Table 2 Characteristics of the included studies

Healthcare provider perspective

Barraclough et al. 2016; Lismore NSW

Lismore NSW (MM3)

Evaluation; mixed methods: documentary and quantitative evidence, qualitative interviews and meeting

N = 21; participants were nurse practitioner (NP) n = 1, senior health service managers n = 5, nursing leaders n = 2, manager of non-government organisation n = 1, mental health/drug and alcohol workers and community nurses/nurses from the emergency department (ED) n = 6, general practitioner (GP) n = 1, police superintendent n = 1, representative community-based organisation n = 1; sex: NR; majority ≥ 18 years (98%)

NP-led primary mental health service

Beks et al. 2018; Warrnambool VIC

Portland (MM4), Hamilton (MM4), and Ararat (MM4) VIC

Qualitative interviews

N = 13; participants were registered nurses without postgraduate mental health qualifications; sex: female 100%; 25–34 years n = 1, 35–44 years n = 5, 45–54 years n = 4, ≥ 55 years n = 3

Acute mental health presentations in a rural emergency department and urgent care centres

Clough et al. 2019; Southport QLD

Metropolitan, outer regional, rural Australia

Mixed methods: quantitative cross-sectional, qualitative interviews

Quantitative: n = 274, qualitative: n = 25; participants were medical doctors and stakeholders representing the Australian

Medical Association, the Doctors’ Health Advisory Service, hospital-based medical education, and practice

management; sex: female (73.4%), age M = 37.4, SD = 9.2 years

Perceptions of help-seeking for stress and burnout among medical doctors

Cosgrave et al. 2015; Armidale NSW

Rural NSW

Qualitative interviews

N = 5; participants were community mental health mangers working in rural services; sex: NR; age NR

Community mental health services in rural Australia

Cosgrave et al. 2018; Wangaratta VIC

Rural north-western NSW

Qualitative interviews

N = 25; participants were registered nurses n = 6, social workers n = 6 psychologists n = 4, occupational therapists (OT) n = 3, Aboriginal mental health workers n = 5, other workers n = 1; small town n = 9, medium town n = 3, large town n = 12, town NR n = 1; sex: NR; age NR

Community mental health services operated by NSW Health

Crotty et al., 2012; Adelaide SA

Regional SA

Qualitative interviews

N = 10; participants were health and community service professionals working within local mental health and related services; sex: NR; age NR

Local mental health and related services

De Silva et al. 2017; Lismore NSW

Northern Rivers Region NSW (MM5)

Qualitative interviews

N = 10; participants were GPs working in the Northern Rivers Region, NSW; sex: female 20%; age NR

Mental health services for mild to moderate depression in rural northern NSW

Ellem et al. 2019; Brisbane QLD

Regional and rural NSW, regional QLD, regional and rural VIC

Qualitative interviews and focus groups

N = 43; participants were direct practitioners n = 25, supervisors n = 6, managers n = 9, or worked in policy/advocacy roles n = 3 within child and family welfare, Indigenous-specific, and mental health settings. Sex: NR, age NR

Services for youth with complex support needs, including family welfare, Indigenous-specific, and mental health services

Evans et al. 2020; Port Macquarie NSW

Rural NSW

Qualitative focus groups

N = 16; participants were registered nurses n = 7, clinical nurse specialists n = 2, clinical nurse consultants n = 3, nurse unit manager n = 1, social workers n = 2, welfare officer n = 1 working within a substance use treatment setting

sex: female (93.8%); age NR

Public health community-based substance use treatment services

Hays et al. 2020; Mount Isa QLD

Rural and remote Australia

Quantitative cross-sectional

N = 19; participants were rural pharmacists; sex: female 63%; age < 25 n = 1; 26–35 n = 7; 36–45 n = 3; 46–55 n = 4; 56 + n = 4

Rural pharmacy services

Henderson et al. 2018; Adelaide SA

Adelaide Hills (MM2), the Fleurieu Peninsula (MM3), and Kangaroo Island SA (MM7)

Qualitative interviews

N = 31; local service providers n = 25 and senior managers from major service providers n = 6; sex: NR; age NR

Service providers in mental health, community health, general practice, residential aged care, private practice, non-government organisations, and local government in the public and private sectors

Hinton et al. 2015; Darwin NT

Remote NT

Qualitative interviews

N = 27; participant were NT government and local council representatives, education and early childhood service providers, employment and housing agencies, police and correctional services, alcohol and other drug (AOD) workers, remote health centre staff and Top End mental health staff; sex: NR; age NR

Indigenous mental health services

Isaacs et al. 2017; Moe VIC

Echuca VIC (MM3)

