{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T14:10:00Z","timestamp":1790172600986,"version":"4.1.0"},"reference-count":24,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T00:00:00Z","timestamp":1782086400000},"content-version":"vor","delay-in-days":21,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J Mental Health Nurs"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>In mental health care, the term \u2018hard\u2010to\u2010reach\u2019 is frequently used in relation to individuals and populations who have reduced access and engagement with services. While positioned as a neutral term, this term can conceal and minimise the multiple factors influencing access to and engagement with care. It also clearly places the responsibility for disengagement as an individual decision or failing, removing responsibility from services themselves. In this paper, we consider the term \u2018hard\u2010to\u2010reach\u2019 and provide a counter\u2010framing of \u2018hardly reached\u2019 to centre patterns of underservice within mental health services and systems. Using the phenomenon of being unhoused as a lens, we consider how language informs assumptions about people and populations. We propose that the label \u2018hard\u2010to\u2010reach\u2019 operates discursively to redirect attention from service limitations and reinforce deficit\u2010based positioning of marginalised people and populations. Contrary to this framing, the concept of \u2018hardly reached\u2019 refocuses attention back to the ways in which service design contributes to disengagement with care services. We highlight the obligations of mental health services and systems to recognise and effectively address structural barriers. We argue that embracing a \u2018hardly reached\u2019 position provides us with a more ethically responsive and socially just framework for understanding and addressing systemic inequities in mental health care.<\/jats:p>","DOI":"10.1111\/inm.70286","type":"journal-article","created":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T08:09:16Z","timestamp":1782115756000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["\u2018Hard\u2010to\u2010Reach\u2019 or \u2018Hardly Reached\u2019? Underservice, Marginalisation and Inequity in Care"],"prefix":"10.1111","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5252-5325","authenticated-orcid":false,"given":"Debra","family":"Jackson","sequence":"first","affiliation":[{"name":"University of Sydney  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9945-8577","authenticated-orcid":false,"given":"Carmel","family":"Bond","sequence":"additional","affiliation":[{"name":"Sheffield Hallam University  Sheffield UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adrianna","family":"Watson","sequence":"additional","affiliation":[{"name":"Brigham Young University  Provo Utah USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1453-4850","authenticated-orcid":false,"given":"Michelle","family":"Cleary","sequence":"additional","affiliation":[{"name":"University of New England  Sydney New South Wales 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