TY - JOUR
KW - Adolescent
KW - Adult
KW - Aged
KW - Aged, 80 and over
KW - Female
KW - Health Services Accessibility
KW - Humans
KW - Male
KW - Mental Disorders
KW - Mental Health Services/utilization
KW - Middle Aged
KW - Patient Acceptance of Health Care
KW - Primary Health Care
KW - Young Adult
AU - J. Lamb
AU - P. Bower
AU - A. Rogers
AU - C. Dowrick
AU - L. Gask
A1 - 
AB - Knowledge about depression, access and help-seeking has increasingly been influenced from a range of disciplines including clinical and applied social science. A range of interventions can improve outcomes of depression and anxiety. However, many in need do not seek help, or their interaction with care-givers does not address their needs. We carried out a systematic search for qualitative articles focusing on the experiences of eight exemplar groups with exceptional problems in access (the homeless, long-term unemployed, adolescents with eating disorders, depressed elderly people, advanced cancer sufferers, patients with medically unexplained symptoms, asylum seekers and people from black and minority ethnic groups). Twenty articles representing these groups were selected, findings were then developed using qualitative meta-synthesis, this suggested a range of mechanisms accounting for poor access among these groups. Many regarded their mental health problems as rooted in social problems and employed a variety of self-management strategies to maintain function. These strategies could involve social withdrawal, focusing available resources on close family relationships and work roles. Over-investment in these roles could result in a sense of insecurity as wider networks were neglected. Material disadvantage affected both the resources people could bring to performing social roles and influenced help-seeking. A tacit understanding of the material, psychological and social 'costs' of engagement by patients and health professionals could influence decisions to seek and offer help. These costs were felt to be proportionally higher in deprived, marginalized and minority communities, where individual resources are limited and the stigma attached to mental ill-health is high.
BT - Health (London, England : 1997)
C5 - Healthcare Disparities
CP - 1
CY - England
DO - 10.1177/1363459311403945
IS - 1
JF - Health (London, England : 1997)
N2 - Knowledge about depression, access and help-seeking has increasingly been influenced from a range of disciplines including clinical and applied social science. A range of interventions can improve outcomes of depression and anxiety. However, many in need do not seek help, or their interaction with care-givers does not address their needs. We carried out a systematic search for qualitative articles focusing on the experiences of eight exemplar groups with exceptional problems in access (the homeless, long-term unemployed, adolescents with eating disorders, depressed elderly people, advanced cancer sufferers, patients with medically unexplained symptoms, asylum seekers and people from black and minority ethnic groups). Twenty articles representing these groups were selected, findings were then developed using qualitative meta-synthesis, this suggested a range of mechanisms accounting for poor access among these groups. Many regarded their mental health problems as rooted in social problems and employed a variety of self-management strategies to maintain function. These strategies could involve social withdrawal, focusing available resources on close family relationships and work roles. Over-investment in these roles could result in a sense of insecurity as wider networks were neglected. Material disadvantage affected both the resources people could bring to performing social roles and influenced help-seeking. A tacit understanding of the material, psychological and social 'costs' of engagement by patients and health professionals could influence decisions to seek and offer help. These costs were felt to be proportionally higher in deprived, marginalized and minority communities, where individual resources are limited and the stigma attached to mental ill-health is high.
PP - England
PY - 2012
SN - 1461-7196; 1363-4593
SP - 76
EP - 104
EP - 
T1 - Access to mental health in primary care: a qualitative meta-synthesis of evidence from the experience of people from 'hard to reach' groups
T2 - Health (London, England : 1997)
TI - Access to mental health in primary care: a qualitative meta-synthesis of evidence from the experience of people from 'hard to reach' groups
U1 - Healthcare Disparities
U2 - 21486918
U3 - 10.1177/1363459311403945
VL - 16
VO - 1461-7196; 1363-4593
Y1 - 2012
ER -