A Qualitative Study Examining the Perceived Barriers and Facilitators to Medical Healthcare Services among Women with a Serious Mental Illness

Perceptions of Barriers to Physical Health Care for People with Serious Mental Illness: A Review of the International Literature

“…People with SMI are more likely than those without SMI to have challenging living conditions, low quality of life, and a lack of resources fundamental to gaining contact and access to the health care system. Barriers reported were lack of social support and social isolation (Borba et al, 2012;Happell, Scott, Platania-Phung, & Nankivell, 2012;McCabe & Leas, 2008). A social factor could be not wanting others to know that one may have a physical health problem; for the statement, "Were you concerned that your partner, parents, or others might find out about your problems if you went for help?"…”

“…17.5% of the homeless with SMI responded in the affirmative (Kim et al, 2007, p. 368). Financial issues were considerable barriers, including a shortage of money (Happell et al, 2012;McCabe & Leas, 2008;O'Day, Killeen, Sutton, & Iezzoni, 2005); cost of care (Borba et al, 2012;O'Day et al, 2005), concern with rising finanicial debt as part of considering whether to access care services (Schmutte et al, 2009), and insurance coverage (Borba et al, 2012;Decoux, 2005;O'Day et al, 2005;Schmutte et al, 2009). Cost was an issue to access for 34% (proportion representing a "yes" response) of the participants in Kim et al's study (2007) and 12% endorsed this issue in the Drapalski et al (2008) study of veterans in the US.…”

“…These included lack of knowledge on health (McCabe & Leas, 2008), symptoms of SMI and psychiatric disability (O'Day et al, 2005), helplessness (Decoux, 2005), anxiety or fear on finding out about medical problems-such as a fear of the results of medical tests (Borba et al, 2012;Miller et al, 2007), issues with accessing services (Mesidor et al, 2011;O'Day et al, 2005), and side-effects of medication such as fatigue (Happell et al, 2012). Beliefs of consumers with SMI also were considered in studies on barriers.…”

Physical Health Examinations in a Psychiatric Setting: The Interactions between Medical Doctor and Patients

“…Evidently, this is not uncommon. To like the health professional and feel the person listens and cares are all factors that facilitate good health care (Bellamy et al, 2016;Lester, Tritter, & Sorohan, 2005), and negative experiences can in turn disempower the patients (Ewart, Bocking, Happell, Platania-Phung, & Stanton, 2016) patients will be more likely to trust other health professionals they are referred to by a health care provider they trust and feel comfortable with (Borba et al, 2012).…”

A Randomized Clinical Trial Investigating the Effect of a Healthcare Access Model for Individuals with Severe Psychiatric Disabilities

“…A lack of coordination and continuity of care as well as a lack of integration of primary and mental health care may compromise the medical care that individuals with psychiatric disabilities do receive (Cradock-O'Leary et al 2002;McCabe and Leas 2008;Lawrence and Kisely 2010). Systemic and provider-level factors have also been implicated in qualitative studies including problems related access and integration (Pahwa et al 2010;Kaufman et al 2012) as well as non-medical reasons such as societal stigma and self-stigma (Pahwa et al 2010;Borba et al 2012;Van Den Tillaart et al 2009). Negative attitudes among healthcare providers have been cited in several studies as an important factor, leading to poor communication with primary care providers and the provision of less than adequate care (McCabe and Leas 2008;Lester et al 2005;Pahwa et al 2010;Van Den Tillaart et al 2009).…”