Qualitative interviews

N = 27; participants were Aboriginal workers n = 24, senior mental health clinician n = 1, police officer n = 1, Aboriginal Elder n = 1; sex: female 44.4%; age > 18 years

Help seeking and suicide services for Aboriginal people in rural VIC

Kidd et al. 2012; Unknown VIC

Rural VIC

Mixed methods: quantitative cross-sectional and qualitative focus groups

N = 17; participants were nurses working in rural EDs; sex: NR; age 73% ≥ 45 years, a small number were aged > 60 years, and one aged over 70 years

Nurses from rural health services who had ED clients in the previous 12 months

Malatzky et al. 2020; Brisbane QLD

Large rural town

Qualitative interviews

N = 13; participants were allied health, medical, community, youth work, management and administration professionals; sex: NR; age NR

Mental health services for young people

Mirza et al. 2019; location NR

Rural and remote Australia

Abstract of case reports

N = NR; participants were spiritual healers and Aboriginal mental health workers

General mental health services

Mollah et al. 2018; Clayton VIC

Rural Australia

Mixed methods: quantitative cross-sectional and qualitative interviews

N = 20; participants had experience working with immigrant patients in the previous 12 months and were counsellors n = 4, age M = 45.25 years; psychologists/

psychiatrists n = 6, age years M = 37.5 years; nurses n = 5, M = 37.5 years; social workers n = 2, age M = 31.5 years; other n = 3, age M = 49.7 years

Mental health services for immigrant patients

Muir-Cochrane et al. 2014; Adelaide SA

Rural Australia

Qualitative interviews

N = 19; participants were managers

of residential and community aged care services, coordinators of programmes and care packages, nurses, OTs, social workers, counsellors, and mental health clinicians; sex NR; age NR

Older person’s mental health services

Newman et al. 2016; Magill SA

Magill SA (MM1); regional, rural, remote SA areas serviced by Country Health SA local health network

Qualitative interviews and focus groups

N = > 40; participants were from a regional mental health team (i.e., managers, team leaders, senior clinicians, mental health NPs, administrative staff), the metropolitan mental health hub’s mental health team, and a tele-mental health support team; sex: NR; age NR

Telehealth mental health services

Orlowski et al. 2016a; Adelaide SA

Rural SA

Qualitative interviews and focus groups

N = 48; interview participants were youth mental health clinicians n = 3, and support and management/executive staff n = 5; sex: female 50%; age: 18–40 years. Focus group participants were mental health and youth service teams, including social workers, mental health nurses, psychologists, psychiatrists, OTs, counsellors, youth workers, management, and other staff; sex: female 50–86% female; age NR

Technology-enhanced mental health services

Orlowski et al. 2017; Bedford Park SA

Rural SA

Qualitative shadowing, non-participant observation, interviews, field noting, documenting analysis, debriefing

N = NR; participants at site 1 were youth workers n = 3, manager n = 1, clinical lead n = 1, medical staff n = 2, psychological staff n = 5, and other government staff; sex: NR; age NR; participants at site 2 were mental health nurses n = 7, social workers n = 3; sex: NR; age NR

Technology-enhanced mental health services

Procter 2015; Adelaide SA

Rural SA

Qualitative focus groups

N = 9; participants were nurses n = 4, social workers n = 2, clinical psychologist n = 1, OT = 1; paramedical aid n = 1; sex: female 77.8%; age M = 46 years SD = NR

Community mental health services

Taylor et al. 2019; Brisbane QLD

Regional, rural, and remote QLD

Qualitative interviews

N = 14; participants were medical officers, social workers, nurses, mental health clinicians, managers, and health promotion workers of an electronic perinatal and infant mental health service; sex: female 78.6%; age 26–62 years

Perinatal and infant tele-mental health services

Trail et al. 2021; Parkville VIC

Macedon Ranges VIC (MM5)

Qualitative interviews

N = 19; participants were healthcare and health promotion professionals n = 8, community service/law enforcement/sports staff n = 8, educational staff n = 3; sex: female 52.6%; age M = 49.9; SD = 11.8

Healthcare and community services working in male suicide and harm prevention

Wand et al. 2021a; Camperdown NSW

Maitland (MM1) and Dubbo (MM3)

NSW

Qualitative interviews

N = 12; participants were MHLNs; sex: NR; age NR

ED-based mental health nursing care services

Service user perspective

Batterham et al. 2020; Canberra ACT

Metropolitan, regional, rural Australia

Quantitative cross-sectional

N = 2,374; participants from the Assessing Mental Health Survey [115] who met criteria for a DSM-5 mental disorder/suicidal ideation; sex: female 79.6%, 18–35 years n = 913, 36–55 years n = 878, 56 + years n = 582; metropolitan area (n = 1,249), regional area (n = 867), rural area (n = 258)

