Reasons for not seeking general medical care among individuals with serious mental illness

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.