Recorded presentation

Tasseli McKay, MPH¹, Eugenia Eng, DrPH¹, Lynn Blanchard, PhD², and Sheila Pfaender, MS³. (1) Health Behavior and Health Education, University of North Carolina - Chapel Hill, Rosenau Hall - Campus Box 7440, Chapel Hill, NC 27599, (919) 542-6323, tmckay@email.unc.edu, (2) Carolina Center for Public Service, University of North Carolina, Bank of America Center, Suite 201, 137 E. Franklin St., Campus Box 3142, Chapel Hill, NC 27599, (3) North Carolina Institute for Public Health, University of North Carolina - Chapel Hill, CB #8165, Chapel Hill, NC 27599

Evidence suggests that stigma and labor market participation impact access to services among individuals with mental illness and addiction. Relationships among these constructs are typically only examined at the individual level. Moreover, the constructs lack empirical grounding in the experiences of people with mental illness and addiction.

Given recent legislation decentralizing public mental health services in NC, this study aimed to inform policymakers by: (1) exploring possible economic and sociocultural determinants of access to resources from the perspective of consumers of mental health and addiction services, and (2) comparing their “insider” perspectives with those of service providers. Data were collected through 60 semi-structured interviews and 17 focus group interviews with service providers and consumers of mental health and addiction services in three rural NC counties. Session notes and verbatim transcripts were analyzed using Atlas/ti. Findings were validated by service providers and members of a local consumer advisory board.

A total of 102 men and women participated in one of 17 focus groups. Sixty service providers completed the interviews. While further research is needed, our findings suggest that the determinants of access can be framed with constructs from Social Ecology and Political Economy of Health, including public policy regarding mental health and addiction services, public opinion about persons with mental illness and addiction, and labor market characteristics of rural communities. An urgent need exists to address the consequences of these recent policy reforms for persons with mental illness and addiction, and the communities of which they are a part.

Learning Objectives:

At the end of this session, participants will be able to
• Discuss the application of constructs from Social Ecology and the Political Economy of Health to local perspectives on access to resources for individuals with mental illness and addiction in three rural NC counties.
• Compare and contrast the perspectives of service providers and persons using mental health and addiction services.
• Articulate a grounded theory of the social determinants of access to resources among people with mental illness and addiction.

Keywords: Access and Services, Mental Health

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

Recorded presentation