The main objectives of this research were to determine the influence of bush identity on attitudes to mental health in rural Australia, what influence these attitudes have on service provision and utilisation, and what measures can be taken to improve attitudes to mental health and services in the bush. The research has included an extensive literature review of Australian historical and contemporary rural culture, the political economy of rural restructuring, rural mental health, as well as State and Federal policies and programmes for mental health care delivery. An ethnographic community study of “Ruraltown”, a rural centre in Queensland, was undertaken over a three-year period which involved semi-structured interviews, questionnaires, observations and community interaction. The results from the questionnaires and interviews in the community study indicate that attitudes to mental health in rural areas are influenced by bush identity, defined by reference to historical and current characteristics which include self-reliance, resilience, independence and stoicism. Social identity theories have been applied in this study to determine how the socialisation processes have incorporated these characteristics among the rural population, and rural males especially. In turn, these incorporated attributes and values have a direct impact on their attitudes to mental health and the willingness to seek help for problems of a psychological nature. Other aspects of rural life such as perceived lack of confidentiality and anonymity, fear of gossip, and isolation also impact on attitudes and the utilisation of mental health resources. Stigma is a significant barrier to recognition and acceptance of mental health issues. Hence, seeking help for mental health problems does not form part of the coping strategies for many in the bush. Mental health services, therefore, are not as readily accepted or utilised in rural Australia. Although some rural people do access mental health services, many more go on suffering with mental health problems rather than addressing them. Recommendations have been made to promote awareness and enhance education and attitudes to mental health, improve services and increase service utilisation. The study has also identified the problems facing mental health consumers in Ruraltown and some suggestions have been made to overcome these and assist in consumer empowerment.

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