Engagement in primary care treatment by persons with severe and persistent mental illness

Arch Psychiatr Nurs. 2012 Aug;26(4):272-84. doi: 10.1016/j.apnu.2011.12.001. Epub 2012 Jan 20.


Even when primary care provider relationships exist, persons with severe and persistent mental illness (SPMI) are more likely to be undertreated and seek care from emergency room settings. The purpose of this study was to describe the social process of engagement in primary care treatment from the perspective of persons with SPMI. Using grounded theory and semistructured interviews, 32 adults were interviewed. The process of engagement includes mattering, being perceived as credible and capable, and working together. Clinical, education, and research implications are discussed. Future studies should explore engagement in primary care with this population from the perspective of providers.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Antipsychotic Agents / adverse effects
  • Antipsychotic Agents / therapeutic use
  • Bipolar Disorder / diagnosis
  • Bipolar Disorder / nursing*
  • Bipolar Disorder / psychology*
  • Chronic Disease
  • Emergency Services, Psychiatric* / statistics & numerical data
  • Female
  • Health Services Needs and Demand
  • Health Services Research
  • Humans
  • Interview, Psychological
  • Male
  • Metabolic Syndrome / chemically induced
  • Middle Aged
  • Ohio
  • Patient Participation
  • Patient Satisfaction*
  • Physician-Patient Relations
  • Primary Health Care* / statistics & numerical data
  • Retreatment
  • Schizophrenia / diagnosis
  • Schizophrenia / nursing*
  • Schizophrenic Psychology*
  • Utilization Review / statistics & numerical data


  • Antipsychotic Agents