Researchers from the Violet Vines Marshman Centre for Rural Health Research are identifying much-needed oral health solutions for rural Australians living with mental illness.
The disparity in oral health outcomes in metropolitan and rural areas is significant. Around 30% of Australians who live in rural areas have higher levels of tooth loss and untreated decay than their urban counterparts. They also have a higher rate of preventable hospitalisations due to oral health conditions, higher levels of dissatisfaction with oral health services, and difficulty accessing care.
These problems are compounded for the 20% of rural Australians living with mental illness.
“Rural people living with mental illness are more susceptible to oral disease,” says Emeritus Professor Amanda Kenny, lead researcher of the study. “This is due a range of contributing factors including dental phobia, dental costs, poor health service design, difficulty accessing care, and the adverse side effects of anti-psychotic and anti-depressant medications.”
“There is a close association between dental disease, coronary heart disease, stroke, diabetes, and respiratory disease, conditions that are commonly experienced by people with mental illness,” she adds. “Poor oral health contributes to social withdrawal, isolation, lack of employment opportunities, and low self-esteem for those who are already highly vulnerable.”
The issue has been largely ignored by policymakers, service providers and researchers, until now. Using a realist approach that prioritises rural people with mental illness in all aspects of the research, the team are examining why oral health interventions for people with mental illness might work differently depending on the context.
“We want to understand what works for whom, in what context and how,” says Kenny. “The context, circumstances and stakeholders create the solution.”
This framework will be used to develop tailored strategies to ensure high quality, accessible community-based oral healthcare for rural Australia’s most disadvantaged community members.
“By tackling oral health and mental illness together, we hope that our research will reduce the oral health disease burden and optimise the rural health workforce,” adds Kenny. “And, that it will mobilise stakeholders, including rural people, to be creative, inventive, ingenious and revolutionary as they work together to develop solutions tailored to their community.”
“By co-partnering in research, we can build an evidence-base, translate findings into practice, and improve the health outcomes for vulnerable groups in rural and regional communities.”