S.TRUEMAN PhD THESIS 2016

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Chapter 2: Background

2.1 Introduction This chapter discusses the background to the study and situates it in the context of the field of remote nursing. Chapter 1 answered questions of ‘who’ and ‘what’ regarding the make-up of the remote nurse’s field; in contrast, this chapter focuses on what is happening in the field. The chapter is divided into three sections. The first section outlines the poor health status and burden of general disease in Australia’s remote population, the types of mental health services and resources available, and expenditure and investment in mental health services. The second section discusses the demographics of remote Australia and how these shape and determine models of health and mental health service delivery. This section also discusses the dynamic external forces that affect changing remote models of healthcare delivery, and that remote nurses are obliged to accommodate. The final section outlines the formation of remote nurses into a professional and political representational body, concluding with an examination of the current issues and concerns that affect remote nurses delivering mental healthcare. In this chapter, the terms ‘metropolitan areas’ and ‘major cities’ are employed interchangeably, as are the terms ‘remote’ and ‘very remote’. The adoption of the descriptors ‘major cities’ and ‘remote’ and ‘very remote’ is deliberate in the discussion of the terms used by AIHW and the AGSC-RA classificatory system of remoteness in Australia. On other occasions, the adoption of the terms ‘metropolitan areas’ and ‘remote areas’ should be read with the same referability. Finally, the term ‘rate’ as used in this chapter means the number of events or occurrences per unit of population or class group over a set period of time. Unless