Abstract
Mental health promotion programs are important in rural communities but the factors which influence program effectiveness remain unclear. The aim of this mixed-methods study was to assess how community resilience affected the implementation of a mental health promotion program in rural Tasmania, Australia. Four study communities were selected based on population size, rurality, access to local support services, history of suicide within the community, and maturity of the mental health promotion program. Data from self-report questionnaires (n = 245), including items of Communities Advancing Resilience Toolkit (CART) assessment, and qualitative (focus group and interview) data from key local stakeholders (n = 24), were pooled to explore the factors perceived to be influencing program implementation. Survey results indicate the primary community resilience strengths across the four sites were related to the ‘Connection and Caring’ domain. The primary community resilience challenges related to resources. Qualitative findings suggested lack of communication and leadership are key barriers to effective program delivery and identified a need to provide ongoing support for program staff. Assessment of perceived community resilience may be helpful in informing the implementation of mental health promotion programs in rural areas and, in turn, improve the likelihood of their success and sustainability.
Highlights
Mental health promotion programs are important in rural communities, where the impact of mental health problems are compounded by geographic isolation and a lack of relevant services [1]
The survey results indicated the primary community resilience strengths across the four sites were related to the connection and caring domain, with most survey respondents agreeing that people in their communities feel like they help each other and that they have a sense of belonging
These survey results were supported by qualitative data, the community mobilization sub-theme that emphasized the positive benefits of communities facilitating mental health promotion events and generating conversations about suicide
Summary
Mental health promotion programs are important in rural communities, where the impact of mental health problems are compounded by geographic isolation and a lack of relevant services [1]. Socio-cultural factors [2] such as stigma and/or a reluctance to seek help, are often identified as the major barriers to timely access of support and treatment [3,4,5]. Standard approaches to health promotion may be less relevant for those in rural and remote areas because of the lowered access to services and community infrastructure that support and promote campaigns. Individuals living in rural and remote areas may experience a real and/or perceived lack of privacy and confidentiality in matters relating to their health.
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