Jose A Salinas-Perez1,2, Mencia R Gutierrez-Colosia3,4, Mary Anne Furst2, Petra Suontausta5, Jacques Bertrand6, Nerea Almeda3, John Mendoza7, Daniel Rock8,9, Minna Sadeniemi10, Graça Cardoso11, Luis Salvador-Carulla2,12. 1. Department of Quantitative Methods, Universidad Loyola Andalucía, Dos Hermanas, Sevilla, Spain. 2. Centre for Mental Health Research, Australian National University, Canberra, Australian Capital Territory, Australia. 3. Department of Psychology, Universidad Loyola Andalucía, Dos Hermanas, Sevilla, Spain. 4. Asociación Científica Psicost, Dos Hermanas, Sevilla, Spain. 5. Faculty of Social Sciences, Tampere University, Pirkanmaa, Finland. 6. Ippigusugiursavik, Kuujjuaq, Quebec, Canada. 7. ConNetica Consulting, Coolum, Queensland, Australia. 8. WA Primary Health Alliance, Perth, Western Australia, Australia. 9. Discipline of Psychiatry, The University of Western Australia, Perth, Western Australia, Australia. 10. Unit for Mental Health, National Institute for Health and Welfare, Helsinki, Finland. 11. Lisbon Institute of Global Mental Health, Comprehensive Health Research Center (CHRC), Nova Medical School, Nova University of Lisbon, Portugal. 12. Menzies Centre for Health Policy, School of Public Health, Faculty of Medicine and Health, University of Sydney, New South Wales, Australia.
Abstract
OBJECTIVE: Mental health (MH) care in remote areas is frequently scarce and fragmented and difficult to compare objectively with other areas even in the same country. This study aimed to analyze the adult MH service provision in 3 remote areas of Organization for Economic Cooperation and Development countries in the world. METHODS: We used an internationally agreed set of systems indicators, terminology, and classification of services (Description and Evaluation of Services and DirectoriEs for Long Term Care). This instrument provided a standard description of MH care provision in the Kimberley region (Australia), Nunavik (Canada), and Lapland (Finland), areas characterized by an extremely low population density and high relative rates of Indigenous peoples. RESULTS: All areas showed high rates of deprivation within their national contexts. MH services were mostly provided by the public sector supplemented by nonprofit organizations. This study found a higher provision per inhabitant of community residential care in Nunavik in relation to the other areas; higher provision of community outreach services in the Kimberley; and a lack of day services except in Lapland. Specific cultural-based services for the Indigenous population were identified only in the Kimberley. MH care in Lapland was self-sufficient, and its care pattern was similar to other Finnish areas, while the Kimberley and Nunavik differed from the standard pattern of care in their respective countries and relied partly on services located outside their boundaries for treating severe cases. CONCLUSION: We found common challenges in these remote areas but a huge diversity in the patterns of MH care. The implementation of care interventions should be locally tailored considering both the environmental characteristics and the existing pattern of service provision.
OBJECTIVE: Mental health (MH) care in remote areas is frequently scarce and fragmented and difficult to compare objectively with other areas even in the same country. This study aimed to analyze the adult MH service provision in 3 remote areas of Organization for Economic Cooperation and Development countries in the world. METHODS: We used an internationally agreed set of systems indicators, terminology, and classification of services (Description and Evaluation of Services and DirectoriEs for Long Term Care). This instrument provided a standard description of MH care provision in the Kimberley region (Australia), Nunavik (Canada), and Lapland (Finland), areas characterized by an extremely low population density and high relative rates of Indigenous peoples. RESULTS: All areas showed high rates of deprivation within their national contexts. MH services were mostly provided by the public sector supplemented by nonprofit organizations. This study found a higher provision per inhabitant of community residential care in Nunavik in relation to the other areas; higher provision of community outreach services in the Kimberley; and a lack of day services except in Lapland. Specific cultural-based services for the Indigenous population were identified only in the Kimberley. MH care in Lapland was self-sufficient, and its care pattern was similar to other Finnish areas, while the Kimberley and Nunavik differed from the standard pattern of care in their respective countries and relied partly on services located outside their boundaries for treating severe cases. CONCLUSION: We found common challenges in these remote areas but a huge diversity in the patterns of MH care. The implementation of care interventions should be locally tailored considering both the environmental characteristics and the existing pattern of service provision.
Entities:
Keywords:
DESDE-LTC; mental health care; rural and remote mental health; service mapping; service provision
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