Chung Joyce Y, Frank Lori, Subramanian Asha, Galen Steve, Leonhard Sarah, Green Bonnie L
Intramural Research Program, National Institute of Mental Health, Bethesda, MD 20892-1276, USA.
J Nerv Ment Dis. 2012 May;200(5):438-43. doi: 10.1097/NMD.0b013e31825322b3.
This study aimed to identify barriers and facilitators of mental health care for patients with trauma histories via qualitative methods with clinicians and administrators from primary care clinics for the underserved. Individual interviews were conducted, followed by a combined focus group with administrators from three jurisdictions; there were three focus groups with clinicians from each clinic system. Common themes were identified, and responses from groups were compared. Administrators and clinicians report extensive trauma histories among patients. Clinician barriers include lack of time, patient resistance, and inadequate referral options; administrators cite reimbursement issues, staff training, and lack of clarity about the term trauma. A key facilitator is doctor-patient relationship. There were differences in perceived barriers and facilitators at the institutional and clinical levels for mental health care for patients with trauma. Importantly, there is agreement about better access to and development of trauma-specific interventions. Findings will aid the development and implementation of trauma-focused interventions embedded in primary care.
