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Climate change impacts human health and there is growing recognition of the explicit consequences for mental health and wellbeing. Rural communities are recognised as one of the most vulnerable populations to climate change. The majority of research to date is quantitative and has a focus on farmers specifically, with the impacts of climate change on the wider rural community considered to a lesser extent. Our study addresses this gap by analyzing qualitative data from the Australian Rural Mental Health Study (ARMHS), a longitudinal study conducted in non-metropolitan New South Wales (NSW), Australia, during the Millennium Drought. Free text responses from 823 participants to the open-ended question "What is your biggest concern about climate change?" were analysed to determine what the qualitative data from ARMHS reveals about the mental health and wellbeing of rural communities. Four themes were identified: (i) suffering under climate change; (ii) causes of climate change; (iii) extremes of climate change; and (iv) leadership and action to address climate change. The environmental, financial, health and social impacts of climate change were of greatest concern to rural residents. Many participants also had concerns relating to climate change attribution, with many believing climate change was a natural, cyclical process not caused by human actions. Other major concerns were the financial consequences of extreme events and the adequate communication of climate change information. Analysis of qualitative data such as that presented here gives context and breadth of understanding to issues identified via quantitative analysis. Importantly, insights emerging from qualitative data, and the personal/community context that is not always available from quantitative data, can lead to more informed community-based approaches to addressing climate change issues experienced by vulnerable populations. • First population-based study to ask rural residents about climate change concerns. • Qualitative analysis offers perspective of those most vulnerable to climate change. • Rural residents are concerned about the financial burden of extreme weather events. • Rural residents are concerned about government policies related to climate change. • Many rural residents' concerns relate to the causes of climate change. [ABSTRACT FROM AUTHOR]

Purpose: Many major studies of depression in Australia are under-representative of rural and remote residents, limiting the generalizability of their findings. This study explores the contributions of a range of individual, social, and community factors to the trajectory of depressive symptoms among a cohort of rural and remote residents.Methods: Data from four waves of the Australian Rural Mental Health Study (baseline n = 2639), a 5 year longitudinal study of rural community residents, were examined within generalized linear mixed models to predict depressive symptoms. Depression was measured using the PHQ-9, with key correlates including social support, employment status, financial wellbeing, neuroticism, and rural community factors.Results: Moderate-to-severe depression was reported by 6.3% of the baseline sample. Being permanently unable to work resulted in over a threefold increase in the odds of depression at the following survey wave. Self-rated financial hardship was associated with a fourfold increase in the odds of future depression, as was a high level of community concerns. Neuroticism and tobacco use also made a significant independent contribution to future depressive symptoms. Interpersonal support was a protective factor, reducing the odds of next-wave depression by 64%.Conclusion: Financial and employment-related difficulties appear to be important risk factors for depression, and targeting individuals experiencing such difficulties may be an effective means of reducing depression among certain sub-groups. Strategies to prevent depression in rural and remote Australia may benefit from a focus on interpersonal and community-level support, as the effects of this support are lasting and contribute to a reduced likelihood of depressive episodes in future years. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the association between unintentional injury and mental health in Australian rural communities. Methods: Using cross-sectional baseline data for a longitudinal study from randomly selected adults in nonmetropolitan Australia, we fitted logistic regression models for the outcomes of domestic or public setting injury and injury in high-risk settings, using prior depression and demographic factors. OR and 99% CI were reported and also calculated for current mental health including psychological distress, depressive symptoms and risky alcohol consumption, comparing those injured with those not. Findings: Of 2,639 participants who completed the injury component, 364 (13.8%) reported injury requiring treatment from a doctor or a hospitalization in the previous 12 months. Of those requiring treatment or hospitalization, 147 (40.4%) reported being injured in a domestic or public setting and 207 (56.9%) in a high-risk setting. The most common types and mechanisms of injury were sprains and strains, and falls, trips and slips, respectively. Preinjury depression was independently associated with unintentional injury in a domestic or public setting. Being injured in this setting was associated with double the odds of experiencing current depressive symptoms. The likelihood of a high-risk setting injury was significantly associated with male gender. High-risk setting injury was associated with current psychological distress and higher levels of alcohol usage. Conclusions: This study supports the hypothesis that pre-existing depression is associated with unintentional injury in a rural sample and indicates the important role of prior depression in management of injury, given the high rate of injury in rural communities. Mechanisms by which prior depression increases likelihood of unintentional injury will be further investigated using longitudinal data. [ABSTRACT FROM AUTHOR]

Objective: This paper outlines the methods and baseline data from a multisite cohort study of the determinants and outcomes of mental health and well-being within rural and remote communities. Methods: A stratified random sample of adults was drawn in non-metropolitan New South Wales using the Australian Electoral Roll, with the aim of recruiting all adult members of each household. Surveys assessed psychological symptoms, physical health and mental disorders, along with individual-, family/household- and community-level characteristics. A stratified subsample completed a telephone-administered World Mental Health-Composite International Diagnostic Interview (World Mental Health-3.0). Proxy measures of child health and well-being were obtained. Follow up of this sample will be undertaken at one, three and five years. Results: A total of 2639 individuals were recruited (1879 households), with 28% from remote/very remote regions. A significant relationship was found between recent distress (Kessler-10 scores), age and remoteness, with a linear reduction of Kessler-10 scores with age and the lowest mean scores in remote regions. Conclusions: Existing rurality categories cannot address the diverse socio-cultural, economic and environmental characteristics of non-metropolitan regions. While it has limitations, the dataset will enable a fine-grained examination of geographic, household and community factors and provide a unique longitudinal dataset over a five-year period. [ABSTRACT FROM AUTHOR]