TY - JOUR AU - R. Instone AU - A. Achinanya AU - C. Burton AU - E. Chambers AU - M. Horspool AU - T. Isherwood AU - P. Oliver AU - V. Huddy A1 - AB - BACKGROUND: Primary care is often the first point of contact for adults with complex mental health difficulties, yet many experience persistent barriers to accessing timely and appropriate support. Despite policy commitments to integrated and equitable care, there remains a need to better understand how individuals make sense of distress and navigate services that may struggle to meet complex needs. This study aimed to better understand the experiences of adults with complex mental health difficulties as they access primary care services. It sought to further understand how they made sense of their difficulties accessing care and their psychological distress. METHOD: This study used a qualitative design with reflexive thematic analysis. Nineteen participants with complex mental health difficulties were interviewed using a semi-structured schedule. They were recruited via their GP practices. RESULTS: Three themes were identified: participants' desire to understand why they felt the way they did, the mental health condition itself creating barriers to care, and the precarity of self-management and help. An overarching theme of "Contradictions" was evident across all three themes. "Contradictions" included professionals talking of connecting but then distancing, help being offered but never arriving, trauma being present but ignored, and diagnosis getting in the way of receiving care. CONCLUSIONS: Overall, the study provided further evidence that those with complex mental health difficulties are currently underserved in the NHS. Novel insight into their health literacy questioned the assumptions that those with complex mental health difficulties lack understanding; rather, it provides evidence that services need to collaborate effectively with service users to enable better communication. AD - Tees, Esk And Wear Valleys NHS Foundation Trust, Darlington, UK.; University of Sheffield, Sheffield, UK.; , Sheffield, UK.; Sheffield Health Partnership University NHS Foundation Trust, Sheffield, UK.; University of Leeds, Leeds, UK.; University of Sheffield, Sheffield, UK. v.huddy@sheffield.ac.uk. AN - 42092783 BT - BMC Prim Care C5 - Healthcare Disparities CP - 1 DA - 05/2026 DO - 10.1186/s12875-026-03322-5 DP - NLM ET - 20260506 IS - 1 JF - BMC Prim Care LA - eng N2 - BACKGROUND: Primary care is often the first point of contact for adults with complex mental health difficulties, yet many experience persistent barriers to accessing timely and appropriate support. Despite policy commitments to integrated and equitable care, there remains a need to better understand how individuals make sense of distress and navigate services that may struggle to meet complex needs. This study aimed to better understand the experiences of adults with complex mental health difficulties as they access primary care services. It sought to further understand how they made sense of their difficulties accessing care and their psychological distress. METHOD: This study used a qualitative design with reflexive thematic analysis. Nineteen participants with complex mental health difficulties were interviewed using a semi-structured schedule. They were recruited via their GP practices. RESULTS: Three themes were identified: participants' desire to understand why they felt the way they did, the mental health condition itself creating barriers to care, and the precarity of self-management and help. An overarching theme of "Contradictions" was evident across all three themes. "Contradictions" included professionals talking of connecting but then distancing, help being offered but never arriving, trauma being present but ignored, and diagnosis getting in the way of receiving care. CONCLUSIONS: Overall, the study provided further evidence that those with complex mental health difficulties are currently underserved in the NHS. Novel insight into their health literacy questioned the assumptions that those with complex mental health difficulties lack understanding; rather, it provides evidence that services need to collaborate effectively with service users to enable better communication. PY - 2026 SN - 2731-4553 ST - Experiences of people with complex mental health difficulties accessing help from primary care services: a qualitative interview study T1 - Experiences of people with complex mental health difficulties accessing help from primary care services: a qualitative interview study T2 - BMC Prim Care TI - Experiences of people with complex mental health difficulties accessing help from primary care services: a qualitative interview study U1 - Healthcare Disparities U3 - 10.1186/s12875-026-03322-5 VL - 27 VO - 2731-4553 Y1 - 2026 ER -