Child Adolescent and Family Centered Care

This paper discusses the challenges faced by individuals and communities in rural areas of Australia in terms of chronic illness and mental health issues. It explores how a primary care approach can support nurses in working with children and families in rural and remote areas, and highlights a mental health promotion program and a sexual health education program that can improve wellbeing. Recommendations are provided for improving access to mental health services and implementing effective sexual health education in rural and remote communities.

Running head: CHILD ADOLESCENT AND FAMILY CENTERED CARE
Child adolescent and family centered care
Name of the Student
Name of the University
Author Note

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CHILD ADOLESCENT AND FAMILY CENTERED CARE
Introduction:
Many individuals, and communities outside of the major urban region of Australia,
especially the indigenous community is experiencing the severe burden of the chronic illness
(Humphreys, Lyle & Barlow, 2018). With the rising rate of the mental illness as well as family
breakdowns, the health care services are already struggling to assists families across the rural
areas in living a healthy life. As discussed by Morley et al. (2017), people living in rural
communities generally score lower on various aspects of health, displaying higher rates of
disabilities and mortality rate in the urban counterparts. The Australian Bureau of Statistics
reported that 65% of deaths amongst indigenous people occurred before 65 years compared to
19% of non-indigenous individuals (Meiklejohn et al., 2016). The mortality rate is 1.6 times
higher in the individuals who live in remote areas compared to the individuals who live in the
urban counterpart (Gregory, Phillips & Brumby, 2015). The social and economic disadvantages
are the strongest reason behind these health disabilities. The crisis begins to dominate the public
and medical report which further contributed to the mortality rate and global burden of disease.
This paper will illustrate how PHC approach supports nurses to work in partnership with children
and families in rural and remote areas, one health promotion program and one education program
promote wellbeing along with the recommendation in following paragraphs.
Primary care approach:
To promote the well-being of the families and children, the world health organization
adopted the primary-care approach as a basis for providing effective health care services. As
discussed by McGrail and Humphreys (2015), the primary care approach embrace five types of
care such as promotive, curative, rehabilitative supportive. In each type of delivery of care, the
focus is on the prevention and illness and promoting health. As discussed by Thomas,

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Wakerman and Humphreys (2015), PHC services in the remote areas are smaller compared to
the rural areas which further highlighted the disadvantages associated with the geographical
location. In individuals in the rural and remote areas are subject to the high level of
psychological distress such as anxiety, depression and other mental health issues because of the
potential social determinants including unemployment, low sociodemographic status, illiteracy,
childhood experiences (Roden et al., 2015). They tend to develop unhealthy habits such as
smoking, drinking, reckless sexual activities which resulted in health issues such as
cardiovascular disease, cancer, obesity, diabetes, kidney, and renal disease. The primary care
approach provided a new direction to the nurses in the both rural and remote communities to
work in partnership with children and families for management of chronic illness and promote
wellbeing (Schmidt & Kirby, 2016). The primary care approach enable nurses to provide
interventions by prioritizing the needs of the children and families, incorporating them in the
treatment procedures, taking account of the social determents of the health while providing care
to close the gap in the healthcare services in between urban and rural areas. The approach also
enables nurses to incorporate to engage the families, children, and communities in the
educational program on emerging health problems and how to prevent them. The approach
enables nurses to create a safe and comfortable environment by integrating cultural values and
beliefs and encourage each family in the community to participate in the health promotional
program which promotes the collaborative practice (Sturgiss et al., 2017). With the help in the
approach, nurses in the rural and remote areas are able to be transparent to the population and
able to promote the shared decision making and share responsibility. Consequently, the families,
children, and communities of the rural and remote areas feel empowered, confident and safe.
The consensus report suggested that after adaptation of the primary care approach, nurses in the

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rural area and remote areas are able to provide exclusive services such mental health and social
wellbeing , maternal and child health , sexual and reproductive health, public health and
prevention , aged care disability services and counselling in the work , domestic violence.
Health promotion program and health education topic:
There is a diverse range of health promotion programs are documented in the literature
to promote the wellbeing of the children, adolescents, and families in rural areas. As discussed
by Mehrotra et al. (2017), the individuals in the rural and remote area are almost three times
more likely report psychological distress compared individuals’ lives in the urban counterpart
with 32% in the regional areas and 31% in the remote areas. Considering the prevalence, the
psychiatrist in the remote and rural areas is only 38% compared to the 78% psychiatrist in urban
areas. Consequently, the suicide rate is 1.9 % higher in remote and rural areas compared to the
urban counter parts of Australia. This paper will focus on Mental Health Services in Rural and
Remote Areas (MHSRRA) program to support the wellbeing of the children, families, and
communities living in rural areas. The program aims to improve the mental health of the
individuals of the rural and remote areas with mild to moderate mental health disabilities by
providing better mental health services. The program conducted by a non-government health
organization to deliver the mental health services by social workers, psychologist, occupational
therapist, aboriginal health workers, and nurses (Ntphn.org.au. 2019). It is mainly provided by
royal flyer doctors who promote the better wellbeing of the individual’s lives in the rural areas in
partnership with the families and patient. The program offers low-intensity mental health
services, youth, and mental health services, psychological therapies for hard to reach group,
suicide prevention program and Aboriginal and Torres Strait Islander services (Ntphn.org.au.
2019). After the implementation program, the suicide rates of these areas significantly reduced,

