Stigma;
access to medical care;
mental illness;
health care reform;
HEALTH-CARE;
PUBLIC-HEALTH;
UNITED-STATES;
DISORDERS;
EMPOWERMENT;
INDIVIDUALS;
IMPACT;
D O I:
10.1353/hpu.2014.0185
中图分类号:
R19 [保健组织与事业(卫生事业管理)];
学科分类号:
摘要:
Introduction. Wellness of people with mental illness is increasingly a public health priority This study examined factors associated with difficulties receiving medical care in adults with mental illness. Methods. In a sample of 1,670 adults with mental illness, we assessed difficulties in accessing medical care and stigma. Results. A total of 465 (28%) participants reported difficulties in accessing medical care; 211 (13%) attributed difficulties in access to stigma. Lack of comprehensive medical care coverage and mental health symptoms were associated with increased odds of perceived difficulties in accessing medical care; personal empowerment was negatively associated with perceived difficulties attributed to stigma; education was positively associated. Discussion. The findings highlight unmet need for medical care in this population and the need to recognize stigma as a barrier medical care. Interventions to empower patients and educate medical providers about wellness for people with serious mental illness could help to reduce barriers.
机构:
Univ Calif San Francisco, Sch Med, Dept Med, San Francisco, CA 94143 USA
Zuckerberg Gen Hosp, San Francisco, CA 94110 USAUniv Calif San Francisco, Sch Med, Dept Med, San Francisco, CA 94143 USA
Garcia, Maria E.
Schillinger, Dean
论文数: 0引用数: 0
h-index: 0
机构:
Univ Calif San Francisco, Sch Med, Dept Med, San Francisco, CA 94143 USA
Zuckerberg Gen Hosp, San Francisco, CA 94110 USAUniv Calif San Francisco, Sch Med, Dept Med, San Francisco, CA 94143 USA
Schillinger, Dean
Vittinghoff, Eric
论文数: 0引用数: 0
h-index: 0
机构:
Univ Calif San Francisco, Sch Med, Dept Epidemiol & Biostat, San Francisco, CA USAUniv Calif San Francisco, Sch Med, Dept Med, San Francisco, CA 94143 USA
Vittinghoff, Eric
Creasman, Jennifer M.
论文数: 0引用数: 0
h-index: 0
机构:
Univ Calif San Francisco, Sch Med, Clin & Translat Sci Inst, San Francisco, CA USAUniv Calif San Francisco, Sch Med, Dept Med, San Francisco, CA 94143 USA
Creasman, Jennifer M.
Knapp, Penelope
论文数: 0引用数: 0
h-index: 0
机构:
Univ Calif Davis, Dept Psychiat & Behav Sci, Davis, CA 95616 USAUniv Calif San Francisco, Sch Med, Dept Med, San Francisco, CA 94143 USA
Knapp, Penelope
Newcomer, John W.
论文数: 0引用数: 0
h-index: 0
机构:
Florida Atlantic Univ, Charles E Schmidt Coll Med, Dept Integrated Med Sci, Boca Raton, FL 33431 USAUniv Calif San Francisco, Sch Med, Dept Med, San Francisco, CA 94143 USA
Newcomer, John W.
