In this action research study, service providers, consumers and carers came together to explore mental health service access in small rural communities. Within the literature there are few examples of these groups working together on service planning. An extensive scoping review was completed to map the evidence base. Interviews with 20
consumers and carers ensured local issues were contextualised. Seven themes emerged: Try standing in my shoes, Creating a drama, Capability aligned with need, Seeking stability and connection, Unseen and unimportant, Pick your team, and People like me. Entrenched stigmatizing attitudes evident in small rural communities impacted on the
emotional wellbeing of consumers, carers and family members. Barriers to service access included a lack of understanding of mental illness amongst community members, health professionals and emergency service staff. Participants stated that the only way they could get help was in a crisis situation, and they described contacting multiple services
for support. A lack of discharge planning and inadequate service coordination was described. Stories were consistently told about how family members were excluded from care. Stigma reduction strategies, service coordination, early intervention to avoid crises, skill and knowledge development of health professionals and other support workers, improved discharge planning, recognition of the role of families and carers, different methods of engaging with people, and a central coordination model were identified as recommendations. The key recommendation is for a multi-sectoral, strategic, whole of
system, coordinated, and longitudinal body of work, to implement a planned and coordinated approach in addressing the multiple system failures.