Background: Poor mental health prevalence is similar to urban areas, yet rurality and remoteness are associated with worse outcomes including higher rates of suicide and self-harm. People living in rural and remote communities have distinct and cumulative vulnerabilities. They experience place-based rural adversity such as natural disasters which intersect and compound with life-course adversity and more recently the impacts of the pandemic.
Aim: Investigate how the COVID-19 Pandemic impacted the mental health and wellbeing of people living in rural and remote locations.
Objectives:
1. report lived mental health and wellbeing experiences of people in rural and remote settings
2. identify and explain adaptive strategies deployed at system (macro), community (meso) and individual (micro) levels
3. make recommendations for interventions that support mental health and wellbeing in rural and remote settings.
Methods: We established a group of national experts to advise on study design, method and analysis (rural ecosystem framework). Our study included (1) Literature review, (2) Analysis of existing research and public data, and (3) Field research interviews - with rural and remote residents, and key informants in health, community, and education services.
Key Learnings:
1. COVID-19 impacts were socially determined, with those most vulnerable before the pandemic most likely to be significantly impacted.
2. Telehealth and other health innovations enabled services to be delivered in difficult circumstances, but this has been achieved by a workforce in short supply due to long-term underinvestment and recruitment/retention challenges and fatigued by prior rural adversity (drought, fire etc).
3. The rural digital divide has widened, with those who could access the online world benefitting from connection to work, social (family and friends) and health support. However, accessibility, affordability and skills for digital access are not even across Australia, with many rural and remote communities inequitably disadvantaged.