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Access to primary mental health care for hard-to-reach groups : from ‘silent suffering’ to ‘making it work’

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Kovandžić, Marija, Chew-Graham, Carolyn, Reeve, Joanne L., Edwards, Suzanne, Peters, Sarah, Edge, Dawn, Aseem, Saadia, Gask, Linda and Dowrick, Christopher (2011) Access to primary mental health care for hard-to-reach groups : from ‘silent suffering’ to ‘making it work’. Social Science & Medicine, Volume 72 (Number 5). pp. 763-772. doi:10.1016/j.socscimed.2010.11.027

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Official URL: http://dx.doi.org/10.1016/j.socscimed.2010.11.027

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Abstract

Equitable access to primary care for people with common mental health problems in the UK remains problematic. The experiences of people from hard-to-reach groups offer important insights into barriers to accessing care. In this study, we report on secondary analysis of qualitative data generated within seven previously-reported studies. Thirty-three of ninety-two available transcripts were re-analysed using a new heuristic of access, generated to frame narrative-based comparative case analysis. The remaining transcripts were used to triangulate the findings via a process of collaborative analysis between a secondary researcher, naïve to research findings of the original studies, and primary researchers involved in data generation and analysis within the original studies. This method provided a rich body of ‘fine grain’ insights into the ways in which problem formulation, help-seeking, use of services and perceptions of service quality are interlinked in a recursive and socially embedded matrix of inequitable access to primary mental health care. The findings indicate both extensive commonalities between experiences of people from different ‘hard-to-reach groups’, and considerable diversity within each group. An idiographic generalisation and aggregation of this variety of experiences points to one main common facilitator (communicated availability of acceptable mental health services) and two main common barriers (lack of effective information and multiple forms of stigma) to equitable access to primary mental health care. We conclude that there is a need to provide local care that is pluralistic, adaptive, holistic, resonant and socially conscious in order to ensure that equitable access to mental health services can become a reality.

Item Type: Journal Article
Divisions: Faculty of Medicine > Warwick Medical School > Health Sciences
Faculty of Medicine > Warwick Medical School > Health Sciences > Social Science & Systems in Health (SSSH)
Faculty of Medicine > Warwick Medical School
Journal or Publication Title: Social Science & Medicine
Publisher: Elsevier
ISSN: 0277-9536
Official Date: March 2011
Dates:
DateEvent
March 2011Published
Volume: Volume 72
Number: Number 5
Page Range: pp. 763-772
DOI: 10.1016/j.socscimed.2010.11.027
Status: Peer Reviewed
Publication Status: Published
Access rights to Published version: Open Access

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