Supporting strong families and capable communities through cross-national research

Abstract

# Background Mental and behavioral ill-health are growing global problems and while there are promising evidence-based approaches aimed at reducing their impact, availability of services varies greatly, not only across nations, but also between urban, regional, and remote locations. Rural areas face accessibility and acceptability challenges related to mental health services that are similar to barriers experienced in developing countries. Initiatives to address mental health challenges in under-served rural areas can inform global mental health strategies. # Methods Using a public health approach, we illustrate how innovations in rural communities build community capacity and capability in areas that are currently, and are likely to remain, under-served by specialist mental health services. We provide examples of initiatives and key principles of action from three locations in Nebraska, United States of American and New South Wales, Australia to highlight similarities of context and practice. # Results While each of the initiatives was developed independently, there are striking similarities across them. Similarities in initiatives include: a) recognition that solutions developed in urban settings are not necessarily the most effective in under-served rural areas, b) engagement of community members is needed to ensure acceptance of initiatives in target communities, c) each initiative involved community members acting on their own behalf with an emphasis on prevention and early intervention, and d) research is a key aspect that informs practice and has local relevance. Commonalities of contexts and environments may have played an important role in the similarities. # Conclusions Linking initiatives within and between countries can expand local, national, and global reach and impacts. If we are to meet lofty global goals related to health and wellbeing, cross-national collaborations are needed to share resources, expand expertise, and stimulate ideas necessary to develop and enhance local and global initiatives. High-income country partnerships addressing mental health in under-served areas, such as rural communities, can play a vital role in contributing to global mental health solutions.