S.TRUEMAN PhD THESIS 2016

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2.15 Primary Healthcare

Primary healthcare is a broad conceptualisation encompassing all social, environmental and lifestyle determinants of health (Félix-Bortolotti, 2009). In Australia, primary healthcare has been defined as incorporating personal care, health promotion, the prevention of illness and community development, including the interconnecting principles of equity, access, empowerment, community self-determination and intersectoral collaboration. These principles also encompass an understanding of the social, economic, cultural and political determinants of health (Keleher, 2001). Such an approach has been described as a world-wide imperative due to its comparative effectiveness and efficiency in delivering people-centred primary healthcare (Starfield, 2009). To deliver this approach to mental healthcare in remote Australia requires commitment of resources, including workforce, and sustainable funding; however, historically, such commitment has been lacking. Under present conditions, a number of different primary healthcare models are the only means for sustainably delivering mental healthcare in remote areas, for there exist no or very few secondary and tertiary mental health services. In remote communities, mental healthcare services are integral to the primary healthcare system. In remote areas, there is no separation between mental health and other primary healthcare services. Just as presentations of mild angina are cared for within the remote primary healthcare facility, while recoveries from severe heart attacks are not, mild to moderately severe mental health presentations are addressed by primary healthcare services in remote areas (Harte & Bowers, 2011), and only the severe presentations are transported to a regional facility. Mentally ill patients are often transported out of remote