TY - JOUR
AU - M. Ambreen
AU - C. Canning
AU - B. Lo
AU - S. M. Agarwal
AU - D. Castle
AU - B. Konkolÿ-Thege
AU - F. Sirotich
AU - S. Sockalingam
AU - T. Tajirian
AU - P. G. Tibbo
AU - M. R. van Kesteren
AU - C. Walker
AU - V. Stergiopoulos
A1 - 
AB - BACKGROUND: Individuals with serious mental illness (SMI) have higher rates of comorbid physical health conditions, poorer associated health outcomes, and die on average 10-20 years earlier than the general population. This qualitative study aimed to explore the perspectives and experiences of adults living with SMI and family members with accessing physical healthcare within primary and mental health settings in Canada. METHODS: We conducted a qualitative descriptive study using semi-structured interviews with 20 adults living with SMI and five focus groups with 18 family members between July 2023 and April 2024. After coding by two authors, thematic analysis was completed with the support of a data analysis team to identify overarching themes capturing participant experiences with accessing physical healthcare, care needs and preferences. RESULTS: Four main themes emerged from participant narratives: (1) The centrality of mental health problems in the lives of people with SMI; (2) Challenges in accessing physical healthcare; (3) The role of families in supporting access to care; (4) Perceived health priorities and preferences. There was a high degree of congruence between the perspectives of individuals living with SMI and family members. Both participant groups described challenges accessing primary care settings, fragmented health services, and a desire for person-centred, whole-person health within mental health settings, with family member support where available. CONCLUSIONS: Findings from this study highlight the need for advancing the integration of physical healthcare within mental health settings for adults living with SMI, who are less likely to engage with community-based primary care services. Enhanced access to physical healthcare could leverage multidisciplinary resources in these settings and partnerships with families. These findings can inform efforts to provide whole-person healthcare for individuals experiencing SMI. PATIENT OR PUBLIC CONTRIBUTION: The study team collaborated closely with community organizations and individuals with lived experience at every stage of this research. This included contributions to the funding proposal, the study protocol, participant recruitment, study materials, data analysis and preparing the manuscript. Individuals with lived experience and family members actively participated in management and project meetings for the duration of the study.
AD - Centre for Addiction and Mental Health, Toronto, Ontario, Canada.; Waypoint Research Institute, Waypoint Centre for Mental Health Care, Penetanguishene, Ontario, Canada.; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.; School of Medicine, University of Tasmania, Hobart, Australia.; Tasmanian Centre for Mental Health Service Innovation, Tasmanian Health Service, Hobart, Australia.; Canadian Mental Health Association Toronto Branch, Toronto, Ontario, Canada.; Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada.; Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada.; Department of Psychology and Neuroscience, Dalhousie University, Halifax, Nova Scotia, Canada.; Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada.
AN - 40130751
BT - Health Expect
C5 - Education & Workforce; Healthcare Disparities
CP - 2
DA - Apr
DO - 10.1111/hex.70224
DP - NLM
IS - 2
JF - Health Expect
LA - eng
N2 - BACKGROUND: Individuals with serious mental illness (SMI) have higher rates of comorbid physical health conditions, poorer associated health outcomes, and die on average 10-20 years earlier than the general population. This qualitative study aimed to explore the perspectives and experiences of adults living with SMI and family members with accessing physical healthcare within primary and mental health settings in Canada. METHODS: We conducted a qualitative descriptive study using semi-structured interviews with 20 adults living with SMI and five focus groups with 18 family members between July 2023 and April 2024. After coding by two authors, thematic analysis was completed with the support of a data analysis team to identify overarching themes capturing participant experiences with accessing physical healthcare, care needs and preferences. RESULTS: Four main themes emerged from participant narratives: (1) The centrality of mental health problems in the lives of people with SMI; (2) Challenges in accessing physical healthcare; (3) The role of families in supporting access to care; (4) Perceived health priorities and preferences. There was a high degree of congruence between the perspectives of individuals living with SMI and family members. Both participant groups described challenges accessing primary care settings, fragmented health services, and a desire for person-centred, whole-person health within mental health settings, with family member support where available. CONCLUSIONS: Findings from this study highlight the need for advancing the integration of physical healthcare within mental health settings for adults living with SMI, who are less likely to engage with community-based primary care services. Enhanced access to physical healthcare could leverage multidisciplinary resources in these settings and partnerships with families. These findings can inform efforts to provide whole-person healthcare for individuals experiencing SMI. PATIENT OR PUBLIC CONTRIBUTION: The study team collaborated closely with community organizations and individuals with lived experience at every stage of this research. This included contributions to the funding proposal, the study protocol, participant recruitment, study materials, data analysis and preparing the manuscript. Individuals with lived experience and family members actively participated in management and project meetings for the duration of the study.
PY - 2025
SN - 1369-6513 (Print); 1369-6513
SP - e70224
ST - Strengthening the Delivery of Physical Healthcare for Adults Living With Serious Mental Illness - A Qualitative Description of Patient and Family Member Perspectives
T1 - Strengthening the Delivery of Physical Healthcare for Adults Living With Serious Mental Illness - A Qualitative Description of Patient and Family Member Perspectives
T2 - Health Expect
TI - Strengthening the Delivery of Physical Healthcare for Adults Living With Serious Mental Illness - A Qualitative Description of Patient and Family Member Perspectives
U1 - Education & Workforce; Healthcare Disparities
U3 - 10.1111/hex.70224
VL - 28
VO - 1369-6513 (Print); 1369-6513
Y1 - 2025
ER -