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. 2015 Oct 13:16:135.
doi: 10.1186/s12875-015-0353-3.

Barriers and facilitators to primary care for people with mental health and/or substance use issues: a qualitative study

Lori E Ross  1   2 , Simone Vigod  3 , Jessica Wishart  4 , Myera Waese  5 , Jason Dean Spence  6 , Jason Oliver  7 , Jennifer Chambers  8 , Scott Anderson  9 , Roslyn Shields  10
Affiliations

Barriers and facilitators to primary care for people with mental health and/or substance use issues: a qualitative study

Lori E Ross et al. BMC Fam Pract. .

Abstract

Background: 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.

Method: 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.

Results: 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.

Conclusions: 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.

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Figures

Fig. 1
Fig. 1
Barriers and facilitators to primary care access for people living with mental health and/or substance use issues: Ontario, Canada, 2011–2012
See this image and copyright information in PMC

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