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Mental health

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Full-Text Articles in Medicine and Health Sciences

Addiction Panel Discussion: Finding Support, Karen Yost, Matthew Q. Christiansen M.D., M.P.H., Lyn M. O'Connell Ph.D., Dan Curry, Amy Saunders, Michelle Perdue, Sabrina Thomas May 2019

Addiction Panel Discussion: Finding Support, Karen Yost, Matthew Q. Christiansen M.D., M.P.H., Lyn M. O'Connell Ph.D., Dan Curry, Amy Saunders, Michelle Perdue, Sabrina Thomas

Matthew Christiansen

“Addiction Panel Discussion: Finding Support,” is the third of five in the, “Don’t Call Me Crazy: MU Mental Health Initiative,” panel discussion series, which was held on January 24, 2019. This initiative is comprised of three major components: “Resiliency through Education;” which includes: panel discussions with mental health professionals and a research guide, “Resiliency through Art;” an art exhibition that featured works form MU students, faculty and staff, and community members, and “Resiliency through Community;” an extensive collection of campus, local, state, and national mental health resources. Libraries hold a unique position as places to hold civil conversations on challenging …


Addiction Panel Discussion: Finding Support, Karen Yost, Matthew Q. Christiansen M.D., M.P.H., Lyn M. O'Connell Ph.D., Dan Curry, Amy Saunders, Michelle Perdue, Sabrina Thomas May 2019

Addiction Panel Discussion: Finding Support, Karen Yost, Matthew Q. Christiansen M.D., M.P.H., Lyn M. O'Connell Ph.D., Dan Curry, Amy Saunders, Michelle Perdue, Sabrina Thomas

Sabrina Thomas

“Addiction Panel Discussion: Finding Support,” is the third of five in the, “Don’t Call Me Crazy: MU Mental Health Initiative,” panel discussion series, which was held on January 24, 2019. This initiative is comprised of three major components: “Resiliency through Education;” which includes: panel discussions with mental health professionals and a research guide, “Resiliency through Art;” an art exhibition that featured works form MU students, faculty and staff, and community members, and “Resiliency through Community;” an extensive collection of campus, local, state, and national mental health resources. Libraries hold a unique position as places to hold civil conversations on challenging …


Disordered Eating Panel Discussion: Finding Help, Kelli Williams Ph.D., R.D., L.D., Candace Layne Ed.D., Alps, Lpc, Ncc, James R. Bailes M.D., Kristina M. Bryant-Melvin M.D., Licia Rei, Brittany Chapman, Tiffany Bowes, Sabrina Thomas May 2019

Disordered Eating Panel Discussion: Finding Help, Kelli Williams Ph.D., R.D., L.D., Candace Layne Ed.D., Alps, Lpc, Ncc, James R. Bailes M.D., Kristina M. Bryant-Melvin M.D., Licia Rei, Brittany Chapman, Tiffany Bowes, Sabrina Thomas

Sabrina Thomas

“Disordered Eating Panel Discussion: Finding Help,” is the fourth of five in the, “Don’t Call Me Crazy: MU Mental Health Initiative,” panel discussion series, which was held on February 21, 2019. This initiative is comprised of three major components: “Resiliency through Education;” which includes: panel discussions with mental health professionals and a research guide, “Resiliency through Art;” an art exhibition that featured works form MU students, faculty and staff, and community members, and “Resiliency through Community;” an extensive collection of campus, local, state, and national mental health resources. Libraries hold a unique position as places to hold civil conversations on …


The Association Between Self-Rated Health And Social Environments, Health Behaviors And Health Outcomes: A Structural Equation Analysis, Bevan Craig, Darren Morton, Peter Morey, Lillian Kent, Barry Gane, Terry Butler, Paul Rankin, Kevin Price Nov 2018

The Association Between Self-Rated Health And Social Environments, Health Behaviors And Health Outcomes: A Structural Equation Analysis, Bevan Craig, Darren Morton, Peter Morey, Lillian Kent, Barry Gane, Terry Butler, Paul Rankin, Kevin Price

Lillian Kent

Background

The factors shaping the health of the current generation of adolescents are multi-dimensional and complex. The purpose of this study was to explore the determinants of self-rated health (SRH) of adolescents attending a faith-based school system in Australia.

