Research Database: Article Details

Citation:  Ruud, T., Aarre, T. F., Boeskov, B., le Husevåg, P. S., Klepp, R., Kristiansen, S. A., & Sandvik, J. (2016). Satisfaction with primary care and mental health care among individuals with severe mental illness in a rural area: A seven-year follow-up study of a clinical cohort.. International Journal of Mental Health Systems, 10 (33), 101-109.
Title:  Satisfaction with primary care and mental health care among individuals with severe mental illness in a rural area: A seven-year follow-up study of a clinical cohort.
Authors:  Ruud, T., Aarre, T. F., Boeskov, B., le Husevåg, P. S., Klepp, R., Kristiansen, S. A., & Sandvik, J.
Year:  2016
Journal/Publication:  International Journal of Mental Health Systems
Publisher:  BioMed Central
DOI:  https://doi.org/10.1186/s13033-016-0064-8
Full text:  https://ijmhs.biomedcentral.com/articles/10.1186/s13033-016-0064-8   
Peer-reviewed?  Yes
NIDILRR-funded?  Not reported

Structured abstract:

Background:  Traditionally, studies of services for people with severe mental illness have not been performed in rural areas.
Purpose:  The purpose of this study is to investigate the clinical course and satisfaction with services for individuals with severe mental illness who live in a rural area and receive community mental health services. These services were provided by primary care providers and a community mental health center (CMHC).
Study sample:  This study followed 57 patients with severe mental illness seen by the CMHC in 1992-1993. Those who were still alive in 1999 were asked to participate. Forty patients (70.2%) gave written consent to participate in the study.
Data collection and analysis:  Retrospective data was collected for the first month of contact in 1992-1993 from patient records and detailed notes. Semi-structured interviews were conducted in 1999-2000. DSM-IV diagnoses were made using OPCRIT. Assessments included the Brief Psychiatric Rating Scale Expanded version 4 (BPRS-E), the Health of the Nation Outcome Scales (HoNOS), the Global Assessment of Functioning Scale (split version), and the Practical and Social Functioning Scale (PSF).
Findings:  Findings of this study showed improvements in psychiatric problems. Patients with schizophrenia improved primarily in psychotic symptoms. Patients with severe affective disorders improved primarily in affective symptoms. There were large variations in the use of primary care and mental health services, with more intensive specialized mental health services for individuals with schizophrenia spectrum disorders than severe affective disorders. Overall, participants were satisfied with the services that were provided by CMHC. Participants were most satisfied with their general practitioners, and were more satisfied with local outpatient and inpatient services than with hospital inpatient services and medication.
Conclusions:  Individuals with severe mental illness living in rural areas value local services that emphasize relationships and close collaborations among the community mental health care and their primary care providers. General practitioners can play a key role for this population.

Disabilities served:  Chronic mental illness
Populations served:  Rural and remote communities
Interventions:  Psychological counseling