Gippsland Mental Health Vacation School: development and investigation of the impact of a targeted short-term intervention to address mental health workforce shortages in Gippsland, Victoria, Australia

The mal-distribution of health practitioners across urban and rural areas in Australia, Canada and the USA is well documented. Despite disparities across all health disciplines, research and policy addressing rural disadvantage have principally focused upon the medical profession. There is limited rural allied health workforce research and even less into the mental health professions. Emerging strong evidence from medicine to redress the urban-rural imbalance suggests that the probability of rural practice post-registration increases through: selection of students from rural backgrounds and/or having rural practice intent, and exposure of pre-registration students to rural life and practice through a mix of rural health training modules and extended clinical placements. Even though evidence regarding rural background may be generalizable to nursing, there is scant evidence that any of the above factors pertain to either allied health or mental health practitioners. Furthermore, evidence regarding the efficacy of interventions designed to address rural mental health workforce shortages is lacking. Therefore, the three primary aims of the thesis were: 1) identify mental health workforce recruitment and retention issues and solutions in rural Gippsland; 2) investigate the impact of one strategy: a brief mental health workforce recruitment intervention that addresses recruitment challenges in Gippsland; 3) examine how to establish a sustainable recruitment intervention for the sector. Three separate data collections were carried out to achieve each of these research aims: 1. Qualitative data was collected from 24 senior personnel from Gippsland mental health services. Thematic analysis identified issues and solutions to mental health workforce challenges in Gippsland. 2. Quantitative and qualitative data were collected from 76 students who attended five Gippsland Mental Health Vacation Schools from 2010 to 2014. Multivariate statistics and content analysis explored the immediate and longer term impact of the Vacation School experience upon students’ interest in and attitudes towards living and working in a rural setting. 3. 18 students and 9 regional mental health service staff who participated in Vacation Schools contributed as ‘experts’ in a three-stage Delphi Study, designed to inform the long term sustainability of the intervention. Findings from Research Aim 1 led to the development and implementation of the Gippsland Mental Health Vacation School. This brief and inexpensive intervention addresses: a) the lack of training for mental health professionals in Gippsland; and b) the limited regional pool of potential mental health workers. Findings from Research Aim 2 indicate that this annual 5 day program positively impacted upon students’ interest in and attitudes towards both rural living and rural mental health work. These immediate positive changes weakened in the six months following the program; however, the level of interest in rural work diminished less compared to the decline in interest in rural life. This weakening of interest was then used to inform a Delphi study undertaken in pursuit of Research Aim 3. The findings of which suggested: 1) that Vacation School student engagement could be maintained through the use of social media to promote employment opportunities to participants in the months following the program; and 2) transitioning to a blended learning approach to delivery of the program. The findings of the thesis have important implications for mental health workforce policy, specifically the promotion of rural practice and collaborative development of tailored strategies to address local rural practitioner shortages.