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BMC Primary Care
Published in: BMC Primary Care 1/2015

Open Access 01-12-2015 | Research article

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

Authors: Lori E. Ross, Simone Vigod, Jessica Wishart, Myera Waese, Jason Dean Spence, Jason Oliver, Jennifer Chambers, Scott Anderson, Roslyn Shields

Published in: BMC Primary Care | Issue 1/2015

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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.
Footnotes
1
Family Health Teams (FHTs) are the most prevalent model of shared primary care in Ontario, Canada (the setting for this research). FHTs include a variety of health professionals; commonly primary care physicians, nurses and nurse practitioners, dieticians, and social workers. FHTs are often focused on chronic disease management and prevention, community health needs and health promotion. (https://​www.​ontario.​ca/​page/​family-health-teams).
 
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Metadata
Title
Barriers and facilitators to primary care for people with mental health and/or substance use issues: a qualitative study
Authors
Lori E. Ross
Simone Vigod
Jessica Wishart
Myera Waese
Jason Dean Spence
Jason Oliver
Jennifer Chambers
Scott Anderson
Roslyn Shields
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Primary Care / Issue 1/2015
Electronic ISSN: 2731-4553
DOI
https://doi.org/10.1186/s12875-015-0353-3

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