Barriers to Primary Medical Care Among Patients at a Community Mental Health Center

Abstract

People with chronic mental disorders may be at risk of reduced access to medical treatment and poor quality of medical care. The authors examined receipt of and barriers to medical treatment among patients at a community mental health center. Fifty-nine patients completed a validated instrument for measuring access to medical care and the quality of primary care. Their responses indicated problems with access to care, and their scores were significantly lower than those of the general population on all four domains used to assess the quality of primary medical care. The findings suggest the need for community mental health centers to better assess and address barriers to primary medical care.

Self-Efficacy and Self-Care: Missing Ingredients in Health and Healthcare among Adults with Serious Mental Illnesses

“…This qualitative study confirms similar reports of various systemic and financial barriers to accessing quality medical care and some of the interpersonal challenges with healthcare providers that adults with serious mental illnesses experience [19][20][21][22][23]. A new and concerning obstacle that emerged in this study was participants' limited knowledge and selfefficacy regarding active self-management of their physical health.…”

“…Commonly cited barriers include problems with transportation [19][20][21][22], poor coordination, comprehensiveness, or continuity of care [21][22][23], and lack of insurance coverage and affordability [19,20]. Adults with serious mental illnesses also describe interpersonal challenges with providers, such as medical staff's unfamiliarity with mental illnesses, impersonal interactions with physicians, and vague information about treatment [19,21,23].…”

Associations of multiplicity of comorbid health conditions, serious mental illness, and health care costs

“…In addition, it raises awareness of expenditure-related concerns for individuals who are coping with both a serious mental illness and one or more comorbid medical conditions. The findings may reflect prior studies indicating that medical conditions are not well managed by patients or providers for individuals with SMI (Daumit, Crum, Guallar, & Ford, 2002;Druss, Bradford, Rosenheck, Radford, & Krumholz, 2000;Levinson Miller, Druss, Dombrowski, & Rosenheck, 2003). When medical and psychiatric disorders are not well managed, conditions worsen and health care costs can increase.…”

“…When medical and psychiatric disorders are not well managed, conditions worsen and health care costs can increase. Furthermore, individuals with SMI face access barriers (e.g., cost) to seeking medical treatment (Chadwick, Street, McAndrew, & Deacon, 2012;Levinson Miller et al, 2003). They often seek services primarily from behavioral health specialists, who typically lack sufficient training to treat medical conditions and contend with time, staffing, and equipment constraints related to assessing for physical health needs (Carney, Allen, & Doebbeling, 2002;Druss et al, 2008;Koyanagi, 2004).…”

“…They often seek services primarily from behavioral health specialists, who typically lack sufficient training to treat medical conditions and contend with time, staffing, and equipment constraints related to assessing for physical health needs (Carney, Allen, & Doebbeling, 2002;Druss et al, 2008;Koyanagi, 2004). Subsequently, medical conditions often fail to be diagnosed or addressed in behavioral health settings (Levinson Miller et al, 2003).…”