Globally, depression is well known to be a major medical problem. In rural
and remote communities, the condition often remains less visible than in urban
locations. Geographical and infrastructural limitations pose additional challenges to its
disclosure, documentation and treatment. Historically, depression was understood from
a biomedical model characterised by an individualistic understanding. Thus, treatment
of this mental illness has remained largely at an individual, rather than community,
level. This chapter conceptualises major depression as a social problem impacted and
shaped by systemic conditions that require a holistic understanding. Depression requires
transcending an ‘ideology of individualism’ to be more successfully addressed and
treated. To achieve this, sociological concepts, such as social capital, social networks,
social isolation and others, are identified as paramount for re-conceptualising
depression, which is understood to result from the dynamic relationship existing
between individuals and their broader communities, including the natural environment.
In this chapter, we commence this task through a critical literature review examining
biomedical and alternative discourses and research literature on depression as a mental
illness. Our objective is to demonstrate how the unique geospatial characteristics of
rural and remote Australian communities pose unique challenges for the management
and treatment of depression, particularly for women and other disadvantaged social
groups. Although feminist and alternative discourses have largely remained outside
mental health arenas, their potential to consider different bodies of evidence, such as the
range of barriers rural and remote Australians face in accessing and utilising mental
health services in comparison with urban counterparts, is argued invaluable to the
treatment and prevention of major depression.
Keywords: Depression, rural Australia, rurality, sociology of medicine, social
change, women.