Abstract
BackgroundFarmers represent a subgroup of rural and remote communities at higher risk of suicide attributed to insecure economic futures, self-reliant cultures and poor access to health services. Early intervention models are required that tap into existing farming networks. This study describes service networks in rural shires that relate to the mental health needs of farming families. This serves as a baseline to inform service network improvements.MethodsA network survey of mental health related links between agricultural support, health and other human services in four drought declared shires in comparable districts in rural New South Wales, Australia. Mental health links covered information exchange, referral recommendations and program development.Results87 agencies from 111 (78%) completed a survey. 79% indicated that two thirds of their clients needed assistance for mental health related problems. The highest mean number of interagency links concerned information exchange and the frequency of these links between sectors was monthly to three monthly. The effectiveness of agricultural support and health sector links were rated as less effective by the agricultural support sector than by the health sector (p < .05). The most highly linked across all areas of activity were Rural Financial Counsellors, the Department of Primary Industry Drought Support Workers and Community Health Centres. Hence for a mental health service network targeting farming families these are three key agencies across the spectrum of case work to program development. The study limitations in describing service networks relate to the accuracy of network bounding, self report bias and missing data from non participants.ConclusionAligning with agricultural agencies is important to build effective mental health service pathways to address the needs of farming populations. Work is required to ensure that these agricultural support agencies have operational and effective links to primary mental health care services. Network analysis provides a baseline to inform this work. With interventions such as local mental health training and joint service planning to promote network development we would expect to see over time an increase in the mean number of links, the frequency in which these links are used and the rated effectiveness of these links.
Highlights
Farmers represent a subgroup of rural and remote communities at higher risk of suicide attributed to insecure economic futures, self-reliant cultures and poor access to health services
An important improvement in access to mental health care is suicide prevention and the most effective strategies for suicide prevention include those that improve access to appropriate services and improve the quality of response received from those services [9]
Our experience in a pilot study was that a network size of up to 30 agents was satisfactory for descriptive network analysis, whereas a larger network would make data collection quite resource intensive when this was being done by interview [15]
Summary
Farmers represent a subgroup of rural and remote communities at higher risk of suicide attributed to insecure economic futures, self-reliant cultures and poor access to health services. This study describes service networks in rural shires that relate to the mental health needs of farming families. This serves as a baseline to inform service network improvements. The health risk of farmers is influenced by their occupational, environmental and social conditions, which includes poor access to health care services in rural and remote areas in general [4], and by their own specific cultural barriers to health care [5,6]. An important improvement in access to mental health care is suicide prevention and the most effective strategies for suicide prevention include those that improve access to appropriate services (such as health services) and improve the quality of response received from those services [9]
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