title: Reasons for not seeking general medical care among individuals with serious mental illness.
abstract: OBJECTIVE
  The study compared delays in seeking general medical care among adults with serious mental illness and a general population sample. Associations of delays with health status and use of emergency department services among individuals with serious mental illness were also assessed.
  
  
  METHODS
  Data for 271 persons with serious mental illness (clinic sample) and 40,016 participants in the National Health Interview Survey (NHIS sample) were compared.
  
  
  RESULTS
  Fifty-three percent of the clinic sample and 13% of the NHIS sample reported delays, most because of difficulties accessing services. In the clinic sample, delays were associated with receipt of routine care at a public clinic, rather than a physician's office; more severe depressive symptoms; and functional difficulties. Delays were also associated with poorer health status and use of emergency department services.
  
  
  CONCLUSIONS
  Integration of services as envisioned in the Affordable Care Act and targeted case management may reduce delays among individuals with serious mental illness.
authors.forename: Ramin
authors.initials: R
authors.lastname: Mojtabai
authors.forename: Bernadette
authors.initials: B
authors.lastname: Cullen
authors.forename: Anita
authors.initials: A
authors.lastname: Everett
authors.forename: Katie L
authors.initials: KL
authors.lastname: Nugent
authors.forename: Akira
authors.initials: A
authors.lastname: Sawa
authors.forename: Vandad
authors.initials: V
authors.lastname: Sharifi
authors.forename: Yoichiro
authors.initials: Y
authors.lastname: Takayanagi
authors.forename: Jaimie S
authors.initials: JS
authors.lastname: Toroney
authors.forename: William W
authors.initials: WW
authors.lastname: Eaton
mesh_terms: D000328:Adult; D001294:Attitude to Health; D001714:Bipolar Disorder / Q000523:psychology*; D003865:Major Depressive Disorder / Q000523:psychology*; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006296:Health Services / Q000706:statistics & numerical data; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D058991:Patient Protection and Affordable Care Act; D011618:Psychotic Disorders / Q000523:psychology*; D012559:Schizophrenia; D012565:Schizophrenic Psychology