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Psychological problems in rural primary care : evaluating a model of mental health service delivery in rural Tasmania

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Campbell, Alistair (2004) Psychological problems in rural primary care : evaluating a model of mental health service delivery in rural Tasmania. PhD thesis, University of Tasmania.

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Abstract

Over the past 10 years in Australia, there has been
significant expenditure of resources on mental health. Research
has demonstrated that psychological disorders are a frequent and
disabling health issue for many in the community. However, there
continues to be a singular gap in our knowledge of mental health
in rural and remote Australia.
Numerous publications have identified the issue and called
for more research in rural settings at all levels. Yet a number of
reviews have shown that most publications in this area are
commentaries, descriptions of services, or policy statements.
There is a significant gap in our understanding of the prevalence
of mental health problems in rural and remote Australia. Currently
we know very little about the risk and protective factors that
moderate prevalence and the impact of service delivery on
outcome for clients in rural and remote areas.
This study included basic research on common mental
disorders in a Tasmanian primary care population whilst
evaluating the relative clinical effectiveness of a locally developed
model of mental health service delivery.
The study used a combined survey and naturalistic
experimental design to screen participants (N=490) making a
routine visit to their GP and subsequently assess them (N=227)
using a diagnostic interview and rating scales of psychiatric
symptoms and quality of life. Participants were re-assessed on
these measures after 12 months. The primary care sample was
grouped into those who had received a mental health service
(N=22), those who had symptoms but did not receive treatment
(Untreated Control, N=100), and those who did not have
symptoms and did not receive mental health treatment (Normal
Control, N=105). Clients being seen by a Local Mental Health
Worker (N=28) were compared to the different groups of primary
care participants. The study revealed a high prevalence of common mental
disorders in this sample. In addition, a moderate correlation was
established between the GP evaluation of psychological well-being
and measures used in the survey suggesting that the GPs in this
study were good at identifying psychological distress. Finally, it
was found that the clients of the Local Mental Health Worker
improved to a statistically and clinically significant degree on all
the indicators of symptom level, distress, and quality of life
compared to the other groups. More research is necessary but this study supports the idea
that people do better when treated by mental health professionals
in their own community. Such a model should be given serious
consideration when developing future services.

Item Type: Thesis (PhD)
Keywords: Mental health services, Rural health services, Mental health
Copyright Holders: The Author
Copyright Information:

Copyright 2004 the Author - The University is continuing to endeavour to trace the copyright
owner(s) and in the meantime this item has been reproduced here in good faith. We
would be pleased to hear from the copyright owner(s).

Additional Information:

Thesis (PhD.)--University of Tasmania, 2005. Includes bibliographical references

Date Deposited: 25 Nov 2014 00:54
Last Modified: 28 Jun 2016 03:37
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