Rural and remote psychological service delivery: perceptions of rural psychologists, general practitioners, and community members
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Date
2017
Authors
Sutherland, Carly Rose
Editors
Advisors
Chur-Hansen, Anna
Winefield, Helen Russell
Winefield, Helen Russell
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Theses
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Abstract
This thesis explores psychological service delivery from the perspectives of
three key stakeholders: fly-in, fly-out (FIFO) and drive-in, drive-out (DIDO) rural and
remote psychologists; rural and remote General Practitioners (GPs); and rural and urban
community members. The thesis builds on previous research with resident rural
psychologists in exploring what is required of rural psychologists and psychological
services in the context of unique challenges, including a lack of access to psychologists,
ethical challenges, and poorer health and mental health outcomes for rural communities.
This thesis is comprised of three studies. Study 1 is a qualitative exploration of
the experiences of FIFO/DIDO rural and remote psychologists. Study 2 is a qualitative
exploration of the experiences of rural and remote GPs. These studies employed
purposive sampling and a semi-structured interview format, and were subject to
thematic analysis. Study 3 is a quantitative survey comparing rural and urban
community members’ understandings and perceptions of psychologists and psychology
services.
The findings are presented in the form of four papers. FIFO/DIDO
psychologists, as described in Paper 1, face similar challenges to resident rural
psychologists, but also face additional unique personal and professional challenges due
to working away from home, including caring for dependents, managing fatigue, greater
intensity of work, and logistical challenges. While FIFO/DIDO work arrangements are
contentious, there may be personal and professional advantages for psychologists,
including financial and time compensation, greater support and fewer ethical dilemmas
compared to resident rural psychologists. Support required to provided FIFO/DIDO
services may include an appropriate induction into the community, the availability of
local support, and appropriate compensation for lifestyle impacts.
GPs were the focus of Papers 2 and 3. Participants highlighted how rural
psychologists may be a source of support for rural GPs and vice versa. While rural GPs
tend to hold positive views about psychologists, they report challenges in
communicating with psychologists, and gaps in their knowledge of psychologists’
training and expertise. Given the knowledge gaps identified, Paper 3 is written for a GP
professional audience and outlines ‘6 top tips’ about working with psychologists.
Paper 4 reports on the results of Study 3, the quantitative survey. Rural
participants were significantly less likely than urban participants to have seen a
psychologist, more likely to perceive seeing a psychologist as helpful, more likely to
endorse travel as a barrier to seeing a psychologist, scored significantly lower on a
multiple-choice test of knowledge about psychologists, and were less aware of
Medicare rebates for psychological services, highlighting a gap between rural and urban
Australians regarding knowledge and understanding of psychologists.
This thesis demonstrates a need for greater awareness and initiatives to improve
understanding of psychologists amongst rural GPs and rural communities, and
highlights opportunities of alternative service delivery models (such as FIFO/DIDO) in
addressing recruitment and retention problems in the rural psychology workforce. The
findings of this thesis have implications in terms of models of rural psychological
service delivery, professional development and education for rural psychologists and
GPs, mental health and Medicare policy in rural areas, recruitment and retention, and
primary care psychology.
School/Discipline
School of Psychology
Dissertation Note
Thesis (Ph.D.) (Research by Publication) -- University of Adelaide, School of Psychology, 2016
Provenance
Copyright material removed from digital thesis. See print copy in University of Adelaide Library for full text.
This electronic version is made publicly available by the University of Adelaide in accordance with its open access policy for student theses. Copyright in this thesis remains with the author. This thesis may incorporate third party material which has been used by the author pursuant to Fair Dealing exceptions. If you are the owner of any included third party copyright material you wish to be removed from this electronic version, please complete the take down form located at: http://www.adelaide.edu.au/legals
This electronic version is made publicly available by the University of Adelaide in accordance with its open access policy for student theses. Copyright in this thesis remains with the author. This thesis may incorporate third party material which has been used by the author pursuant to Fair Dealing exceptions. If you are the owner of any included third party copyright material you wish to be removed from this electronic version, please complete the take down form located at: http://www.adelaide.edu.au/legals