How does mental health status relate to accessibility and remoteness?

OBJECTIVE To determine whether mental illness is associated with accessibility and remoteness. DESIGN A cross-sectional, population-based, computer-assisted telephone interview survey, stratified by Accessibility and Remoteness Index of Australia (ARIA) categories. SETTING Secondary analysis of data collected from 2545 South Australian adults in October and November 2000. OUTCOME MEASURES Psychological distress and depression as determined by the Kessler 10 Psychological Distress Scale, the SF-12 measure of health status, and self-reported mental illness diagnosed by a doctor in the previous 12 months. RESULTS Overall, mental illness prevalence estimates were similar using the three measures of psychological distress (10.5%), clinical depression (12.9%) and self-reported mental health problem (12.7%). For each measure, there was no statistically significant variation in prevalence across ARIA categories, except for a lower than expected prevalence of depression (7.7%) in the "accessible" category. There was no trend suggesting higher levels of mental illness among residents of rural and remote regions. CONCLUSIONS The prevalence rates of psychological distress, depression and self-reported mental illness are high. However, we found no evidence that the prevalence of these conditions varies substantially across ARIA categories in South Australia. This finding may challenge existing stereotypes about higher levels of mental illness outside metropolitan Australia.