TY - JOUR
T1 - Patterns of Mental Health Care in Remote Areas
T2 - Kimberley (Australia), Nunavik (Canada), and Lapland (Finland): Modèles de soins de santé mentale dans les régions éloignées: Kimberley (Australie), Nunavik (Canada) et Laponie (Finlande)
AU - Salinas-Perez, Jose A.
AU - Gutierrez-Colosia, Mencia R.
AU - Furst, Mary Anne
AU - Suontausta, Petra
AU - Bertrand, Jacques
AU - Almeda, Nerea
AU - Mendoza, John
AU - Rock, Daniel
AU - Sadeniemi, Minna
AU - Cardoso, Graça
AU - Salvador-Carulla, Luis
N1 - Funding Information:
We would like to acknowledge the support of Western Australia Primary Health Alliance (WAPHA), including Leigh Newman, and the assistance of Ms. Kirsty Snelgrove from WA Health. We are also grateful to the members of the Project Reference Group, to the Lapland Hospital District Psychiatric care division, and to all the service providers who participated in this study. The author(s) received no financial support for the research, authorship, and/or publication of this article.
Publisher Copyright:
© The Author(s) 2020.
PY - 2020/10/1
Y1 - 2020/10/1
N2 - 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.
AB - 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.
KW - DESDE-LTC
KW - mental health care
KW - rural and remote mental health
KW - service mapping
KW - service provision
UR - http://www.scopus.com/inward/record.url?scp=85088827394&partnerID=8YFLogxK
U2 - 10.1177/0706743720944312
DO - 10.1177/0706743720944312
M3 - Article
C2 - 32720514
AN - SCOPUS:85088827394
SN - 0706-7437
VL - 65
SP - 721
EP - 730
JO - Canadian Journal of Psychiatry
JF - Canadian Journal of Psychiatry
IS - 10
ER -
