Exploring the Challenges of Context in Accessing Mental Health Support in Rural New Zealand: A Case Study Approach.

Abstract

This paper explores the complexities that impact access to mental health services in rural New Zealand. Historical, cultural, social and political factors will be examined against the philosophical positioning of Foucault and Fairclough. This research is a single-embedded case study design exploring participants' discourses in the context of a rural, bounded geographical area of New Zealand. The results show that mental health support that addresses people's actual needs rather than the needs that governments map against ever-changing policy is required and that an awareness of context within case study research is important. The process of case study design is described, including building upon a rationale for selecting the case, collecting data and conducting case analysis and interpretation. This study examines factors influencing the real-life rural context of accessing mental health support. This article demonstrates that case-study research can be valuable for navigating context complexity and developing nuanced understandings of complex phenomena. The paper highlights how the multifaceted case study context is more than mapping discourses against a rural backdrop. It is necessary to consider the power dynamics that shape experiences and their impact on service creation and its consequent delivery. Rather than services being created that are complex and not meeting people's needs, there is a need to listen to the people who have experienced mental health distress and provide services and support in locations other than clinical settings.