati, Conrad, Frost, and Johnston (2010) found that the outcome of rehabilitation intervention for chronic severe mental disorders was better in the rural residents than in those living in urban areas. More recently, Yang et al (2015) examined marriage as the primary outcome in urban and rural residents with schizophrenia in China.…”

Section: Introductionmentioning

confidence: 99%

Functioning in community-dwelling patients with schizophrenia spectrum disorders in rural Greece

Peritogiannis¹,

Nikolaou

2019

Int J Soc Psychiatry

View full text Add to dashboard Cite

Background: There is a dearth of studies on functioning in patients with psychotic disorders in rural areas. Aim: The objective of this study was to assess functioning in a population-based sample of patients with psychotic disorders who live in rural, remote and deprived areas in Greece, and to explore the differences in functioning across ages. Methods: The sample consisted of 61 patients with psychotic disorders that were engaged to treatment with a community mental health service. The mean age of patients was 54.2 years, and the mean illness duration was 26.5 years. Results: A total of 23 patients (37.7%) had score in the Global Assessment of Functioning scale >60, and were rated as adequately functioning, and 18 patients (29.5%) had score in Clinical Global Impression scale-Schizophrenia ⩽3 and could be rated as mildly or minimally ill. Functioning was found to be inversely related to the patients’ symptomatology. No correlation with age was found. Conclusion: This study suggests that a large proportion of patients with psychotic disorders in rural Greece may achieve a satisfactory level of functioning in the long-term, across the whole age range despite the not completely remitted symptomatology. More research is needed to clarify the factors associated with rural residency that may account for patients’ functioning.

show abstract

Urban–rural differences in psychiatric rehabilitation outcomes

Abstract: For rural communities the improvement in rehabilitation outcomes might be attributable to a more benign form of the illness and the availability of higher levels of social capital.

Cited by 26 publications

References 30 publications

The impact of strengthening mental health services to prevent suicidal behaviour

The impact of strengthening mental health services to prevent suicidal behaviour

Availability of mental health service providers and suicide rates in Slovenia: a nationwide ecological study

Functioning in community-dwelling patients with schizophrenia spectrum disorders in rural Greece

Contact Info

Product

Resources

About