Methods

A total of 788 students attending 21 Seventh-day Adventist schools in Australia responded to a health and lifestyle survey that assessed SRH as well as potential determinants of SRH including the health outcomes mental health, vitality, body mass index (BMI), select health behaviors, social factors and personal demographics. Structural equation modeling was used to analyze the data and examine the …


The Association Between Self-Rated Health And Social Environments, Health Behaviors And Health Outcomes: A Structural Equation Analysis, Bevan Craig, Darren Morton, Peter Morey, Lillian Kent, Barry Gane, Terry Butler, Paul Rankin, Kevin Price Nov 2018

The Association Between Self-Rated Health And Social Environments, Health Behaviors And Health Outcomes: A Structural Equation Analysis, Bevan Craig, Darren Morton, Peter Morey, Lillian Kent, Barry Gane, Terry Butler, Paul Rankin, Kevin Price

Darren Morton

Background

The factors shaping the health of the current generation of adolescents are multi-dimensional and complex. The purpose of this study was to explore the determinants of self-rated health (SRH) of adolescents attending a faith-based school system in Australia.

Methods

A total of 788 students attending 21 Seventh-day Adventist schools in Australia responded to a health and lifestyle survey that assessed SRH as well as potential determinants of SRH including the health outcomes mental health, vitality, body mass index (BMI), select health behaviors, social factors and personal demographics. Structural equation modeling was used to analyze the data and examine the …


Combining Lifestyle Medicine And Positive Psychology To Improve Mental Health And Emotional Well-Being, Darren Morton Oct 2018

Combining Lifestyle Medicine And Positive Psychology To Improve Mental Health And Emotional Well-Being, Darren Morton

Darren Morton

This article presents the evidence for a variety of lifestyle-based and non-pharmacological approaches for improving mental health and emotional well-being. The strategies presented arise from the lifestyle medicine literature as well as the complementary discipline of positive psychology, which is a branch of psychology that adopts a strengths-based approach to helping individuals to flourish.


Self-Injurious Behaviors In Prisons: A Nationwide Survey Of Correctional Mental Health Directors, Kenneth L. Appelbaum, Judith A. Savageau, Robert L. Trestman, Jeffrey L. Metzner Sep 2017

Self-Injurious Behaviors In Prisons: A Nationwide Survey Of Correctional Mental Health Directors, Kenneth L. Appelbaum, Judith A. Savageau, Robert L. Trestman, Jeffrey L. Metzner

Judith A. Savageau

Self-injurious behavior (SIB) by inmates has serious health, safety, operational, security and fiscal consequences. Serious incidents require a freeze in normal facility operations. Injuries that need outside medical attention create additional security risks, including potential escape attempts. The interruption of normal operations, diversion of staff, cost of outside care, and drain on medical and mental health resources all have significant fiscal consequences. This session will present the results and implications of a survey of the Mental Health Directors in all 51 state and federal prison systems on the extent of SIB by inmates, including incidence and prevalence, adverse consequences, and …


Evaluation Of The Massachusetts Peer Specialist Training And Certification Program (Phase Two), Linda M. Cabral, Kathy Muhr, Laura A. Sefton, Judith A. Savageau Sep 2017

Evaluation Of The Massachusetts Peer Specialist Training And Certification Program (Phase Two), Linda M. Cabral, Kathy Muhr, Laura A. Sefton, Judith A. Savageau

Judith A. Savageau

Most public mental health systems are shifting to a recovery-oriented system of care; however, offering recovery-oriented and peer support services to various cultural and linguistic groups is challenging. This study sought to better understand how persons with mental health conditions from two cultural groups – Latinos and Deaf and Hard of Hearing (D/HH) - access recovery-based services. Interviews with national key informants were conducted prior to data collection to better formulate instruments. Cultural brokers, identified as leaders in their communities who also have mental health conditions, were hired to aid in recruitment and data collection. Interviews and focus groups were …


Medical Mental Health Screening, Michelle Flaum Hall, Scott E. Hall Dec 2016

Medical Mental Health Screening, Michelle Flaum Hall, Scott E. Hall

Scott E. Hall, Ph.D., LPCC-S

The Medical Mental Health Screening tool assesses risk factors that can contribute to adverse psychological responses (specifically, traumatic stress responses) to medical events, illnesses, and procedures. It is a pre-screening tool and should be used as a means of flagging risk factors and intervening appropriately in order to prevent or minimize adverse emotional reactions to medical care.
The tool is a self-administered checklist that can be completed by patients during pre-admission to the hospital for a scheduled procedure, in a provider’s office prior to hospital admission, or in other circumstances deemed appropriate by clinicians.