Mangurian, Christina
论文数: 0引用数: 0
h-index: 0
机构:
Univ Calif San Francisco, Sch Med, Dept Psychiat, San Francisco, CA USA
Zuckerberg Gen Hosp, San Francisco, CA 94110 USAUniv Calif San Francisco, Sch Med, Dept Med, San Francisco, CA 94143 USA
机构:
Yonsei Univ, Coll Med, Dept Psychiat, Seoul 120752, South KoreaYonsei Univ, Coll Med, Dept Psychiat, Seoul 120752, South Korea
Kim, Woo Jung
Song, Youn Joo
论文数: 0引用数: 0
h-index: 0
机构:
Yonsei Univ, Coll Med, Dept Psychiat, Seoul 120752, South KoreaYonsei Univ, Coll Med, Dept Psychiat, Seoul 120752, South Korea
Song, Youn Joo
Ryu, Hyun-Sook
论文数: 0引用数: 0
h-index: 0
机构:
Yonsei Univ, Coll Med, Inst Behav Sci Med, Seoul 120752, South KoreaYonsei Univ, Coll Med, Dept Psychiat, Seoul 120752, South Korea
Ryu, Hyun-Sook
Ryu, Vin
论文数: 0引用数: 0
h-index: 0
机构:
Seoul Natl Hosp, Dept Psychiat, Seoul, South KoreaYonsei Univ, Coll Med, Dept Psychiat, Seoul 120752, South Korea
Ryu, Vin
Kim, Jae Mm
论文数: 0引用数: 0
h-index: 0
机构:
Yonsei Univ, Coll Med, Dept Psychiat, Seoul 120752, South KoreaYonsei Univ, Coll Med, Dept Psychiat, Seoul 120752, South Korea
Kim, Jae Mm
Ha, Ra Yeon
论文数: 0引用数: 0
h-index: 0
机构:
Yonsei Univ, Coll Med, Dept Psychiat, Seoul 120752, South KoreaYonsei Univ, Coll Med, Dept Psychiat, Seoul 120752, South Korea
Ha, Ra Yeon
Lee, Su Jin
论文数: 0引用数: 0
h-index: 0
机构:
Yonsei Univ, Coll Med, Inst Behav Sci Med, Seoul 120752, South KoreaYonsei Univ, Coll Med, Dept Psychiat, Seoul 120752, South Korea
Lee, Su Jin
Namkoong, Kee
论文数: 0引用数: 0
h-index: 0
机构:
Yonsei Univ, Coll Med, Dept Psychiat, Seoul 120752, South Korea
Yonsei Univ, Coll Med, Inst Behav Sci Med, Seoul 120752, South KoreaYonsei Univ, Coll Med, Dept Psychiat, Seoul 120752, South Korea
Namkoong, Kee
Ha, Kyooseob
论文数: 0引用数: 0
h-index: 0
机构:
Seoul Natl Hosp, Dept Psychiat, Seoul, South Korea
Seoul Natl Univ, Bundang Hosp, Dept Neuropsychiat, Gyeonggi Do, South KoreaYonsei Univ, Coll Med, Dept Psychiat, Seoul 120752, South Korea
Ha, Kyooseob
Cho, Hyun-Sang
论文数: 0引用数: 0
h-index: 0
机构:
Yonsei Univ, Coll Med, Dept Psychiat, Seoul 120752, South Korea
Yonsei Univ, Coll Med, Inst Behav Sci Med, Seoul 120752, South KoreaYonsei Univ, Coll Med, Dept Psychiat, Seoul 120752, South Korea
机构:
Dartmouth Hitchcock Med Ctr, Lebanon, NH 03756 USA
Geisel Sch Med Dartmouth, Hanover, NH USA
New Hampshire Dept Hlth & Human Serv, Bur Mental Hlth Serv, Concord, NH 03301 USADartmouth Hitchcock Med Ctr, Lebanon, NH 03756 USA
Brunette, Mary F.
Gowarty, Minda A.
论文数: 0引用数: 0
h-index: 0
机构:
Dartmouth Hitchcock Med Ctr, Lebanon, NH 03756 USA
Geisel Sch Med Dartmouth, Hanover, NH USADartmouth Hitchcock Med Ctr, Lebanon, NH 03756 USA
Gowarty, Minda A.
Gaughan-Maher, Ashley E.
论文数: 0引用数: 0
h-index: 0
机构:
Geisel Sch Med Dartmouth, Hanover, NH USADartmouth Hitchcock Med Ctr, Lebanon, NH 03756 USA
Gaughan-Maher, Ashley E.
