An integrated review of the barriers and facilitators for accessing and engaging with mental health in a rural setting

Int J Ment Health Nurs. 2021 Dec;30(6):1525-1538. doi: 10.1111/inm.12929. Epub 2021 Sep 5.


The review investigated the barriers and facilitators associated with assessing and engaging with mental health in a rural setting. The aim is to describe and synthesize the literature that examines the experiences of adults who access or attempt to access mental health services in rural settings. A systematic search from 2010 to 2020 was conducted using CINAHL, PsycINFO, Web of Science Core Collection, PubMed, Psychology and Behavioural Sciences Collection, Google Scholar, and Scopus. PRISMA protocols located 32 relevant papers from the overall 573 first selected. Braun and Clarke (Qualitative Research in Psychology, 3:77-101, 2006) thematic analysis methodology was applied to the data resulting in two themes: first theme identified help-seeking with subthemes of stigma and locality of health services. The second theme was connectedness, inclusive of subthemes of support systems and personal identity. The review identified gender-related perspectives concerning accessing mental health support, exposing the need for more research to examine the diverse social connections and support networks in rural communities. The findings suggest the need to further explore the impediments that reduce the likelihood of accessing mental health services in rural communities.

Keywords: barriers; health beliefs; mental health; psychological distress/stress; rural health services; rural or remote.

Publication types

  • Review

MeSH terms

  • Adult
  • Health Services Accessibility
  • Humans
  • Mental Health Services*
  • Mental Health*
  • Qualitative Research
  • Rural Population
  • Social Stigma

Grant support