The Care Situation, Stigmatization and Requirements of People with Mental Health Problems in Rural Areas

Abstract

With a lifetime prevalence of about 27 % mental disorders are amongst the most common diseases. They typically are of chronic course, thus affecting not only the respective people, but also the social surroundings. In order to provide mental health care in best possible proximity to their homes, transparency of the services offered and a rapid access are needed. The present study aims at defining the problems and requirements of rural mental health in a Carinthian region (Austria). The users (n = 46) and the family members (n = 37) were surveyed regarding their individual situation, the current strains and the level of social support. Additionally, expert interviews (n = 44) were conducted and analysed by using qualitative content analysis. Findings revealed that much of mental health care is delivered by primary care physicians and is too often limited to medication. As far as mobile psychosocial offers and expert staff are concerned, all of our interviewed people locate serious flaws and need for action. The present study concludes that there is urgent need to improve the care situation in rural areas. Case and care management and initiatives to reduce stigmatization are of paramount importance.

Share and Cite:

Jenull, B. , Salem, I. & Mir, E. (2012). The Care Situation, Stigmatization and Requirements of People with Mental Health Problems in Rural Areas. Advances in Applied Sociology, 2, 268-273. doi: 10.4236/aasoci.2012.24035.

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1] Bazelon Center for Mental Health Law (2006). Get it together. How to integrate physical and mental health care for people with serious mental disorders. URL (last checked 14 August 2012). http://www.bazelon.org./issues/mentalhealth/publications/getittogether/execsumm.htm
[2] Blackstock, K. L., Innes, A., Cox, S., Smith, A., & Mason, A. (2006). Living with dementia in rural and remote Scotland: Diverse experiences of people with dementia and their carers. Journal of Rural Studies, 22, 161-176. doi:10.1016/j.jrurstud.2005.08.007
[3] BMGFJ, Bundesministerium für Gesundheit, Familie und Jugend (2005). Das Gesundheitswesen in ?sterreich. Horn: Berger.
[4] Bombosch, J., Hansen, H., & Blume, J. (2004). Trialog praktisch. Neumünster: Paranus.
[5] Bühl, A. (2011). SPSS 20. Einführung in die moderne datenanalyse (13th ed.) (Introduction to modern data analysis). München: Pearson.
[6] Burns, T. (2007). Community mental health teams. Psychiatry, 6, 325- 328. doi:10.1016/j.mppsy.2007.05.009
[7] Corrigan, P., Kerr, A., & Knudsen, L. (2005). The stigma of mental illness: explanatory models and methods for change. Applied and Preventive Psychology, 11, 179-190. doi:10.1016/j.appsy.2005.07.001
[8] Creswell, J., & Plano Clark, V. (2007). Designing and conducting mixed methods research. Thousand Oaks: Sage.
[9] Demyttenaere, K., Bonnewyn, A., Bruffaerts, R., De Girolamo, G., Gasquet, I., Kovess, V., Haro, J., & Alonso, J. (2008). Clinical factors influencing the prescription of antidepressants and benzodiazepines. Results from the European study of the epidemiology of mental disorders (ESEMeD). Journal of Affective Disorders, 110, 84-93. doi:10.1016/j.jad.2008.01.011
[10] Fydrich, T., Sommer, G., & Br?hler, E. (2007). Fragebogen zur Sozialen Unterstützung (F-SozU) (survey of social support). Manual. G?ttingen: Hogrefe.
[11] Gamm, L., Tai-Seale, M., & Stone, S. (2002). White paper: Meeting the mental health needs of people living in rural areas. Galveston, TX: Department of Health Policy and Management School of Rural Public Health, Texas A&M University System Health Science Center College Station,
[12] Health Scotland (2008). Stigma: A guidebook for action. Tackling the discrimination, stigma and social exclusion experienced by people with mental health problems and those close to them. Edinburgh: Health Scotland.
[13] Kelly, B. (2006). The power gap: Freedom, power and mental illness. Social Science & Medicine, 63, 2118-2128. doi:10.1016/j.socscimed.2006.05.015
[14] Knapp, M., McDaid, D., Mossialos, E., & Thornicroft, G. (2007). Mental health policy and practice across Europe. The future direction of mental health care. Maidenhead: Open University Press.
[15] Kumar, A. (2011). Mental health services in rural India: Challenges and prospects. Health, 3, 757-761. doi:10.4236/health.2011.312126
[16] Lewis, J., Baeza, J., & Alexander, D. (2008). Partnerships in primary care in Australia: Network structure, dynamics and sustainability. Social Science & Medicine, 67, 280-291. doi:10.1016/j.socscimed.2008.03.046
