PDF(Pubmed)
Abstract：
UNASSIGNED: Although depression is common in primary care, challenges to timely intervention exist, particularly for communities of color and lower socioeconomic status. Our objective was to understand barriers and facilitators to mental healthcare access among a sample of patients receiving care at a federally qualified health center (FQHC) in Minnesota, United States.
UNASSIGNED: We qualitatively interviewed 34 patients of an urban FQHC, purposively sampled on race/ethnicity, insurance status, language, and depression symptom status (based on Patient Health Questionnaire-9 responses). We inductively and deductively analyzed interview data, leveraging theory in both the codebook development and analysis processes.
UNASSIGNED: Participants, who were predominantly English-speaking, female, not privately insured, and people of color, shared numerous barriers and facilitators to accessing mental healthcare. Prominent barriers primarily concerned healthcare providers, including perceived dismissal of mental health concerns and challenges with provider continuity. Additional barriers included the costs of mental health care, communication breakdowns, the patient portal, and community-specific perceptions of mental health. Prominent facilitators included clinic organizational factors (internal and external) and staff friendliness and warmth. Other factors including consideration of patients\' financial situation, integrated management of behavioral and physical health conditions, language concordant staff, the telehealth visit modality, and the clinic\'s social mission were also raised as facilitating access.
UNASSIGNED: Patient voices from a single FQHC illustrate the challenges and possibilities of providing mental healthcare in safety net settings. Clinical, strategy, and policy solutions can be tailored to minimize barriers and optimize facilitators documented herein.
UNASSIGNED: We qualitatively interviewed 34 patients of an urban FQHC, purposively sampled on race/ethnicity, insurance status, language, and depression symptom status (based on Patient Health Questionnaire-9 responses). We inductively and deductively analyzed interview data, leveraging theory in both the codebook development and analysis processes.
UNASSIGNED: Participants, who were predominantly English-speaking, female, not privately insured, and people of color, shared numerous barriers and facilitators to accessing mental healthcare. Prominent barriers primarily concerned healthcare providers, including perceived dismissal of mental health concerns and challenges with provider continuity. Additional barriers included the costs of mental health care, communication breakdowns, the patient portal, and community-specific perceptions of mental health. Prominent facilitators included clinic organizational factors (internal and external) and staff friendliness and warmth. Other factors including consideration of patients\' financial situation, integrated management of behavioral and physical health conditions, language concordant staff, the telehealth visit modality, and the clinic\'s social mission were also raised as facilitating access.
UNASSIGNED: Patient voices from a single FQHC illustrate the challenges and possibilities of providing mental healthcare in safety net settings. Clinical, strategy, and policy solutions can be tailored to minimize barriers and optimize facilitators documented herein.
摘要：
■尽管抑郁症在初级保健中很常见，存在及时干预的挑战，特别是对于有色人种和较低社会经济地位的社区。我们的目标是了解在明尼苏达州联邦合格的健康中心（FQHC）接受护理的患者样本中的障碍和促进者，美国。
■我们定性采访了34名城市FQHC患者，有目的地对种族/族裔进行抽样，保险状况,语言,和抑郁症状状态（基于患者健康问卷-9回答）。我们对访谈数据进行归纳和演绎分析，在码本开发和分析过程中利用理论。
■参与者，他们主要说英语，女性,不是私人保险，和有色人种，在获得精神卫生保健方面存在许多障碍和促进者。突出的障碍主要涉及医疗保健提供者，包括对精神健康问题的感知解雇和具有提供者连续性的挑战。额外的障碍包括精神卫生保健的费用，通信故障，病人入口，和社区对心理健康的看法。突出的促进者包括诊所组织因素（内部和外部）以及工作人员的友善和热情。其他因素，包括考虑患者的财务状况，行为和身体健康状况的综合管理，语言和谐的工作人员，远程医疗访问模式，诊所的社会使命也被提升为促进进入。
■来自单个FQHC的患者声音说明了在安全网设置中提供精神保健的挑战和可能性。临床,战略,和政策解决方案可以量身定制，以最大程度地减少障碍并优化此处记录的促进者。
■我们定性采访了34名城市FQHC患者，有目的地对种族/族裔进行抽样，保险状况,语言,和抑郁症状状态（基于患者健康问卷-9回答）。我们对访谈数据进行归纳和演绎分析，在码本开发和分析过程中利用理论。
■参与者，他们主要说英语，女性,不是私人保险，和有色人种，在获得精神卫生保健方面存在许多障碍和促进者。突出的障碍主要涉及医疗保健提供者，包括对精神健康问题的感知解雇和具有提供者连续性的挑战。额外的障碍包括精神卫生保健的费用，通信故障，病人入口，和社区对心理健康的看法。突出的促进者包括诊所组织因素（内部和外部）以及工作人员的友善和热情。其他因素，包括考虑患者的财务状况，行为和身体健康状况的综合管理，语言和谐的工作人员，远程医疗访问模式，诊所的社会使命也被提升为促进进入。
■来自单个FQHC的患者声音说明了在安全网设置中提供精神保健的挑战和可能性。临床,战略,和政策解决方案可以量身定制，以最大程度地减少障碍并优化此处记录的促进者。
