Barriers to care in severe mental illness: accounts from perpetrators of intra-familial homicide.
OBJECTIVE
To review perceptions of barriers to receiving effective mental health care described by patients who had committed intra-familial homicide in the context of untreated severe mental illness.


METHODS
Semi-structured interviews addressed issues such as support, help-seeking, experience of illness, and what participants felt might have helped prevent the death(s). Transcripts were analysed for themes related to barriers to help-seeking.


RESULTS
Themes identified included: hiding or minimizing difficulties, lack of knowledge or understanding of mental illness, loss of control in the context of illness, seduction by the illness, reality-distorting effects of the illness, distortion of interpersonal relationships, diminished ability to trust and difficulty acknowledging need for medication.


CONCLUSIONS
Barriers to care exist at individual, interpersonal and wider societal levels and need to be addressed at all of them.
Child and Family Unit, Starship Children's Health, Auckland, New Zealand. josephinest@xtra.co.nz
Josephine
J
Stanton
Jeremy
J
Skipworth
D005260:Female; D006708:Homicide / Q000523:psychology*; D006801:Humans; D008297:Male; D008605:Mental Health Services / Q000706:statistics & numerical data*; D009520:New Zealand; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D011329:Prisoners; D011618:Psychotic Disorders / Q000523:psychology; D012559:Schizophrenia; D012565:Schizophrenic Psychology