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Help-Seeking by Rural Residents for Mental Health Problems: The Importance of Agrarian Values
Open accessAbstract
Objective: To examine the role of stoicism, self-effficacy and perceived stigma in predicting help-seeking by rural residents, for mental health problems. Method: A cross-sectional community survey was conducted with a sample of 467 rural residents (58% female), who completed self-report questionnaires assessing current levels of symptomatology, disability, perceived stigma, self-effficacy, stoicism, attitudes towards and experience of seeking help for psychological problems. Results: Overall, 27.6% (n = 129) of respondents had sought help from a general practitioner and/or mental health professional for psychological problems or a mental health issue. More women than men reported having sought such help. Lifetime helpseeking for a psychological problem or mental health issue was positively associated with higher levels of distress and lower levels of stoicism and, to a lesser extent, lower levels of self-effficacy. Conclusions: Efforts to improve help-seeking by rural residents for mental health problems should focus on understanding and addressing attitudes, such as stoicism which act as barriers to help-seeking.
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“It has also been argued that rural residents are more 'stoic and self-reliant' 13 and prefer to manage their own health problems. 14-16”
From Internet-based mental health programs: A powerful tool in the rural medical kit (2007) · cites this paper as [15]
In the citing paper
“In addition, existing face-to-face services pose significant barriers for young people [10-16] largely due to access, availability, and high costs of these services [17], as well as the reluctance of young people to seek professional help due to stigma and embarrassment [18-20].”
From Do online mental health services improve help-seeking for young people? A systematic review (2014) · cites this paper as [11]
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“Although not examined by general help-seeking studies, stigma was a factor in some of the rural studies (e.g., Barry et al., 2000; Hoyt et al., 1997) but not in others (Judd et al., 2006; Komiti et al., 2006).”
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“32 Furthermore, stoicism in rural Australians has been shown to predict help-seeking for mental health problems.(33) While stoicism has been discussed as a possible factor underlying poorer cancer outcomes in rural Australia,(28) our paper presents novel data to support this assertion.”
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“Therefore, the constructed self-efficacy scale for seeking mental health was adapted based on a review of previous literature on access to care [23, 28, 29] and mental health literacy [30], particularly knowledge, insight and ability to follow through with treatment recommendations as well as psychological factors, in…”
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“…stoicism and selfreliance, the close social proximity of community members that inhibit anonymity, and the stigma associated with mental illness are considered to prevent help seeking in rural communities (Jackson et al., 2007; Judd et al., 2006; Muir-Cochrane et al., 2014; Rughani et al., 2011).”
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“Additionally, general attitudes towards mental health services among rural men are poor [73, 74], further contributing to rural–urban disparities in HRQOL.”
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“bated by lower levels of help-seeking behavior for mental health concerns (Judd et al., 2006) and suicide ideation (Caldwell, Jorm, & Dear, 2004).”
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“…of mental health resources, difficulties framing mental health problems, or challenges in access (such as after external agency withdrawal in this study), also reflect the landscape of rural mental health care in many locations (Judd et al. 2006; Hull et al. 2017; Bondy and Cole forthcoming).”
BackgroundAgricultural Cooperatives in Mental Health: Farmers’ Perspectives on Potential Influence
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“Indeed, stoicism has been linked to less service seeking in rural locations other than Appalachia perhaps because individuals are reticent to admit they have any problems or because they do not recognize their symptoms are problematic until they are quite severe (see Judd et al., 2006).”
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“…be negatively associated with psychological helpseeking (Wong et al., 2017), as well as research that evidenced that an increased self-stigmatization by males compared to females results from their internalization of the masculine norm of self-reliance (Judd et al., 2006; Magovcevic & Addis, 2005).”
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Perceptions and Attitudes About Genetic Counseling Among Residents of a Midwestern Rural Area
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“In addition, personal values of stoicism, self-reliance, conservatism, and a reluctance to seek help have been shown to be more prominent among rural residents (Judd et al. 2006).”
BackgroundCase Management in Rural Australia: Arguments for Improved Practice Understandings
Dellemain, J., & Warburton, J. (2012) · Australian Social Work · doi:10.1080/0312407x.2012.675345 · Cited by 22
“Furthermore, the evidence suggests that rural residents tend to share very little about their personal problems and illnesses and are more likely to rely on friends and family when they need support rather than outside agencies (Judd et al., 2006; Lane, Roufeil, Williams, & Tweedie, 2002).”
BackgroundMental Illness Stigma in the Israeli Context: Deliberations and Suggestions
Tal, A., Roe, D., & Corrigan, P. W. (2007) · International Journal of Social Psychiatry · doi:10.1177/0020764007082346 · Cited by 21
“Moreover, underutilization of mental health services is one of the main consequences of stigma (United States Public Health Service Offi ce of the Surgeon General, 1999; Judd et al., 2006).”