A Transformational Melancholy: One Law Professor's Journey Through Depression, Marjorie A. Silver Aug 2016

A Transformational Melancholy: One Law Professor's Journey Through Depression, Marjorie A. Silver

Marjorie A. Silver

In the fall 2007 issue of the Journal of Legal Education, Professor James Jones shared his deeply personal, remarkable, ongoing, story of living, struggling and succeeding as a law professor with bipolar disorder (James T.R. Jones, Walking the Tightrope of Bipolar Disorder: The Secret Life of a Law Professor, 57 J. LEGAL ED. 349 (2007). His essay ended with an invitation to other members of the legal academy to contact him or Professor Elyn Saks, author of an extraordinary memoir about her life with schizophrenia, (ELYN R. SAKS, THE CENTER CANNOT HOLD (2007)) if interested in forming a confidential support …


Losing Hope: Mental Health And Religious Service Non-Attendance In Australia, Edward Kyle Waters, Helena Mary Millard, Zelda Doyle Jun 2016

Losing Hope: Mental Health And Religious Service Non-Attendance In Australia, Edward Kyle Waters, Helena Mary Millard, Zelda Doyle

Edward Waters

Religious beliefs and practices are related to mental health. Many individuals report a religious affiliation, but do not have specific religious beliefs or practices such as attending religious services. These non-attendees are often assumed to resemble the non-religious, but are poorly studied. This study explored the demographic characteristics and mental health outcomes associated with being a non-attendee using data from a nationally representative Australian sample. Non-attendees were more likely to be non-Christian than attendees at religious services. They had worse mental health than both non-religious individuals and attendees, especially compared to the non-religious. Whether non-attendance is a result of or …


Are There Associations Among Physical Activity, Fatigue, Sleep Quality And Pain In People With Mental Illness? A Pilot Study, Joanne Connaughton, Shane Patman, C Pardoe Jun 2016

Are There Associations Among Physical Activity, Fatigue, Sleep Quality And Pain In People With Mental Illness? A Pilot Study, Joanne Connaughton, Shane Patman, C Pardoe

Joanne Connaughton

Accessible summary

  • Many people with mental health disorders experience fatigue, pain and poor sleep. In other patient groups, physical exercise has been shown to have positive effects on these symptoms.
  • It is unknown whether day-to-day physical activity (not necessarily exercise) affects sleep quality or severity of pain or fatigue in those with mental illness.
  • This study observed physical activity, sleep quality, pain and fatigue in four people hospitalized with severe mental illness.
  • Significant associations were found between pain and fatigue severity in the morning, but not in the evening. A significant association was found between physical activity and morning and …


Enrichment Of Psychiatric Mental Health Clinical Rotations: A Suicide Scenario Simulation, Melinda Hermanns, Mary Luanne Lilly, Bill Crawley May 2016

Enrichment Of Psychiatric Mental Health Clinical Rotations: A Suicide Scenario Simulation, Melinda Hermanns, Mary Luanne Lilly, Bill Crawley

Melinda Hermanns

This poster was presented at the 27th Annual Psychiatric Mental Health Conference.


Body Image Avoidance, Body Dissatisfaction, And Eating Pathology: Is There A Difference Between Male Gym Users And Non–Gym Users?, Peta Stapleton, Timothy Mcintyre, Amy Bannatyne Aug 2015

Body Image Avoidance, Body Dissatisfaction, And Eating Pathology: Is There A Difference Between Male Gym Users And Non–Gym Users?, Peta Stapleton, Timothy Mcintyre, Amy Bannatyne

Peta B. Stapleton

With research highlighting the increasing prevalence and severity of body image and eating disturbances in males, particularly athletes and regular gymnasium users, the current study examined body image and eating disturbances in a sample of male gym users and non–gym users (N = 180). Based on previous research, it was predicted that male gym users would report greater body image disturbance (e.g., body image avoidance and body dissatisfaction) and eating pathology, compared with non–gym users. Results of the study partially supported hypotheses, revealing body dissatisfaction and eating pathology were significantly increased in male gym users. However, no significant differences were …


