A qualitative study: barriers and facilitators to health care access for individuals with psychiatric disabilities

Psychiatr Rehabil J. Spring 2011;34(4):285-294. doi: 10.2975/34.4.2011.285.294.


Objective: This qualitative study was conducted as part of a larger randomized trial to examine barriers and facilitators to accessing and providing comprehensive primary health care for individuals with serious mental illnesses. We examined the perspectives of administrators and providers in a behavioral health organization surrounding the use of a nurse practitioner model of delivering primary healthcare.

Methods: Ten key informant interviews were conducted and analyzed using qualitative data analysis software. Concepts and themes regarding access to and delivery of primary healthcare were inductively derived from the data.

Results: Results confirmed significant issues related to chronic physical health problems among individuals with psychiatric disabilities and detailed a host of barriers to receiving health care as well as the perceived benefits of the nurse practitioner intervention. Financial challenges played a significant role in the organization's ability to make primary and mental health care integration a sustainable endeavor. In addition, staff faced increased burdens on their time due to adding a focus on physical health to their existing job duties.

Conclusions and implications for practice: A nurse practitioner stationed in a behavioral healthcare setting is viewed by administrators and providers as extremely beneficial in addressing issues of access to comprehensive and integrated primary healthcare for individuals with severe psychiatric disabilities but sustaining such a model of care is not without organizational challenges.

MeSH terms

  • Delivery of Health Care, Integrated
  • Health Services Accessibility*
  • Health Status
  • Humans
  • Interviews as Topic
  • Mental Disorders / rehabilitation*
  • Mental Health Services
  • Nurse Practitioners
  • Primary Health Care*