S.TRUEMAN PhD THESIS 2016

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Studies have shown that remote residents, per capita, visited GPs the least of any population of the remoteness classification index (see Chapter 1) and at a rate of about half that of major city populations (Caldwell et al., 2004). In 2012–2013, those living in inner regional areas had the highest rate of mental health-related GP encounters (686.6 per 1,000) and remote and very remote the lowest (295.7 per 1,000) (Britt et al., 2013). Caldwell et al. (2004) found that of the mental health services delivered by GPs in remote Australia, the highest incidence was for treating depression (Britt et al., 2013; Davenport, Hickie, Naismith, Hadzi-Pavlovic & Scott, 2001) and the lowest incidence was for anxiety disorders. Finally, Caldwell et al. (2004) found that remote residents were prescribed mental health medications half as often as capital city residents, which is consistent with previous studies (Britt, Miller & Valenti, 2001). 1.6.9.2 Psychiatrists Psychiatrists are medical practitioners with a recognised specialist qualification in psychiatry. Generally, patient access in Australia to psychiatrists is very limited, because few psychiatrists bulk-bill (i.e. bill directly to Australia’s universal Medicare insurance), most are located in metropolitan areas and too few psychiatrists are employed in the public sector (Senate Select Committee on Mental Health, 2006). According to the Australian Bureau of Statistics (ABS, 2007): There is a severe shortage of consultant psychiatrists in [remote] Australia … due to most [psychiatrists] exercising a strong preference to live and work in major cities. Trainee psychiatrists also report a clear inclination to practice in capital cities or urban centres.