Variability In Depressive Symptoms Of Cognitive Deficit And Cognitive Bias During The First 2 Years After Diagnosis In Australian Men With Prostate Cancer, Christopher Sharpley, Vicki Bitsika, David Christie Jul 2015

Variability In Depressive Symptoms Of Cognitive Deficit And Cognitive Bias During The First 2 Years After Diagnosis In Australian Men With Prostate Cancer, Christopher Sharpley, Vicki Bitsika, David Christie

Vicki Bitsika

The incidence and contribution to total depression of the depressive symptoms of cognitive deficit and cognitive bias in prostate cancer (PCa) patients were compared from cohorts sampled during the first 2 years after diagnosis. Survey data were collected from 394 patients with PCa, including background information, treatments, and disease status, plus total scores of depression and scores for subscales of the depressive symptoms of cognitive bias and cognitive deficit via the Zung Self-Rating Depression Scale. The sample was divided into eight 3-monthly time-since-diagnosis cohorts and according to depression severity. Mean scores for the depressive symptoms of cognitive deficit were significantly …


Evaluation Of The Redeveloped Model Of Mindmatters: First Progress Report, Robert Simons Dec 2014

Evaluation Of The Redeveloped Model Of Mindmatters: First Progress Report, Robert Simons

Dr Robert Simons

No abstract provided.


Evaluation Of The Redeveloped Model Of Mindmatters: Second Progress Report, Robert Simons Dec 2014

Evaluation Of The Redeveloped Model Of Mindmatters: Second Progress Report, Robert Simons

Dr Robert Simons

No abstract provided.


Resilience : An Independent Psychobiological Mental Health Construct (Guest Editorial), Amresh Srivastava Nov 2014

Resilience : An Independent Psychobiological Mental Health Construct (Guest Editorial), Amresh Srivastava

Amresh Srivastava

Survival against trauma is a unique characteristic of all human beings. While a number of factors contribute in building this capacity, resilience appears to be the most important one. Interest in studying resilience arises from number of areas which are of utmost clinical significance such as such as exploring the possibility of at-risk individuals who developing a mental illness]. Resilience is a human capacity to adapt swiftly and successfully to stressful or traumatic events and revert back to a positive state. It is commonly conceptualized as the ability to thrive despite experiencing adversity


Concept Clarification Of Grief In Mothers Of Children With An Addiction, Donna M. Zucker Rn, Phd, Faan, Kimberly Dion Msn, Rn, Roxanne P. Mckeever Msn, Rn Sep 2014

Concept Clarification Of Grief In Mothers Of Children With An Addiction, Donna M. Zucker Rn, Phd, Faan, Kimberly Dion Msn, Rn, Roxanne P. Mckeever Msn, Rn

Donna M. Zucker

Aim: To report an analysis of the concept of grief in mothers of children with addiction. Background. The concept of grief in this context is poorly understood and often synonymously used with concepts depression, loss and chronic sorrow. In the US, the core concept grief has been recently revised by both NANDA and the DSM-V in efforts to better understand and characterize the concept. The plethora of literature on grief worldwide often characterizes grief as a response to a death. Design. Concept analysis. Data sources. Search terms ‘parental grief’ and ‘substance abuse’ yielded 30 articles. A second review using terms …


“Young People These Days, Are Not Like We Used To Be ... #11;Or Are They?”, Harry B. Mayr Sep 2014

“Young People These Days, Are Not Like We Used To Be ... #11;Or Are They?”, Harry B. Mayr

harry b mayr

No abstract provided.


Mental Health Systems Transformation Through Participatory Research And Action: The Young Adult Appreciative Inquiry/Photovoice Project, Thomas M. Laporte, Mason G. Haber, Damie Jackson - Diop, Brittany Holt May 2014

Mental Health Systems Transformation Through Participatory Research And Action: The Young Adult Appreciative Inquiry/Photovoice Project, Thomas M. Laporte, Mason G. Haber, Damie Jackson - Diop, Brittany Holt

Mason G. Haber

Participatory action research and evaluation methods (PAR) have been used to help individuals to address a variety of challenges and improve the responsiveness of service systems to these challenges. To the present, however, few studies have examined applications of PAR in systems change advocacy for youth with mental health needs in the transition to adulthood (transition-age youth [TAY]). PAR may be especially beneficial in systems transformation efforts for this population, which lacks resources of other mental health system consumers for advocacy such as formal settings, specialized professional attention, and well established consumer organizations. The present paper describes how specific strategies …