[17] Manthorpe, J., Moriarty, J., Stevens, M., Hussein, S., & Sharif, N. (2012). Promoting the mentalwell-being of older people from black and minorityethnic communities in United Kingdom rural areas: Findings from an interview study. Journal of Rural Studies, 28, 406- 411.
[18] Mayring, P. (2007). Qualitative inhaltsanalyse (qualitative content analysis). Weinheim: Deutscher Studien Verlag.
[19] McElmurry, B., Marks, B., Cianelli, R., & Mamede, M. (2002). Primary health care in the Americas: Conceptual framework, experiences, challenges and perspectives. Washington DC: Pan American Health Organisation.
[20] Merkel, L. (2004). Rural mental health. URL (last checked 24 January 2007). http://www.healthsystem.virginia.edu/internet/psych-training/seminars/rural-mental-health-1-22-03.pfd
[21] Mueller, B., Nordt, C., Lauber, C., Rueesch, P., Meyer, P., & Roessler, W. (2006). Social support modifies perceived stigmatization in the first years of mental illness: A longitudinal approach. Social Science & Medicine, 62, 39-49. doi:10.1016/j.socscimed.2005.05.014
[22] Philo, C., Parr, H., & Burns, N. (2003). Rural madness: A geographical reading and critique of the rural mental health literature. Journal of Rural Studies, 19, 259-281. doi:10.1016/S0743-0167(03)00005-6
[23] Riedel-Heller, S., Bramesfeld, A., Roick, C., Becker, T., & K?nig, H.-H. (2008). Der ruf nach mehr versorgungsforschung (the need for more health services research). Psychiatrische Praxis, 35, 157-159. doi:10.1055/s-2008-1067424
[24] Rüsch, N., Angermeyer, M., & Corrigan, P. (2005). Mental illness stigma: Concepts, consequences, and initiatives to reduce stigma. European Psychiatry, 20, 529-539. doi:10.1016/j.eurpsy.2005.04.004
[25] Rüsch, N., Corrigan, P. W.,Wassel, A., Michaels, P., Larson, J. E., Olschewski, M., Wilkniss, S. & Batia, K. (2009). Self-stigma, group identification, perceived legitimacy of discrimination and mental health service use. British Journal of Psychiatry, 195, 551-552. doi:10.1192/bjp.bp.109.067157
[26] Salewski, C., & Ostendorf, M. (2003). Entwicklung eines Fragebogens zur Erfassung der Belastung einer alterstypischen Lebensaufgabe: Die Pflege-Belastungs-Skala (PBS) (development of a questionnaire for the assessment of the impact of age-related tasks: The nursing stress scale). In K. Eisfeld, U. Wiesmann, H.-J. Hannich, & P. Hirtz (Eds.), Gesund und bewegt ins alter. Interdisziplin?re ans?tze für eine community medicine (pp. 137-146). Butzbach-Griedel: AFRA.
[27] Sch?ny, W., & Katschnig, H. (1991). Die psychiatriereform in ?sterreich am beispiel der angeh?rigenarbeit und der laienhilfe (The mental health reform in Austria). In M. Bauer, R. Engfer, & J. Rappl (Eds.), Psychiatrie-reform in Europa (pp. 89-113). Bonn: Psychiatrie-Verlag.
[28] Schomerus, G., & Angermeyer, M. C. (2008). Stigma and its impact on help-seeking for mental disorders: What do we know? Epidemiologia e Psichiatria Sociale, 17, 31-37.
[29] Siddiqi, K., & Siddiqi, N. (2007). Treatment of common mental disorders in primary care in lowund middle-income countries. Transactions of the Royal Society of Tropical Medicine and Hygiene, 101, 957-958. doi:10.1016/j.trstmh.2007.04.006
[30] Statistik Austria (2012). ?sterreich und seine bundesl?nder (Austria and its provinces). URL (lase checked 10 September 2012). http://www.statistik.at/web_de/services/wirtschaftsatlas_oesterreich/oesterreich_und_seine_bundeslaender/index.html
[31] Verhaak, P., Schellevis, F., Nuijen, J., & Volkers, A. (2006). Patients with a psychiatric disorder in general practice: determinants of general practitioners psychological diagnosis. General Hospital Psychiatry, 28, 125-132. doi:10.1016/j.genhosppsych.2005.11.001
[32] Walters, P., & Tylee, A. (2006). Mood disorders in primary care. Psychiatry, 5, 138-141. doi:10.1383/psyt.2006.5.4.138
[33] WHO (2006). Psychische gesundheit: Herausforderungen annehmen, l?sungen schaffen (Mental health: Facing the challenges, finding solutions). Kopenhagen: WHO—Regionalbüro für Europa.
[34] Wittchen, H., & Jacobi, F. (2005). Size and burden of mental disorders in Europe. European Neuropsychopharmacology, 15, 357-376. doi:10.1016/j.euroneuro.2005.04.012
[35] Zanjani, F., & Rowles, G. (2012). “We don't want to talk about that”: Overcoming barriers to ruralaging research and interventions on sensitive topics. Jorunal of Rural Studies, 28, 398-405.
[36] Zechmeister, I. (2004). Paradigm shift in mental health care: Challenges and approaches for financing a community mental health care system in Austria. Ph.D. Thesis, Wien: Wirtschaftsuniversit?t Wien.

Copyright © 2024 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.