Differences in mental health service use between urban and rural areas of Australia

Objective: To examine differences in use of mental health services between residents of rural, regional, and metropolitan areas of Australia in a population-based sample of adults who meet clinical criteria for a mental disorder. Method: Participants in this study were drawn from the Assessing Mental Health survey, which included 2,374 participants who met criteria for one or more mental disorders or reported suicidal ideation in the past month. Rates of self-reported use of specific services for mental health problems (doctor/general practitioner, social worker, hospital, psychologist, psychiatrist, or counsellor) were compared between areas of residence, with subsequent logistic regression analyses used to account for potential confounds for variations in service use. Results: There were no differences in overall rates of use of professional services for mental health problems. There were also no significant differences in help seeking from specific sources, with the exception of psychologists. People in rural areas were 26% less likely to report having sought help from a psychologist in the past year than those in metropolitan areas (18% vs. 24%). This discrepancy was not accounted for by stigma, but attenuated after adjustment for severity of psychological distress and demographic factors. Conclusion: Little evidence of differences in help seeking in rural Australia compared to urban centres was observed, with the important exception of psychological service use. Further research is needed to characterise disparities in quality and accessibility of care.