New Voices: Working in a ‘goldfish bowl’ – ethics in rural practice

A question that I have been asked as frequently in my life as 'So, can you read my mind then?' is 'So, you must be one of the Baco family?' Baco is my family nickname, first given to my late grandfather in World War II (nobody is sure why!). In the 10 years since flying the nest, my family heritage has been questioned in numerous places including a pub in Glasgow, a national NHS conference and the departure lounge at Charles-de-Gaulle airport. This is a common experience if, like me and a million other Scots, you were born and raised in a rural community.

Within the literature on rural practice there is no agreed definition of what constitutes a 'rural' area. However, in 2014 the Scottish Government suggested a 'rural' area in Scotland will have fewer than 3000 residents and be defined as either 'accessible rural' or 'remote rural' dependent on whether the drive to a settlement of more than 10,000 residents is under or over 30 minutes in length (see tinyurl.com/qhw2jva). So, with a population of 9000 residents my home town of Stornoway on the Isle of Lewis is not classified as rural itself, but every other settlement in the Western Isles would be. With a total population of approximately 26,000 people, it might be surprising to learn that NHS Western Isles has no local Clinical Psychology Service.