title: Mental health academics in rural and remote Australia.
abstract: BACKGROUND
  The significant impact of mental ill health in rural and remote Australia has been well documented. Included among innovative approaches undertaken to address this issue has been the Mental Health Academic (MHA) project, established in 2007. Funded by the Australian Government (Department of Health), this project was established as a component of the University Departments of Rural Health (UDRH) program. All 11 UDRHs appointed an MHA. Although widely geographically dispersed, the MHAs have collaborated in various ways. The MHA project encompasses a range of activities addressing four key performance indicators. These activities, undertaken in rural and remote Australia, aimed to increase access to mental health services, promote awareness of mental health issues, support students undertaking mental health training and improve health professionals' capacity to recognise and address mental health issues. MHAs were strategically placed within the UDRHs across the country, ensuring an established academic base for the MHAs' work was available immediately. Close association with each local rural community was recognised as important. For most MHAs this was facilitated by having an established clinical role in their local community and actively engaging with the community in which they worked. In common with other rural health initiatives, some difficulties were experienced in the recruitment of suitable MHAs, especially in more remote locations. The genesis of this article was a national meeting of the MHAs in 2014, to identify and map the different types of activities MHAs had undertaken in their regions. These activities were analysed and categorised by the MHAs. These categories have been used as a guiding framework for this article.
  
  
  OBJECTIVE
  The challenge to increase community access to mental health services was addressed by (i) initiatives to address specific access barriers, (ii) supporting recruitment and retention of rural mental health staff, (iii) developing the skills of the existing workforce and (iv) developing innovative approaches to student placements. Strategies to promote awareness of mental health issues included workshops in rural and remote communities, specific suicide prevention initiatives and targeted initiatives to support the mental health needs of Indigenous Australians. The need for collaboration between the widely dispersed MHAs was identified as important to bridge the rural divide, to promote project cohesiveness and ensure new ideas in an emerging setting are readily shared and to provide professional support for one another as mental health academics are often isolated from academic colleagues with similar mental health interests.
  
  
  CONCLUSIONS
  The MHA project suggests that an integrated approach can be taken to address the common difficulties of community awareness raising of mental health issues, increasing access to mental health services, workforce recruitment and retention (access), and skill development of existing health professionals (access and awareness). To address the specific needs and circumstances of their community, MHAs have customised their activities. As in other rural initiatives, one size was found not to fit all. The triad of flexibility, diversity and connectedness (both to local community and other MHAs) describes the response identified as appropriate by the MHAs. The breadth of the MHA role to provide university sponsored educational activities outside traditional student teaching meant that the broader health workforce benefited from access to mental health training that would not otherwise have occurred. Provision of these additional educational opportunities addressed not only the need for increased education regarding mental health but also reduced the barriers commonly faced by rural health professionals in accessing quality professional development.
authors.affiliation: Department of Rural Health, The University of Melbourne, Ballarat, Victoria, Australia. d.pierce@unimelb.edu.au.
authors.forename: David
authors.initials: D
authors.lastname: Pierce
authors.affiliation: Department of Rural Health, University of Newcastle, Tamworth, New South Wales, Australia. fiona.little@newcastle.edu.au.
authors.forename: Fiona
authors.initials: F
authors.lastname: Little
authors.affiliation: University Centre for Rural Health, University of Sydney, Lismore, New South Wales, Australia. james.bennett-levy@ucrh.edu.au.
authors.forename: James
authors.initials: J
authors.lastname: Bennett-Levy
authors.affiliation: Monash Rural Health, Traralgon, Victoria, Australia. anton.isaacs@monash.edu.au.
authors.forename: Anton N
authors.initials: AN
authors.lastname: Isaacs
authors.affiliation: Centre for Rural Health, University of Tasmania, Launceston, Tasmania, Australia. heather.bridgman@utas.edu.au.
authors.forename: Heather
authors.initials: H
authors.lastname: Bridgman
authors.affiliation: Centre for Rural and Remote Health, James Cook University, Mount Isa, Queensland, Australia. sarah.lutkin@jcu.edu.au.
authors.forename: Sarah J
authors.initials: SJ
authors.lastname: Lutkin
authors.affiliation: Flinders University; Charles Darwin University, Alice Springs, Northern Territory, Austalia. tim.carey@flinders.edu.au.
authors.forename: Timothy A
authors.initials: TA
authors.lastname: Carey
authors.affiliation: Deakin University, Geelong, Victoria, Australia. kate.schlicht@deakin.edu.au.
authors.forename: Kate G
authors.initials: KG
authors.lastname: Schlicht
authors.affiliation: Centre for Rural Health, University of Western Australia, Geraldton, Western Australia, Australia. zita.mccabe-gutsa@uwa.edu.au.
authors.forename: Zita P
authors.initials: ZP
authors.lastname: McCabe-Gusta
authors.affiliation: University of Sydney, Broken Hill, New South Wales, Australia. elizabeth.martin1@health.nsw.gov.au.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Martin
authors.affiliation: University of South Australia, Whyalla Norrie, South Australia. lee.martinez@unisa.edu.au.
authors.forename: Lee A
authors.initials: LA
authors.lastname: Martinez
keywords: Allied Health; Australia/Pacific; Medical; Mental Health; Public Health; Researcher