Perceived need for help for a mental health problem

Black et al. 2012; Adelaide SA

Outside of metropolitan Adelaide, SA

Quantitative cross-sectional

N = 531; participants (school students) from the Adolescent Mental Health, Behaviour and Life Experiences Study (unpublished data; authors) who met criteria for a DSM-IV major depressive disorder; sex: female 55.7%; 13–18 years

General mental health services for rural adolescents with depression

Butterfly Foundation 2020; location NR

Rural and remote Australia

Survey and report

N = 563; participants were individuals who currently or previously experienced an eating disorder, or were carers of people with eating disorders; sex: mainly female; age 18–60 years

Eating disorder services

Byrne et al. 2017; Rockhampton QLD

Regional and rural areas QLD

Qualitative interviews

N = 13; sex: female 61.5%; participants were employees of peer-run, government, and non-government organisations

Peer workers working in mental health services in rural and regional locations

Dawson et al. 2016; Adelaide SA

Rural SA

Qualitative interviews

N = 11; participants were rural carers of older people with a mental health issue; sex: NR; age NR

General mental health services

Dunstan et al. 2014; Armidale NSW

Moree NSW (MM4)

Mixed methods: quantitative longitudinal and qualitative feedback comments

Total sample N = 76; sex: female 56.3%; age M = 37.8, SD = 13.0; Individual recovery plan completers n = 19; sex: female 42%; age M = 38.5, SD = 14.8; participants were current and past clients of the Personal Helpers and Mentors service (PHaMs), Moree, who had a diagnosed mental disorder

Personal Helpers and Mentors service in Moree

Handley 2014; Callaghan NSW

Rural and remote NSW

Quantitative cross-sectional

N = 394; participants were from the 3-year follow-up of the Australian Rural Mental Health Study who had a self-reported mental health problem; help/advice sought: sex: female 56.0%; age M = 55.5 SD = 13.1; help/advice sought and needs met: sex: female 68.0%; age M = 55.6 SD = 13.1; help/advice sought and needs not met: sex: female 80.0%; age M = 55.9 SD = 12.1

Professional sources (e.g., GP, psychiatrist, psychologist, MH nurse, Lifeline, specialist doctor), and non-professional sources (e.g., family/friends, alternative therapist, clergy) for seeking mental health help

Hussain et al. 2013; Armidale NSW

Armidale NSW (MM3)

Quantitative cross-sectional

N = 355; participants were full-time university students at a public university (the University of New England) in Armidale, NSW; sex: 69.0% females; age M = 20.2 SD = 4.8

Support services (e.g., counselling) and GP services

Johnson et al. 2021; Wagga Wagga NSW

Wagga Wagga (MM3) and

Riverina region, NSW (MM5)

Qualitative interviews

N = 27; participants were from a regional rural region in NSW who self-reported a mental health issue, some had a formal diagnosis and had accessed services and others had not accessed services; sex: female 100%; age ≥ 30 years, most in their 50s and some over 70 years

General mental health services for regional rural women with depression

Orlowski et al. 2016b; Adelaide SA

Inner rural regions in SA

Qualitative interviews

N = 10; participants were a clinical sample of young people who were currently seeking help for a mental health issue; sex: female 50%; age 16–22 years

Technology-enhanced mental health services

Reynish et al. 2021; Launceston TAS

Rural and remote TAS

Qualitative interviews

N = 6; participants were from a rural or remote TAS, who had compromised access to bodily autonomy (i.e., sex, sexual, gender diverse, or LGTBIQA + people, sex workers, people who are intersex, and kink-oriented people) and had a self-reported mental health issue; sex: female 66.7%; age 24–61 years

Mental health service use for sex workers

Richardson et al. 2015; Murdoch WA

South West region WA (MM5)

Quantitative cross-sectional

N = 8; participants were engaged in a telepsychology psychotherapy service; sex: female 75.0%; age 27–52 years

Videoconferencing telepsychology services

Wilson et al. 2012; Armidale NSW

Hunter New England region (MM3), NSW and Darling Downs, QLD (MM5)

Qualitative interviews

N = 13; participants had experienced of emergent mental health issues with symptoms of psychosis among men (either themselves or someone in their family); sex: 61.5% female; age 21–60 years

General mental health services

Combined health professional and service user perspectives

Bowman et al. 2020; Bathurst NSW

Rural, regional, remote Australia

Qualitative interviews

Group 1: n = 9; sex: female 22.2%, transgender 11.1%, non-binary 22.2%; aged 18–25 years. Group 2: n = 6; participants held roles of director n = 4, manager n = 1, and unspecified n = 1 within general mental health support, youth focused (12–25 years), issue-specific services (e.g., depression and anxiety), and lesbian, gay, bisexual, and transgender (LGBT)-dedicated support services; sex: NR; age NR