Burden Of Stigma On Mentally Ill And Social Exclusion, Amresh Srivastava May 2014

Burden Of Stigma On Mentally Ill And Social Exclusion, Amresh Srivastava

Amresh Srivastava

‘Poverty and social exclusion conference’ London, Ontario, October 23-24, presented during the conference of Lawson Health Care Institute’s conference ‘CUREA’ 24th October 2013

Title: Burden of stigma on mentally ill and social exclusion Amresh Shrivastava, Associate Professor of Psychiatry Western University, London, Ontario, Canada

Abstract Stigma of mental illness causes great burden on the patients and their families. It leads to discrimination, social exclusion and personal isolation. It occurs across all social, economic, and cultural class and geographical regions. As one of the greatest barrier to treatment and outcome, it is a potential clinical risk which leads to suicide, violence, …


Intention To Seek Professional Psychological Help Among College Students In Turkey: Influence Of Help-Seeking Attitudes, Feyza Seyfi, Krishna C. Poudel, Junko Yasuoka, Keiko Otsuka, Masamine Jimba Nov 2013

Intention To Seek Professional Psychological Help Among College Students In Turkey: Influence Of Help-Seeking Attitudes, Feyza Seyfi, Krishna C. Poudel, Junko Yasuoka, Keiko Otsuka, Masamine Jimba

Krishna C. Poudel

Background: Depression rates are high among college students in Turkey, but often students do not seek mental health care. This study aimed to examine the association between attitudes toward seeking professional psychological help and intention to seek professional psychological help among such college students. We also examined the factors associated with students’ professional psychological help-seeking attitudes. We conducted this cross-sectional study among 456 conveniently sampled graduate and undergraduate students in Ankara. We collected students’ data using self-administered, structured questionnaires in the Turkish language and then analyzed the data using both descriptive and multivariate methods. Results: In the multiple linear regression …


Quantification Of Stigma For Clinical Assessment In Psychiatric Practice’ - A Paradigm Shift In Anti-Stigma Intervention: Using Newly Developed Scale (Stigma Quantification Scale ‘Sqs’)., Amresh Srivastava Sep 2013

Quantification Of Stigma For Clinical Assessment In Psychiatric Practice’ - A Paradigm Shift In Anti-Stigma Intervention: Using Newly Developed Scale (Stigma Quantification Scale ‘Sqs’)., Amresh Srivastava

Amresh Srivastava

Purpose: Objective of the project was to develop a quantification tool for measurement of stigma in clinical practice for the purpose of identifying patients who have suffered severe stigma with the hopes of identifying and treating stigma related issues. Methods: Our tool which includes 49 items, quantifies four domains of stigma: (1) Personal; (2) Family; (3) Social; and (4) Illness. In addition, the items are distributed into three subscales: (a) self-experience; (b) illness related consequences; and (c) coping strategies. Results: In this pilot study conducted in India, we present the scale details and results. We found that as age increased …


Re-Hospitalization Of Psychiatric Patients: The Patients, Or The Illness And Treatment?, Amresh Srivastava, Robbie Campbell, Megan Johnston, Ruth Mooser, Larry Stitt Sep 2013

Re-Hospitalization Of Psychiatric Patients: The Patients, Or The Illness And Treatment?, Amresh Srivastava, Robbie Campbell, Megan Johnston, Ruth Mooser, Larry Stitt

Amresh Srivastava

Purpose: The goal of this project was to find out why psychiatric patients get hospitalised repeatedly. Studies have found that repeated hospitalization leads to economic drain, disability, poor outcome, stigma and discrimination. Hospitalization consumes more than 90% of mental health budgets. Identifying the potential risk factors for repeated hospitalization, interrelationships between risk factors, and vulnerability will help us take the appropriate measures to prevent hospitalization and promote care in the community. Logistically, there are three possible factors which may lead to repeated hospitalization: (1) Characteristics of the patient; (2) Nature of the illness; and (3) The management of the illness …


Child Mental Health And Service Needs In Iraq: Beliefs And Attitudes Of Primary School Teachers., A Al-Obaidi, B Nelson, G Albadawi, M Hicks, A Guarino Dec 2012

Child Mental Health And Service Needs In Iraq: Beliefs And Attitudes Of Primary School Teachers., A Al-Obaidi, B Nelson, G Albadawi, M Hicks, A Guarino

Madelyn Hsiao-Rei Hicks

No abstract provided.


