S.TRUEMAN PhD THESIS 2016

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Table 2.5 Episodes by Main Treatment Type and Remoteness (as Percentage of Total Population According to Remoteness Classification Index), 2010–2011 (Source: AIHW, 2012)

Location

Major Cities

Inner Regional

Outer Regional

Remote

Very Remote

Withdrawal management (detoxification)

17.3

13.2

16.5

5.1

1.1

Counselling

39.6

44.8

43.6

23.1

55.8

Support and case management only

9.1

11.9

4.9

3.0

2.7

Information and education only

6.6

8.7

10.0

14.5

13.3

14.2

11.1

12.7

26.1

17.2

Assessment only

The disparity between remote and metropolitan mental healthcare has continued to grow since the 2011–2012 survey (AIHW, 2015a). In 2013–2014 there were 454 government and non-government drug and alcohol treatment agencies in metropolitan areas, compared to 32 in remote and 26 in very remote areas. The lack of resources and specialist facilities for treatment in remote areas affects remote generalist nurses’ practice due to the strong association between mental illness and substance use disorders and the challenges of this comorbidity (Kenny, Kidd, Tuena, Jarvis & Robertson, 2006). While both conditions exist, each may serve to maintain or exacerbate the other (Kavanagh, 2008). For example, a person may engage in alcohol misuse to reduce symptoms of anxiety; however, research has suggested that repeated alcohol use may lead