Pratt, Sarah, I
论文数: 0引用数: 0
h-index: 0
机构:
Dartmouth Hitchcock Med Ctr, Lebanon, NH 03756 USA
Geisel Sch Med Dartmouth, Hanover, NH USADartmouth Hitchcock Med Ctr, Lebanon, NH 03756 USA
Pratt, Sarah, I
Aschbrenner, Kelly A.
论文数: 0引用数: 0
h-index: 0
机构:
Dartmouth Hitchcock Med Ctr, Lebanon, NH 03756 USA
Geisel Sch Med Dartmouth, Hanover, NH USADartmouth Hitchcock Med Ctr, Lebanon, NH 03756 USA
Aschbrenner, Kelly A.
Considine-Sweeny, Sheila
论文数: 0引用数: 0
h-index: 0
机构:
Greater Nashua Mental Hlth, Nashua, NH USADartmouth Hitchcock Med Ctr, Lebanon, NH 03756 USA
Considine-Sweeny, Sheila
Elliott, Jennifer
论文数: 0引用数: 0
h-index: 0
机构:
Community Partners, Los Angeles, CA USADartmouth Hitchcock Med Ctr, Lebanon, NH 03756 USA
Elliott, Jennifer
Almeida, Margaret
论文数: 0引用数: 0
h-index: 0
机构:
Mental Hlth Ctr Greater Manchester, Manchester, NH USA
Harvard Univ, Cambridge, MA 02138 USADartmouth Hitchcock Med Ctr, Lebanon, NH 03756 USA
Almeida, Margaret
L'Esperance, Alicia M.
论文数: 0引用数: 0
h-index: 0
机构:
New Hampshire Dept Hlth & Human Serv, Bur Mental Hlth Serv, Concord, NH 03301 USADartmouth Hitchcock Med Ctr, Lebanon, NH 03756 USA
机构:
Greater Los Angeles Vet Healthcare Syst, Los Angeles, CA 90073 USA
Univ Calif Los Angeles, Los Angeles, CA USAGreater Los Angeles Vet Healthcare Syst, Los Angeles, CA 90073 USA
Young, Alexander S.
Chang, Evelyn T.
论文数: 0引用数: 0
h-index: 0
机构:
Greater Los Angeles Vet Healthcare Syst, Los Angeles, CA 90073 USA
Univ Calif Los Angeles, Los Angeles, CA USAGreater Los Angeles Vet Healthcare Syst, Los Angeles, CA 90073 USA
Chang, Evelyn T.
Cohen, Amy N.
论文数: 0引用数: 0
h-index: 0
机构:
Amer Psychiat Assoc, Washington, DC USAGreater Los Angeles Vet Healthcare Syst, Los Angeles, CA 90073 USA
Cohen, Amy N.
Oberman, Rebecca
论文数: 0引用数: 0
h-index: 0
机构:
Greater Los Angeles Vet Healthcare Syst, Los Angeles, CA 90073 USAGreater Los Angeles Vet Healthcare Syst, Los Angeles, CA 90073 USA
Oberman, Rebecca
Chang, Dennis T.
论文数: 0引用数: 0
h-index: 0
机构:
Southern Nevada Vet Healthcare Syst, North Las Vegas, NV USAGreater Los Angeles Vet Healthcare Syst, Los Angeles, CA 90073 USA
Chang, Dennis T.
Hamilton, Alison B.
论文数: 0引用数: 0
h-index: 0
机构:
Greater Los Angeles Vet Healthcare Syst, Los Angeles, CA 90073 USA
Univ Calif Los Angeles, Los Angeles, CA USAGreater Los Angeles Vet Healthcare Syst, Los Angeles, CA 90073 USA
Hamilton, Alison B.
Lindamer, Laurie A.
论文数: 0引用数: 0
h-index: 0
机构:
San Diego Vet Healthcare Syst, San Diego, CA USAGreater Los Angeles Vet Healthcare Syst, Los Angeles, CA 90073 USA
Lindamer, Laurie A.
