Contents

Resources

Rural and Remote Practice

Providing clinical services in rural settings can be both challenging and rewarding.75 76 On one hand, isolated practitioners have very few, if any, local referral agencies and alternative professionals for providing client care. Rural practitioners often wear many hats. Other specific challenges include:

  • Isolation and burnout
  • Staff turnover and return to urban areas
  • Few referral sources or other professionals
  • Lack of adequate supervision
  • Need for broader training experiences
  • Limits of competence
  • Dual relationships with supervisors or clients
  • Confidentiality in small towns
  • Specialized population groups

On the other hand, rural and remote practitioners have the opportunity to assume diverse roles and more responsibility early in their careers, often providing a wide variety of services to a broad client base with a full range of presenting problems. For clinicians with such a wide scope of practice, it can be very difficult to remain up-to-date about current best practices in specialized topic areas, such as suicide. Part of the challenge then, is to prioritize knowledge areas according to need in the community and level of safety required. Since suicide is a relatively rare, but serious event, suicide risk assessment is likely one area of practice that requires more in-depth training and adequate supervision. Although access to regular clinical supervision has often been limited in the past, new technologies such as telehealth videoconferencing, distance learning, the internet and email are able to augment telephone and face-to-face meetings. These same technologies can also help individual clinicians feel an increased sense of connection with up-to-date information and a personal support network.

In order to adequately address the barriers faced by remote and rural mental health  clinicians, extra care must be taken by individuals and institutions to understand and address the special issues involved. The literature supports the use of technology, such as videoconferencing, to provide regular and ongoing supervision with experienced and expert clinicians, as well as support and consultation from colleagues in the field. Improving supervision, support and consultation will assist local clinicians in better assessing and treating suicidal clients. Professional development activities, such as distance learning, internet research, access to peer-reviewed e-journals, and face-to-face training opportunities are all ways of ensuring clinicians working in isolated areas are kept current in the areas most relevant to the community needs.