Exploring the role of rurality and rural identity in mental health help-seeking behavior: A systematic qualitative review.

People living in rural areas are more likely to experience attitudinal mental health help-seeking barriers than their urban equivalents, but the role rurality plays in this inequality is poorly understood. This systematic qualitative review aimed to explore the attitudinal barriers experienced by rural residents and better define rurality’s role in them. Four attitudinal barrier themes are identified from this review as being experienced by rural residents—stoicism, stigma, distrust, and meaning, and the coexistence of multiple barriers were observed. Rurality is found to have an influence on the stoicism, stigma, and distrust barriers and is explicitly vocalized within barrier statements. With a relationship between rurality and mental health help-seeking barriers strongly implied, we endorse the need for targeted research to inform future policymaking and practice to address urban and rural mental health help-seeking inequalities.