• depression;
  • mental health literacy;
  • rural;
  • young men


Objective: To examine rural and urban differences in depression-related mental health literacy, experience of depression and help-seeking.

Design: Cross-sectional population-based survey stratified by rural and urban area.

Setting: A random and representative sample of South Australian rural and urban young men aged between 15 and 30 years.

Outcome measures: Mental health literacy as determined by recognition and exposure to classical symptoms of depression; perceived helpfulness of various interventions and treatment-seeking behaviour.

Results: Recognition of depression increased significantly in rural and urban young men between 1998 and 2008. More rural young men than urban men identified symptoms of depression in 1998 (odds ratio (OR): 1.53, 95% confidence interval (CI), 1.01–2.40, P < 0.05), but that was not evident in 2008 (OR: 1.32, 95% CI, 0.80–2.25, P = 0.30). Both groups were more likely to have a close friend experience symptoms of depression and to use antidepressant medications in 2008 compared with 1998. Rural young men experienced a significant increase in recognition of personal depressive symptoms (OR: 3.73, 95% CI, 1.72–8.40) and levels of confidence in psychiatrists and psychologists (OR: 2.40, 95% CI, 1.34–4.31) in 2008 compared with 1998. Both rural and urban young men were significantly less likely to rate dealing with problems on their own as helpful in 2008 as in 1998.

Conclusions: There has been an increase in both rural and urban young male mental health literacy between 1998 and 2008, especially in rural young men. Whether this will translate into a reduction of depression and associated suicide, with a reversal of the rural/urban suicide differential, remains to be seen.