title: A qualitative study examining the perceived barriers and facilitators to medical healthcare services among women with a serious mental illness.
abstract: OBJECTIVE
  This qualitative study investigates the barriers and facilitators to accessing and utilizing healthcare services among women with a serious mental illness (SMI).
  
  
  METHODS
  A purposive sample of 30 poor, urban, predominantly African-American women with a diagnosis of an SMI was recruited. Interviews were audio-taped and transcribed verbatim. Data analysis was guided by a modified constant comparison approach.
  
  
  RESULTS
  The findings highlight a variety of nonmedical factors that serve as both barriers and facilitators to accessing and utilizing medical healthcare services, such as a trusting relationship with a mental health provider and a women's social network.
  
  
  CONCLUSIONS
  Nonmedical factors and personal circumstances seem to be important factors influencing pathways to healthcare services among women with an SMI. Efforts to better engage and retain women with an SMI into healthcare will need to better acknowledge and incorporate the larger social context of the women's lives.
authors.affiliation: Rollins School of Public Health, Department of Behavioral Sciences and Health Education, Emory University, Atlanta, Georgia, USA. cborba@partners.org
authors.forename: Christina P C
authors.initials: CP
authors.lastname: Borba
authors.forename: Lara
authors.initials: L
authors.lastname: DePadilla
authors.forename: Frances A
authors.initials: FA
authors.lastname: McCarty
authors.forename: Silke A
authors.initials: SA
authors.lastname: von Esenwein
authors.forename: Benjamin G
authors.initials: BG
authors.lastname: Druss
authors.forename: Claire E
authors.initials: CE
authors.lastname: Sterk
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D003266:Continuity of Patient Care; D005239:Fear; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D007407:Interviews as Topic; D001523:Mental Disorders / Q000175:diagnosis* / Q000523:psychology; D008605:Mental Health Services / Q000706:statistics & numerical data*; D008875:Middle Aged; D010465:Perception; D010817:Physician-Patient Relations; D036301:Qualitative Research; D012720:Severity of Illness Index; D012944:Social Support; D012959:Socioeconomic Factors; D035502:Trust; D014505:Urban Population