Photo Credit: Canadian Tourism Commission
Access to many mental health services has historically been a challenge for many Canadians living in rural and northern communities. However, over the last 20 years, several psychologist-led initiatives have focused on remedying this situation for the more than 6 million Canadians currently living in these communities. These initiatives can be categorized into two main groups, those that focus on “recruiting and retaining psychologists in rural and northern communities” and ones that focus on implementing psychology services that can be offered at a distance such as through “video conferencing, computer/Internet, and telephone”, generally referred to as telepsychology.
Telepsychology has potential to provide much-needed access to mental health services to those living in rural and northern communities. Many mental health services are far less accessible in rural communities than in urban centers and several travel-related barriers such as lack of transportation, lost work time, and transportation costs often make travel to urban centers impractical. Using a broad range of technology, psychologically-informed services can be offered at a distance, greatly enhancing accessibility. Also, since these services can often be accessed from home, telepsychology also serves to enhance anonymity and reduces the stigma commonly associated with seeking mental health services.
Several telepsychology programs are already in place across Canada, such as Strongest Families and the Therapist-Assisted Internet CBT (Cognitive Behavioral Therapy) Service based in Nova Scotia and Saskatchewan respectively.
However, telepsychology is not without its limitations. The small sample size of studies conducted in rural and northern communities make it difficult to come to a meaningful conclusion about the efficacy of telepsychology. Also, limited infrastructure and funding often limit the availability of these services in these communities.
Recruiting and retaining rural and northern psychologists is another critical initiative aimed at increasing access to mental health services. Several Canadian universities such as the University of Manitoba and Lakehead University in Ontario offer specialized coursework and practicums geared towards providing mental health services in rural and northern communities. Also, recommendations have been made to create outreach programs aimed at encouraging practices in rural and northern communities because “having a rural background has consistently been associated with an increased likelihood of rural practice for physicians.”
Community support and connection is critical to retaining health care providers for rural and northern communities and properly orienting new health care personnel is an important part of successfully integrating them with the community they serve. Proper financial incentives, as well as managerial and academic support, must be in place to provide the same opportunities for providers of mental health services in rural and northern communities as their colleagues in urban centers.
While this may seem to be the most obvious and helpful initiative in overcoming the lack mental health services in northern and rural communities, it also has limitations. Despite the steady increase in mental health care personnel in these communities, they “remain responsible for large geographic areas and populations.” Furthermore, a lack of research into how to recruit and retain mental health care personnel for rural and northern communities severely limit the effectiveness of current strategies.
These initiatives have the potential to greatly increase the quality and accessibility of mental health services in rural and northern communities. Continued collaboration between mental health professionals in urban centers as well as rural communities in addition to improved integration between locally and remotely offered services will be essential to future progress.
This is a summary article written by Pierre Lin. For more information, please access the full document:
Dyck, Karen G; et al (2013). Enhancing Access to Psychologically Informed Mental Health Services in Rural and Northern Communities. Canadian Psychology 2013, Vol. 54, No.1, 30-37.