Mental health and/or substance use issues are associated
with significant disparities in morbidity and mortality. The aim of this study
was to identify the mechanisms underlying poor primary care access for this
population.
This was a community-based participatory action qualitative
study, in which 85 adults who self-identified as having a serious mental health
and/or substance use issue and 17 service providers from various disciplines
who worked with this population participated in a semi-structured interview.
Client, service provider and health system barriers to
access were identified. Client factors, including socioeconomic and
psychological barriers, make it difficult for clients to access primary care,
keep appointments, and/or prioritize their own health care. Provider factors,
including knowledge and personal values related to mental health and substance
use, determine the extent to which clients report their specific needs are met
in the primary care setting. Health system factors, such as models of primary
care delivery, determine the context within which both client and service
provider factors operate.
This study helps elucidate the mechanisms behind poor
primary health care access among people with substance use and/or mental health
issues. The results suggest that interdisciplinary, collaborative models of
primary healthcare may improve accessibility and quality of care for this
population, and that more education about mental health and substance use
issues may be needed to support service providers in providing adequate care
for their clients.
Below: Barriers and facilitators to primary care access for people living with mental health and/or substance use issues: Ontario, Canada, 2011–2012
Full article at:
By:
1Dalla Lana School of Public Health,
University of Toronto, 155 College St. Suite 560, Toronto M5T 3M7Ontario,
Canada
2Social and Epidemiological Research
Department, Centre for Addiction and Mental Health, 33 Russell St. Room T406,
Toronto M5S 2S1Ontario, Canada
3Women’s College Hospital and Research
Institute, 76 Grenville Street Rm. 7234, Toronto M5S 1B2, Ontario, Canada
4Department of Psychiatry, University of
Toronto, 250 College St., 8th Floor, Toronto M5T 1R8Ontario, Canada
5The Empowerment Council, 33 Russell St.
Room 2008, Toronto M5S 2S1, Ontario, Canada
6CATIE, 555 Richmond Street West, Suite 505,
Toronto M5V 3B1, Ontario, Canada
7Communications and Partnerships, Centre for
Addiction and Mental Health, 100 Stokes Street, Toronto M6J 1H4, ON, Canada
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