Enhancing Access to Psychologically Informed Mental Health Services in Rural and Northern Communities

By Dyck, Karen G.; Hardy, Cindy | Canadian Psychology, February 2013 | Go to article overview

Enhancing Access to Psychologically Informed Mental Health Services in Rural and Northern Communities


Dyck, Karen G., Hardy, Cindy, Canadian Psychology


Abstract

Access to psychologically informed mental health services has historically been a challenge for the more than 6 million Canadians residing in rural and northern (R&N) communities. However, over the past 20 years, Canada has been witness to a number of positive psychologist-led initiatives aimed at enhancing access for R&N Canadians. These can be grouped into 2 main categories, namely recruiting and retaining psychologists in R&N communities and developing and implementing technologically supported psychology services offered at a distance (telepsychology). This article provides an overview of the barriers to accessing psychologically informed mental health services and reviews some of the psychologist-led initiatives aimed at enhancing access in R&N Canada. Potential benefits and limitations of these initiatives are presented and the importance of enhanced collaboration between urban and R&N-based psychologists is discussed. Finally, psychologists are encouraged to look for and embrace opportunities to further broaden and enhance their positive presence in R&N communities.

Keywords: rural and northern psychology, mental health, telepsychology, recruitment and retention, access to services

Approximately 20% (>6 million) of Canadians reside in rural or northern communities (Statistics Canada, 2006b). Although these communities are diverse in many respects, accessing appropriate health care services, including mental health, remains a challenge for most rural and northern (R&N) residents (Kirby & Keon, 2006). This article is intended to provide a brief overview of the current literature related to barriers to accessing psychologically informed mental health services (defined here as therapy services derived from psychological theory that may or may not be delivered by a psychologist) and to review some of the psychologist-led initiatives aimed at enhancing access to psychologically informed mental health services in R&N Canada. Recognising the lack of definitional consensus (Malone, 201 1), this article reflects current literature in which the subject matter was deemed relevant to R&N Canadians.

Although this article focuses primarily on mental health services and R&N Canadian communities, the concepts and ideas presented here may be equally applicable to the provision of broader psychological services and to other underserved communities (e.g., prisons, military, etc.). Lastly, the focus on psychologically informed services should not be interpreted as negating the importance of a comprehensive mental health strategy that includes a broad range of helpers (e.g., family members, spiritual advisers, peer counsellors, individuals with lived experience, interprofessional health care team) and services (support groups, psychotherapy/counselling, pharmacotherapy, vocational rehabilitation, housing support, etc.).

Barriers to Accessing Psychologically Informed Mental Health Services

Despite the documented mental health needs (for a review, see Hardy, Malone, Dyck, & Rollings, 2013), Canadians residing in R&N communities often face numerous barriers to accessing appropriate mental health services. Mental health services, including psychology services, are less available in R&N communities than urban centres (Bazana, 1999; Hardy et al., in press; Kirby & Keon, 2006). As a result, many R&N Canadians are faced with travelrelated barriers (e.g., lack of transportation, lost work time, transportation costs, childcare issues) associated with accessing services in larger urban centres (Boydell et al., 2006). Even when services are available locally, long wait times, lack of information, stigma, and lack of anonymity may deter residents from accessing services (Boydell et al., 2006; Ryan-Nicholls & Haggarty, 2007; Ryan-Nicholls, Racher, & Robinson, 2003). Based on her qualitative research, Leipert (2002) also contends that norms and values associated with hardiness and self-reliance can further perpetuate stigma associated with mental illness and prevent R&N women from seeking help. …

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