Patients’ with Severe Mental Disorders’ Experiences with Access to General Medical Care
Boris SAMKO, Olivien SASSIAT and Alice PERRAIN
Individuals with severe mental disorders often present with multiple somatic comorbidities that require close monitoring and an increasing level of physical healthcare as their mental health conditions worsen. Paradoxically, these patients experience insufficient monitoring for chronic physical diseases and reduced access to general medical care. Although several studies have highlighted the barriers these patients face in accessing healthcare, few have focused on their personal experiences in this area.The aim of this study was to explore these patients' experiences of accessing care provided by general practitioners (GP).Exploratory qualitative study conducted from November 2023 to June 2024. Involved a purposive, homogenous sample of ten patients with severe psychiatric disorders who were receiving day care at a hospital. Integrative analysis performed, inspired by an interpretative phenomenological approach.Access to GP care was experienced differently, like a labyrinth with multiple entrances centred around the GP. Their experiences fluctuated in phases, with changes in direction reflecting the ups and downs of their approach. Several paths were described: the labyrinthine path of carrying one's burden, the rebellious path of turning away from care, the carefree path of passively going along, the secret path of adhering to care, and the privileged path of participating in care.Patients responded to the difficulty of accessing care, exacerbated by their mental disorder, with a reflexivity that gave rise to a projection of their care. Access to care was an opportunity to seek balance and access to oneself. Their experiences highlight the need to consider them for comprehensive care by helping and promoting their empowerment for their ability to act within the framework of shared care decisions.GP, with their patient-centred approach, should be strongly involved in the care pathway for people with severe psychiatric disorders, in order to break down barriers between different types of care and facilitate collaboration with psychiatrists. Keywords: general practice; mental disorders; access to care, health; continuity of patient care