BackgroundBarriers to the early identification and intervention of early psychosis among young rural males
Wilson, R. L., Cruickshank, M., & Lea, J. (2010) · RUNE (Research UNE) · Cited by 22
Solness, C. L., Kroska, E. B., Holdefer, P. J., & O’Hara, M. W. (2020) · Journal of Behavioral Medicine · doi:10.1007/s10865-020-00188-5 · Cited by 20
“For example, research on suicide and helpseeking suggests that agrarian values and stigma contribute to lower help-seeking and initiating mental health services in rural samples (Judd et al., 2006; McCarthy et al., 2012).”
BackgroundThe Station Community Mental Health Centre Inc: nurturing and empowering
Taylor, J., Jones, R., O'Reilly, P., Oldfield, W., & Blackburn, A. (2010) · Rural and Remote Health · doi:10.22605/rrh1411 · Cited by 22
A Value and Character Educational Model: Repercussions for Students, Teachers, and Families
Puyo, J. G. B. (2020) · Journal of Culture and Values in Education · doi:10.46303/jcve.2020.7 · Cited by 20
“Judd et al. (2006) state that agrarian values are proper for those living in rural areas, farming communities, or small and isolated areas, in which live stoic, self-reliant individuals prone to coping with problems, suffering in silence, and inclined to rely more on family and friends than on professionals. Also, the…”
BackgroundFarmers' perceptions of health in the Riverland region of South Australia: ‘If it's broke, fix it'
Rawolle, T. A., Sadauskas, D., van Kessel, G., & Dollman, J. (2016) · Australian Journal of Rural Health · doi:10.1111/ajr.12272 · Cited by 20
Garnham, B., Bryant, L., Ramcharan, P., Yu, N. G., & ADAMS, V. (2017) · Ageing and Society · doi:10.1017/s0144686x17001258 · Cited by 19
Jaye, C., McHugh, J., Doolan‐Noble, F., & Wood, L. C. (2022) · Journal of Rural Studies · doi:10.1016/j.jrurstud.2022.04.005 · Cited by 19
Corboy, D., McDonald, J. W., & McLaren, S. (2011) · International Journal of Men s Health · doi:10.3149/jmh.1002.163 · Cited by 19
The role of the peer support worker in increasing rural mental health help‐seeking
Cheesmond, N., Davies, K., & Inder, K. (2020) · Australian Journal of Rural Health · doi:10.1111/ajr.12603 · Cited by 19
Laing, R. E., Halsey, R., Donohue, D. P., Newman, C., & Cashin, A. J. (2009) · Issues in Mental Health Nursing · doi:10.1080/01612840902754644 · Cited by 19
“It has been estimated that as little as 27–38% of people with mental health problems seek help from health services (Caldwell, Jorm, Knox, Braddock, & Dear, 2004; Judd et al., 2006; Mental Health Council of Australia, 2005).”
BackgroundAllott, K., & Lloyd, S. M. (2009) · Applied Neuropsychology · doi:10.1080/09084280903098760 · Cited by 19
“Recent research has also suggested that the trait of ‘‘stoicism’’ may mediate a rural dweller’s reduced tendency to seek help (Boyd et al., 2007; Judd et al., 2006).”
BackgroundA model to develop nurse leaders for rural practice.
Hauenstein, E., Glick, D., Kane, C., Kulbok, P., Barbero, E., & Cox, K. (2014) · Journal of Professional Nursing · doi:10.1016/j.profnurs.2014.04.001 · Cited by 16
Braun, L., Titzler, I., Terhorst, Y., Freund, J., Thielecke, J., Ebert, D. D., & Baumeister, H. (2021) · Internet Interventions · doi:10.1016/j.invent.2021.100455 · Cited by 20
Hearn, M., Pinto, C. N., & Moss, J. L. (2024) · Journal of Primary Care & Community Health · doi:10.1177/21501319241266114 · Cited by 18
Speerforck, S., & Schomerus, G. (2020) · Der Nervenarzt · doi:10.1007/s00115-020-00927-8 · Cited by 17
Burke, L., John, M., & Hanna, P. (2022) · Children and Youth Services Review · doi:10.1016/j.childyouth.2022.106440 · Cited by 21
Listening to a Silent Crisis: Men’s Suicide in Rural and Farming Communities in Slovenia
Roy, P., & Hočevar, D. K. (2019) · Revija za socijalnu politiku · doi:10.3935/rsp.v26i2.1593 · Cited by 22
“…farm workers who have been globally recognized as one of the riskiest occupational groups in terms of suicide in the last decades (Alston, 2012; Canadian Agricultural Safety Association, 2005; Hawton, Simkin, & Malmberg, 1998; Hirsch & Cukrowicz, 2014; Judd et al., 2006a; Kennedy, Maple, McKay, &”
BackgroundMitra, D., Amaratunga, C., Sutherns, R., Pletsch, V., Corneil, W., Crowe, S., & Krewski, D. R. (2009) · Journal of Toxicology and Environmental Health · doi:10.1080/15287390903084637 · Cited by 17
“For example, a number of studies examined the relationship between these agrarian values and the unwillingness among farmers to seek formal help (Judd et al., 2006a; Canadian Agricultural Safety Association [CASA] & Western Opinion, Inc., 2005; Parry et al., 2005; Peck et al., 2002).”
