Question

34 What are some primary Care Barriers of Past-Traumatic Stress Disorder?

Answer 1

• Primary care clinicians (PCCs) are often the first contact with the ambulatory health care system for patients suffering from post-traumatic stress disorder (PTSD) because most people with common mental health disorders do not seek treatment from mental health specialists.
• Many barriers hamper the ability for PCCs to deliver high quality care for PTSD. Barriers may stem from patient concerns about the consequences of revealing emotional problems (stigma) as well as the associated trauma they have experienced. Patients also face barriers to access and insurance limitations.
• Clinicians may not have sufficient knowledge about PTSD recognition and treatment which,in turn,leads to discomfort with screening and treating the problem .PCC’s ability to deliver care may also be hindered by systemic barriers. Two key system factors that are critical to care for mental health problems are access to mental health specialists and linkages with other community services such as social and legal programs to help with related social and behavioral problems.

Institutional/administrator Barriers

• Insufficient funding for treatment of mental health(MH) problems in primary care.
• Lack of integration of MH and primary care services.
• Language issues—lack of bilingual providers/translators.
• Lack of culturally informed MH resources for immigrant and non English-speaking patients.
• Patients will not always accept referral to MH provider.
• Turnover in MH providers.
• Dissatisfaction with psychiatric referral outcomes.
• Restrict scope of MH problems they will manage (severity, length of treatment)

Clinical/clinician Barriers

• Perceived social stigma of MH problems and treatment.
• Previous negative experiences with MH care.
• Time constraints in primary care visits.
• Provider reluctance to manage MH problems.
• Complexity/acuity of comorbid medical problems can overshadows other problems.