Barbara Reen: Depression study: Emotions and health.

Background: This is a qualitative cross-sectional study designed to evaluate the nature and extent of unmet need by exploring women's experience of emotional distress, it's etiology and how women understand, cope and seek help for emotional distress.

Methods: 15 women aged 45-49 at baseline, living in rural and remote areas of Australia, who completed both the baseline and second survey of the Australian Longitudinal Study on Women's Health by The Australian Longitudinal Study on Women’s Health, who had scores below 52 on the Mental Health Summary Scale and had not reported being diagnosed with depression, nor taken anti-depressant medication in the previous four weeks were randomly selected to participate in audio-taped telephone interviews guided by open-ended questions. The tapes were transcribed, coded and analysed using the thematic and discourse analysis methods.

Results: Feelings of emotional distress (mainly depression, anxiety and anger) and their effects on women's lives, ranging from mild to severe, were described. Lack of supportive relationships from partner, family and friends, taking the responsibility of caring for a partner, children and ailing parents, adverse life events (relationship problems, accidents, health problems) and childhood experiences were identified as causal factors. Distance and separation from family and friends and women's own attributes of caring for others and denying their own needs compounded the effect of distress and impeded help-seeking. Coping mechanisms, both positive and negative, and help-seeking experiences were described. Lack of awareness of services, distance, lack of anonymity, and cost deterred women from seeking help.

Conclusions: This study identified unmet need and corroborates findings in relation to the experience and etiology of emotional distress, the attributes of women who experienced emotional distress and coping and help-seeking strategies. It highlights the particular role played by distance and separation from family and friends and the added burden placed on women who work on the land and suggest strategies for meeting unmet needs and ideas for futher study.