Sanford, Jesse
论文数: 0引用数: 0
h-index: 0
机构:
Univ Calif Los Angeles, Los Angeles, CA USAGreater Los Angeles Vet Healthcare Syst, Los Angeles, CA 90073 USA
Sanford, Jesse
Whelan, Fiona
论文数: 0引用数: 0
h-index: 0
机构:
Univ Calif Los Angeles, Los Angeles, CA USAGreater Los Angeles Vet Healthcare Syst, Los Angeles, CA 90073 USA
机构:
Geisel Sch Med Dartmouth, Dept Psychiat, Lebanon, NH 03756 USA
Geisel Sch Med Dartmouth, Dept Community & Family Med, Lebanon, NH USAGeisel Sch Med Dartmouth, Dept Psychiat, Lebanon, NH 03756 USA
Bartels, Stephen J.
Pratt, Sarah I.
论文数: 0引用数: 0
h-index: 0
机构:
Geisel Sch Med Dartmouth, Dept Psychiat, Lebanon, NH 03756 USAGeisel Sch Med Dartmouth, Dept Psychiat, Lebanon, NH 03756 USA
Pratt, Sarah I.
Mueser, Kim T.
论文数: 0引用数: 0
h-index: 0
机构:
Boston Univ, Ctr Psychiat Rehabil, Boston, MA 02215 USAGeisel Sch Med Dartmouth, Dept Psychiat, Lebanon, NH 03756 USA
Mueser, Kim T.
Naslund, John A.
论文数: 0引用数: 0
h-index: 0
机构:
Geisel Sch Med Dartmouth, Dartmouth Inst Hlth Policy & Clin Practice, Lebanon, NH USAGeisel Sch Med Dartmouth, Dept Psychiat, Lebanon, NH 03756 USA
Naslund, John A.
Wolfe, Rosemarie S.
论文数: 0引用数: 0
h-index: 0
机构:
Geisel Sch Med Dartmouth, Dept Psychiat, Lebanon, NH 03756 USAGeisel Sch Med Dartmouth, Dept Psychiat, Lebanon, NH 03756 USA
Wolfe, Rosemarie S.
Santos, Meghan
论文数: 0引用数: 0
h-index: 0
机构:
Geisel Sch Med Dartmouth, Dept Psychiat, Lebanon, NH 03756 USAGeisel Sch Med Dartmouth, Dept Psychiat, Lebanon, NH 03756 USA
Santos, Meghan
Xie, Haiyi
论文数: 0引用数: 0
h-index: 0
机构:
Dartmouth Psychiat Res Ctr, Lebanon, NH USAGeisel Sch Med Dartmouth, Dept Psychiat, Lebanon, NH 03756 USA
Xie, Haiyi
Riera, Erik G.
论文数: 0引用数: 0
h-index: 0
机构:
New Hampshire Bur Behav Hlth, Concord, NH USAGeisel Sch Med Dartmouth, Dept Psychiat, Lebanon, NH 03756 USA
机构:
Univ Calif Los Angeles, Semel Inst Neurosci & Human Behav, Div Child & Adolescent Psychiat, Los Angeles, CA 90024 USAUniv Calif Los Angeles, Semel Inst Neurosci & Human Behav, Div Child & Adolescent Psychiat, Los Angeles, CA 90024 USA
Peris, Tara S.
Teachman, Bethany A.
论文数: 0引用数: 0
h-index: 0
机构:
Univ Virginia, Dept Psychol, Charlottesville, VA 22903 USAUniv Calif Los Angeles, Semel Inst Neurosci & Human Behav, Div Child & Adolescent Psychiat, Los Angeles, CA 90024 USA
Teachman, Bethany A.
Nosek, Brian A.
论文数: 0引用数: 0
h-index: 0
机构:
Univ Virginia, Dept Psychol, Charlottesville, VA 22903 USAUniv Calif Los Angeles, Semel Inst Neurosci & Human Behav, Div Child & Adolescent Psychiat, Los Angeles, CA 90024 USA