S.TRUEMAN PhD THESIS 2016

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The paucity of nurses is highlighted starkly by using the figures above that show there are 16.9 rural and remote mental health presentations per year, per nurse. Australia’s rural and remote health profile is compounded by four truths: the total burden of disease increases with remoteness from major urban centres (Al-Motlaq, Mills, Birks & Francis, 2010); the health of people living in rural and remote areas of Australia is poorer than that of people living in metropolitan areas (Strong, Trickett, Titulaer & Bhatia, 1998); physical illness increases the risk of psychiatric disorder ( De Hert, Cohen, Obes, Cetkovich-Bakmas, Leucht, Ndetei, ., . . . Correll, 2011; Clarke, 1998;); and people with a psychiatric disorder are more likely to have physical health problems requiring access to public health facilities (Koranyi & Potoczny, 1992; Lawrence, Holman & Jablensky, 2001). In rural and remote Australia these physical health problems are often treated in a primary healthcare centre staffed by generalist nurses. These four factors add to the burden on rural and remote nurses caring for mental health clients. 3.2.3 Aims The aim of this integrative review is to identify and discuss the published research literature relating to rural and remote generalist nurses caring for mental health clients. The specific questions asked were: 1. What is known about the attitudes and experiences of generalist nurses caring for mental health clients in rural and remote locations? 2. What is known about the training given to rural and remote generalist nurses to support them in caring for mental health clients?