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especially young men with mental illness. This program also reduces drug abuse among young
individuals.
The health education improved the health condition of the individuals who lives in n the
remote and rural area. This paper will focus on sexual health education of the Australian who
lives in the rural and remote community. The Australian Bureau of statistics highlighted that
between 2012 to 2016, gonorrhea notification increased 62% per 1000, 000. The rate of sexually
transmitted disease in higher in men highlighting 72% compared to women with a 42 % increase
(Workowski, 2015). The research highlighted that in the rural area, men in between 25 to
29years and women in between 20 to 24 year are more likely to develop the sexually transmitted
disease which not only affected their health but also disrupts the normal lifestyle of the family
members (Nattabi et al., 2017). Most commonly occurred sexually transmitted disease includes
Gonorrhoea, Chlamydia, and Hepatitis B (Unemo et al., 2017). The sexually transmitted disease
contributed to the rapid increase of the risk of developing HIV infection. Therefore, it is
highlighted as one of the crucial public health issues in rural and remote areas apart from
diabetes and cardiovascular disease. As discussed by Heslop et al. (2017), the rate of sexually
transmitted disease and other health issues associated with the sexually transmitted disease is
higher in rural and remote areas because illiteracy of sexual behavior and stigmatized behavior
because of cultural believes. Therefore, in order to reduce the rapid increase of sexually
transmitted disease, sexual health education is an effective approach for the rural and remote
communities which will support the wellbeing of health education. The authors suggested that
Third National Sexually Transmissible Infections Strategy 2014–2017 is effective in improving
youth sexual behavior and families of rural and remote communities. Sexual health education
with the help of health promotion not only increases the awareness regarding unsafe sexual

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practice but also improves the vaccination rate in rural and remote areas against these diseases
(Nattabi et al., 2017). However, researchers also highlighted that while the sexual health
education with the help of health promotion improves the sexual behavior, it is difficult to
implement in every rural and remote area because of the core cultural beliefs the population have
and because of the educators who are not health professionals. Helmer et al. (2017), suggested
that high-quality sexual education, especially for the young population in the rural and remote
areas of Australia efficiently improve sexual behavior of the young individuals and families with
the sexually transmitted disease.
Recommendation:
The above discussion highlighted one health promotion such as Mental Health Services
in Rural and Remote Areas (MHSRRA) program and health education such as sexual health
education helps to support of the wellbeing of the child and families who live in the rural and
remote communities of Australia. Considering the mental health service in rural and remote
areas, the program mainly supports the families and children who are suffering from mental
health issues because of the social determinants of health. However, the program mainly focuses
on the families and children of the rural and remote areas who are suffering from mental illness.
However, a considerate number of individuals of these areas have an undiagnosed mental illness,
especially the older individuals of the community who lived alone. In this case, it is
recommended to screen every member of the community with the collaboration of the governing
bodies since it would help to provide access to the wide range of the population (Schmidt &
Kirby, 2016).
Considering sexual health education, the majority of the individuals, the majority of sexual
health education is provided by specialist services or untrained health professionals. Moreover,

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women of this community failed to seek education because of the stigmatized behavior of the
community. In this case, it is recommended to create a stigma-free health care environment and
provide education with the assistance of a skilled health care professional who has in-depth
knowledge of sexual health and management of sexually transmitted disease
Conclusion:
Thus, it can be concluded that because of socio-demographic disadvantages people
living in rural communities are generally score lower on various aspects of health, displaying
higher rates of disabilities and mortality rate in the urban counterparts. Primary care approach is
highlighted as one of the effective approaches which enable nurse. nurses to provide
interventions by prioritizing the needs of the children and families, incorporating them in the
treatment procedures, taking account of the social determents of the health while providing care
to close the gap in the healthcare services in between urban and rural areas. Nurses in the rural
and remote areas are able to be transparent to the family members and promote the shared
decision making and share responsibility. Consequently, the families, children, and communities
of the rural and remote areas feel empowered, confident and safe. This paper focused on
mental health program and sexual education which improved the wellbeing of the children and
families of these areas. It is recommended to focus on thorough screening of each individual of
the community. For sexual health education, it is recommended to create stigma-free health
care environment and provide education with the assistance of skilled health care professional
who has in-depth knowledge of sexual health and management of the sexually transmitted
disease.

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