Health-Related Quality Of Life, Depression, And Self-Esteem In Adolescents With Leprosy-Affected Parents: Results Of A Cross-Sectional Study In Nepal, Nobuko Yamaguchi, Krishna C. Poudel, Masamine Jimba Dec 2012

Health-Related Quality Of Life, Depression, And Self-Esteem In Adolescents With Leprosy-Affected Parents: Results Of A Cross-Sectional Study In Nepal, Nobuko Yamaguchi, Krishna C. Poudel, Masamine Jimba

Krishna C. Poudel

Background: Leprosy is a chronic infectious disease that has an impact on the Health-Related Quality of Life (HRQOL) of sufferers as well as their children. To date, no study has investigated the effects of parental leprosy on the well-being of adolescent children.
Methods: A cross-sectional study was conducted in the Lalitpur and Kathmandu districts of Nepal. Adolescents with leprosy-affected parents (n = 102; aged 11–17 years) and those with parents unaffected by leprosy (n = 115; 11–17 years) were investigated. Self-reported data from adolescents were collected using the Kinder Lebensqualität Fragebogen (KINDLR) questionnaire to assess HRQOL, the Center for Epidemiological …


Literature Review: Understanding Nursing Competence In Dementia Care, Victoria Traynor, Kumiyo Inoue, Patrick A. Crookes Aug 2012

Literature Review: Understanding Nursing Competence In Dementia Care, Victoria Traynor, Kumiyo Inoue, Patrick A. Crookes

Professor Patrick Crookes

Aims and objectives. The aim of this study was to review dementia nursing competencies. The objectives were to explain the relevancy of dementia competencies across care settings and levels of practice. Background. Dementia is strongly associated with increasing age and as the world population ages there is an imperative to ensure the healthcare workforce is fully equipped to meet the needs of people with dementia and their carers. Design. A literature review study addressed the research aim and objectives. Method. Literature sources were (i) academic databases, (ii) the internet and (iii) snowballing. Search terms were 'dementia', 'care standards', 'training and …


De”Myth”Ifying Mental Health – Findings From A Community University Research Alliance (Cura), Rick Csiernik, Cheryl Forchuk, Mark Speechley, Catherine Ward-Griffin Aug 2012

De”Myth”Ifying Mental Health – Findings From A Community University Research Alliance (Cura), Rick Csiernik, Cheryl Forchuk, Mark Speechley, Catherine Ward-Griffin

Rick Csiernik

Many myths exist regarding mental illness and those with mental health issues. Under the auspices of a Community-University Research Alliance on Housing and Mental Health, a partnership between academics, community health and social service agencies and representatives of consumer-survivor groups, fourteen consumer-survivor and eight family member focus groups were held throughout Southwestern Ontario. Individual interviews were also conducted with 150 male and 150 female community-based mental health system consumer-survivors living in a variety of housing environments in London, Ontario. The findings dispute beliefs around four myths: that people with mental health problems are a homogenous population, which was highlighted by …


Gaining Ground, Losing Ground: The Paradoxes Of Rural Homelessness, Cheryl Forchuk, Phyllis Montgomery, Helene Berman, Catherine Ward-Griffin, Rick Csiernik, Carolyn Gorlick, Elsabeth Jensen, Patrick Riesterer Aug 2012

Gaining Ground, Losing Ground: The Paradoxes Of Rural Homelessness, Cheryl Forchuk, Phyllis Montgomery, Helene Berman, Catherine Ward-Griffin, Rick Csiernik, Carolyn Gorlick, Elsabeth Jensen, Patrick Riesterer

Rick Csiernik

The study examined rural housing and homelessness issues and looked at similarities and differences between rural and urban areas. It involved a secondary analysis of focus group data collected in a 2001-06 Community University Research Alliance study of mental health and housing. The findings highlight concerns regarding the lack of services, which can precipitate a move from a rural to an urban community. Inadequate transportation services often posed a challenge to rural residents attempting to access services. Many participants preferred rural living but felt they had to choose between residing where they wanted to and having access to essential services. …