Evaluation of a Tasmanian community-based rural mental health program

Purpose: Mental health promotion programs are important in rural communities, where mental health problems may be compounded by isolation, lack of services and negative social constructs. However, it is well-documented the implementation of such programs is challenged by a multitude of factors, including small population size, geographic isolation and difficulty in retaining adequately qualified staff. The aim of this research was to explore factors that impacted the implementation and sustainability of a rural, community-based mental health promotion program.

Methods: A mixed-methods approach evaluated an existing mental health promotion program in four rural Tasmanian community sites, at differing stages of implementation. Surveys (n=245), including the Communities Advancing Resilience Toolkit (CART) assessment, and qualitative (focus group and interview) data from key local stakeholders and community members (n=24), was collected to explore the perceived factors that impacted the implementation of the program. Descriptive statistics for the survey were generated from the survey while the qualitative data was analysed using thematic analysis.

Findings: Survey results identified the more established program sites were perceived to have higher resilience using the CART assessment, including greater community resources (p=0.01) and stronger community connections (p=0.01). Qualitative data supported these findings and identified several other emergent themes including community readiness factors including the desire for the program, community and organisational leadership and community capacity. Perceived barriers to program implementation included high staff turnover and limited awareness of mental health in the community.

Conclusion: The factors that may improve the success of a mental health promotion program include evaluating community resilience, readiness and optimising the structure and delivery of the program and service. These factors should be considered during the design, implementation and evaluation of a mental health promotion program.