Recorded presentation

Michelle Hampton, RN, MS, CS, School of Nursing, University of California, San Francisco, Department of Community Health Systems, San Francisco, CA 94143, 510-278-6148, michellehamp@yahoo.com

Objectives: This study’s purpose was to determine factors influencing choices about health service use among individuals with severe mental illness (SMI). Participants (N=20) with co-occurring general health problems (Axis I and Axis III diagnosis) were recruited in short-term residential programs in San Francisco. Methods: This qualitative study utilized grounded theory method to analyze data from interviews and field notes. Descriptive data was collected also. Results: Findings indicate that SMI adults often perceive emergency treatment as their only option. Reasons reported include: being turned away from treatment without severe signs of illness, lack of insurance or unawareness of benefits eligibility, and negative experiences with healthcare personnel. Furthermore, participants highly praised the care received in county emergency and acute care facilities. Other factors influencing choice findings included: high rates of substance-induced medical crises, lack of support from family, and unawareness of client’s medical conditions in psychiatric facilities. Conclusions: This study indicates positive reinforcement has occurred encouraging utilization of emergency services and negative reinforcement has led clients to avoid outpatient services. Participants were knowledgeable regarding their illnesses and able to articulate symptoms of illness well. Failure to communicate symptoms appeared to reflect the participant’s perception of a lack of response to their reports.

Learning Objectives: At the conclusion of the session, the participants will be able to

• List 3 factors influencing health care choice among individuals with severe mental disorders.
• Describe reasons that individuals with severe mental disorders report for using emergency services.
• Discuss the barriers to health care access for individuals with severe mental disorders.

Keywords: Adult and Child Mental Health, Health Care Access

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

Recorded presentation