Users and providers of internet-based mental health services for LGBT young adults in rural areas

Consumers of Mental Health WA 2018; Cannington WA

Rural WA

Submission to the senate

Participants were mental health service workers, Aboriginal or Torres Strait Islander people, individuals with a lived experienced of a mental health issue, and family members/friends of someone with a lived experienced of a mental health issue

General mental health services

Henderson et al. 2014; Adelaide SA

Port Lincoln (MM6), Port Pirie (MM4), and Berri (MM5) SA

Evaluation; mixed methods: quantitative cross-sectional, qualitative interviews, mapping of client journey

N = 31; participants were key informants working within either the mental health team or external aged care agencies n = 22, clients n = 4, and carers n = 4; sex: NR; age NR

Older person’s mental health services

Isaacs et al. 2012; Moe VIC

Gippsland, VIC (MM5)

Qualitative interviews and focus groups

N = 46; participants were Aboriginal men from the Community n = 12, Aboriginal carers of men diagnoses with a mental illness n = 2, Koori Hospital Liaison Officer n = 1; and social and emotional wellbeing workers n = 2; community mental health nurse n = 1; private psychologist n = 1; acute psychiatric care nurse n = 1; non-Aboriginal social and emotional wellbeing worker n = 1; emergency care liaison nurse n = 1; community mental health team members n = 24; sex: NR; age NR

Mental health services for Aboriginal men

Isaacs et al. 2013; Moe VIC

Gippsland, VIC (MM5)

Qualitative interviews and focus groups

N = 17; participants were clients of mental health services n = 5, non-clients of mental health services n = 5, carers n = 2, cultural advisors n = 2; Aboriginal Hospital Liaison Officer n = 1, social and emotional wellbeing workers n = 2; sex: NR; age NR

Mental health services for Aboriginal men

Mental Health Council of Tasmania 2018; Hobart TAS

Rural and remote Australia

Submission to the senate

N = NR; participants were consumers, carers, family members, service providers, and community members with involvement with the mental health sector

General mental health services

Wand et al. 2021b; Camperdown NSW

Maitland (MM1) and Dubbo (MM3)

NSW

Qualitative interviews

N = 60; participants were ED patients n = 32; nurses n = 14, ED medical officers n = 11, psychiatrists n = 3, patients n = NR; sex: NR; age: NR

ED-based mental health nursing care services

Weber et al. 2012; Clunes NSW

Northern Rivers NSW (MM5)

Evaluation; mixed methods: quantitative cross-sectional, qualitative interviews

N = NR; participants were clients of an ED service and service providers including GPs, private practice psychologists and social workers, dietitians, and mental health service workers; sex: NR; age NR

Eating disorder services

Other

Bridgman et al. 2019; Hobart TAS

Hobart (MM2) & Glenorchy (MM2) TAS

Evaluation; quantitative longitudinal

Evaluation of Pulse Youth Health South—an outreach service consistent with headspace best practice guidelines; sex: NR; age 12–15 years

Mental health services for young people

Duggan et al. 2020; Melbourne VIC

Regional and rural Australia

Report

Data were obtained from the Australian Institute of Health and Welfare [116]; sex: NR; age: NR

Mental health presentations in regional/rural emergency departments

Knight et al. 2018; Mackay QLD

Regional QLD

Evaluation; quantitative longitudinal

Evaluation of the STARR model—an integrated care model between a regional adult mental health team and a non-government organisation; sex: NR; age: NR

Adult mental health services

National Rural Health Alliance 2017; location NR

Regional, rural, and remote Australia

Fact sheet

Data were obtained from Mental Health Services in Australia [117]; sex: NR; age: NR

General mental health services

Onnis et al. 2020; Cairns QLD

South of Mackay (MM2) to Cow Bay (MM6), and west of Croydon (MM7) and Richmond (MM7) QLD

Evaluation; quantitative longitudinal

Evaluation of Connect To Wellbeing—an initial assessment and referral service to improve psychological service access for people on low incomes; sex: NR; age: NR

Mental health intake and assessment service

Salinas-Perez et al. 2020; Kimberly Region, WA

Remote WA

Long-term care service description and classification

Information on service provision was gathered from managers of local organisations and through mental health atlases; sex: NR; age: NR

Mental health services in the Kimberly Region, WA

van Spijker et al. 2019; Western NSW and Country WA local health districts

Rural western NSW and WA

Long-term care service description and classification

Information on service provision was ascertained from peak bodies and sector representatives in Primary Health Networks (PHNs); sex: NR; age: NR

Mental health services in Western NSW and Country WA PHNs