The Healthcare Access Experiences of People in Jamaica with Co-Morbid Serious Mental Illness and Chronic Physical Illness and Their Caregivers: A Mixed-Methods Study

Abstract

Globally, people with serious mental illnesses (SMIs) experience significant challenges with healthcare access. This increases their risk of developing chronic physical illnesses (CPIs) and results in negative health outcomes and shorter life expectancy. The Jamaican public mental health service has undertaken several transformations to increase the accessibility of mental health services and improve outcomes for people with mental illnesses. Despite this, there is an absence of research exploring the prevalence of CPIs among people with SMIs and their experiences accessing healthcare in Jamaica. This study seeks to address the dearth of research by exploring the prevalence of CPIs among people with SMIs, as well as their experiences and their caregivers’ experiences of healthcare access. The study utilised a convergent mixed-methods design with a dominant qualitative strand. Surveys were conducted with 306 people with SMIs attending mental health clinics across Jamaica. In-depth interviews were also conducted with 23 people with SMIs and with five of their caregivers. The findings of the study revealed that approximately 29% of people with SMIs also had one or more CPI. Three themes outlined key influences of healthcare access for this patient population: 1) money, family, and social support, 2) emphasis on the medical model, and 3) healthcare culture and expectations. The findings of the study indicate that social and cultural factors underpin the healthcare access experienced by this population and call for multi-sectoral and inter-disciplinary strategies to address the healthcare access needs of people with comorbid SMIs and CPIs.