BackgroundResultInfluentialPsykisk helsearbeideres erfaringer med å jobbe i små kommuner i Nordland
Masvie, T. B., & Ytrehus, S. (2013) · Nordisk tidsskrift for helseforskning · doi:10.7557/14.2561 · Cited by 16
Mental Health Service Utilization Among Patients with Severe Mental Disorders
Fleury, M., Grenier, G., Bamvita, J., & Caron, J. (2010) · Community Mental Health Journal · doi:10.1007/s10597-010-9320-6 · Cited by 16
Corboy, D., McLaren, S., Jenkins, M., & McDonald, J. (2014) · Psycho-Oncology · doi:10.1002/pon.3559 · Cited by 16
“Although research among rural populations has highlighted self-reliance and stoicism as salient negative influences on helpseeking behaviours in specific rural populations [12,13], no comparative studies have been conducted measuring these variables across varying degrees of geographic remoteness.”
BackgroundResultInfluentialTraumatic Brain Injury, Participation, and Rural Identity
Jones, J., & Curtin, M. (2010) · Qualitative Health Research · doi:10.1177/1049732310365501 · Cited by 16
“This is because commonly experienced TBI sequelae, such as slowness and the desire for solitude (Ponsford, 1995), align with or are accommodated by socially acceptable rural norms or “agrarian values” (Judd et al., 2006, p. 770).”
BackgroundWilson, A., Moretto, N., Langbecker, D., & Snoswell, C. L. (2020) · Value in Health Regional Issues · doi:10.1016/j.vhri.2019.07.007 · Cited by 15
O’Donnell, S., Richardson, N., & McGrath, A. (2025) · Health Promotion International · doi:10.1093/heapro/daae209 · Cited by 18
Corboy, D., Meier, J., & McLaren, S. (2019) · Psychology of Men & Masculinity · doi:10.1037/men0000197 · Cited by 15
Yang, X., Ding, N., Tu, X., Zhao, C., Xu, H., Lai, X., & Zhang, G. (2021) · Addictive Behaviors · doi:10.1016/j.addbeh.2021.107233 · Cited by 15
Metadata
- Authors
- Judd, F., Jackson, H., Komiti, A., Murray, G., Fraser, C., Grieve, A., & Gomez, R.
- Affiliations
- Bendigo Health (AU)
- The University of Melbourne (AU)
- Swinburne University of Technology (AU)
- Federation University (AU)
- Corresponding author
- Judd, Fiona
- Fraser, Caitlin
- Venue
- Australian & New Zealand Journal of Psychiatry
- Publisher
- SAGE Publications
- Published
- 2006-09
- Volume
- 40
- Issue
- 9
- Pages
- 769-776
- ISSN
- 0004-8674 (ISSN-L)
- 1440-1614
- OpenAlex
- W1982167110
- Cited by
- 219
- References
- 30
- Citations by year
- 2026: 9 · 2025: 8 · 2024: 12 · 2023: 6 · 2022: 14 · 2021: 22 · 2020: 14 · 2019: 10 · 2018: 8 · 2017: 13 · 2016: 12 · 2015: 10 · 2014: 16 · 2013: 15 · 2012: 9
- FWCI
- 7.77
- Type
- journal article
- Language
- en
- Open access
- green
- figshare.com
- Locations
- Australian & New Zealand Journal of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- eCite Digital Repository (University of Tasmania) (submittedVersion)
- FedUni ResearchOnline (Federation University Australia) (submittedVersion)
- Figshare (submittedVersion, cc-by)
- Swinburne figshare (Swinburne University of Technology) (submittedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
- Social Sciences › Gender Studies › Gender Roles and Identity Studies
- Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
- Keywords
- help-seeking, rural mental health, mental illness, Stoicism, self-efficacy, perceived stigma, agrarian values, help-seeking barriers, psychological distress, gender differences, help-seeking attitudes
- MeSH terms
- Adult, Aged, Attitude to Health, Mental Disorders, Community Mental Health Services, Cross-Sectional Studies, Demography, Disability Evaluation, Female, Health Services Needs and Demand, Humans, Health Knowledge, Attitudes, Practice, Male, Middle Aged, Patient Acceptance of Health Care, Predictive Value of Tests, Surveys and Questionnaires, Rural Population, Sex Factors, Reproducibility of Results
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