Too tough to ask for help? Stoicism and attitudes to mental health professionals in rural Australia

Purpose: Rural and remote Australia has long been recognised as an area with reduced help seeking for mental health concerns and an increased suicide mortality.  The current study aimed to investigate the differences between help seeking intentions and its predictors between different locations across Australia to better understand the barriers to seeking help for rural residents.
Methods: An anonymous online survey measuring attitudes, stoicism, help seeking intentions and demographics was conducted through various channels across Australia. Differences between locations and relationships between variables of interest were analysed using multiple regression and mediation analysis.
Findings: In total 471 participants were included to the analysis, majority resided in the outer regional area (37.4%), followed by inner regional (29.9%), major city (18.3%), remote (12.3%) and very remote (2.1%). Location, along with attitudes and stoicism were predictors of help seeking.  A novel mediation model also revealed attitudes partially mediated the association between stoicism and lower help seeking intentions for both rural and urban participants. 
Conclusions: Findings from this study extend our knowledge of what differentiates people who are from those who are not willing to seek help for a mental health concern or suicidal ideation by their living location. The findings also suggest practical implications for clinical intervention and community prevention that could assist improving help seeking for rural Australians in the future.