Strength and Vulnerability of Mental Illness in Older Persons within the Rural Context

Abstract

Purpose: In this paper we analyzed the complex issue of mental illness in older persons living in rural areas using the Strength and Vulnerability Integration (SAVI) model as a conceptual framework to bring balance to negative accounts of older persons' emotional experiences. Method: A narrative review was conducted to examine the mental health issues of older persons living in rural areas. Three databases were searched for data pertaining to rural mental health and the SAVI model. Theoretical and empirical articles that analyzed the strengths and vulnerabilities in relation to mental illness in older persons living in rural areas were included and analyzed. Additionally, policy and position papers were used to interrogate this issue. Findings: Analysis revealed three themes: individual vulnerabilities, system vulnerabilities and strengths. Rural individuals' struggles with chronic stress, a loss of social belonging, and neurological dysregulation across their lifespans were discussed in how they developed strengths in ageing and overcame vulnerabilities. Barriers to accessing mental health services, caregiving respite care, and health promotional services in rural areas included system vulnerabilities that exacerbated the rates of mental illness and poor health outcomes in older persons. Strengths included the rural social connection and community engagement that fostered a sense of community. Conclusions: Research and practice recommendations situated within the SAVI model include the importance of acknowledging individual differences viewing the strengths of ageing, cultural perceptions of time and leveraging community-based strengths to overcome vulnerabilities of ageing in rural areas. These changes will facilitate nurses and other health care providers assess, respond to, and prevent mental illness and poor health outcomes in the diverse ageing population living in rural areas.