Access to primary care for people with serious mental health and/or substance use issues: A qualitative study
People living with serious mental health and/or substance use issues face unique barriers accessing primary care (health care provided by a medical professional that is a patient’s first point of entry into the medical system) and often end up as unattached patients. Unattached patients are people who do not have regular access to a primary care provider (i.e., a doctor, nurse, or nurse-practitioner). We want to learn about what happens when people with serious mental health and/or substance use issues go to the doctor or try to go to the doctor and don’t get the care they need. We also want to learn about positive primary care experiences. We want to know what has helped people with mental health and/ or substance use issues access medical care.
In addition to some members of the Re:searching for LGBTQ Health team, partners on this project include The Empowerment Council, Parkdale Activity & Recreation Centre, Scadding Court Community Centre, Sherbourne Health Centre, Somerset West Community Health Centre, The Ontario College of Family Physicians, Susan Pigott and Barney Savage from CAMH and Dr. Simone Vigod from Women’s College Hospital. These partners contribute diverse and valuable insights which will help us to use our results to improve access to primary care for people with mental health and substance use issues.
Like all of our current projects, this is a community-based research (CBR) project. As such, we are concerned with asking questions that are important to people who are the focus of the research, in this case consumer/survivors, and including consumer/survivors in the design and development of the project.
We used both interviews and a short questionnaire to learn about people’s primary care experiences. In the interview we asked people who have experienced mental health and/or substance use issues to talk about their experiences seeking medical care. The questionnaire asked questions regarding one’s identity or background such as their age, gender, and ethnic or cultural background. We also interviewed service providers about what they think prevents people with mental health and/or substance use issues from accessing primary care and what supports them to access primary care.
We want to use the information gained from this project to provide ideas for programs and policies that will improve access to medical care for people with mental health and/or substance use issues.
- Principal Investigator: Dr. Lori Ross
- Co-Investigators: Dr. Simone Vigod (Women’s College Hospital), Barney Savage (CAMH), Jennifer Chambers (Empowerment Council), Jan Kasperski (Ontario College of Family Physicians)
- Project Coordinator: Jason Oliver
- Research Assistants: Myera Waese and Dean Spence
Funded by the Centre for Addiction & Mental Health Development and Dissemination Fund
- Final recommendations to increase primary care access for people living with mental health and substance use issues.
- Tips for clients seeking primary healthcare to help them understand their rights.
- An educational intervention addressing values and attitudes of primary health care providers. This intervention will be delivered to nursing students at Toronto universities during the 2013-2014 academic year.
- A community report that summarizes study findings in accessible language.
- A policy brief to use for dialogue with health care funders and other policy- makers.
- A CAMH presentation in September 2013.