Rural and remote communities face unique mental health challenges, including higher rates of acute mental health conditions, substance use, and suicide, compounded by geographic isolation, workforce shortages, and limited access to specialist services. Dialectical Behaviour Therapy (DBT) is a well-established, evidence-based treatment for complex and high-risk presentations such as borderline personality disorder, suicidality, addictions, and emotion dysregulation. However, traditional DBT models, which are resource-intensive and require multidisciplinary teams, can be difficult to implement and sustain in rural contexts due to limited staffing and high service demand.
This presentation draws on experience from Far West NSW services, including collaborative work with the Royal Flying Doctor Service (RFDS), to explore practical adaptations of DBT for rural settings. This presentation highlights the importance of innovation, collaboration, and local adaptation in making DBT accessible and effective for rural and remote communities and services. The lessons learned have broader implications for rural mental health service delivery and the ongoing development of stepped, community-oriented models of care.