ArticleBMJ open2019
Self-identified barriers to rural mental health services in Iowa by older adults with multiple comorbidities: qualitative interview study.
Article in BMJ open, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.
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Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it, 33 citations in OpenAlex.
- Perceived barriers to access mental health services for refugees and asylum seekers: a systematic review of qualitative studies.BMC psychiatry · 2026Pooled it
- Early Evidence of Geographic Variation in Medicare Participation Among Newly Eligible Mental Health Providers Following the 2024 Coverage Expansion.The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association · 2026Article
- Assessment of barriers to accessing mental health services in rural or remote areas using a socio-ecological resilience framework: a scoping review.International journal of mental health systems · 2026Review
- Diabetic retinopathy in rural communities: a review of barriers to access of care and potential solutions.Annals of medicine · 2025Review
- Care trajectories of people with mood disorders in Quebec using latent class and latent profile analysis methods.Journal of mood and anxiety disorders · 2025Article
- Reviews for multimorbidity risk in people with inflammatory conditions: a qualitative study.BJGP open · 2024Article
- Real-world treatment modalities, health care resource utilization, and costs among commercially insured patients with newly diagnosed major depressive disorder in the United States.Journal of managed care & specialty pharmacy · 2023Article
- The Use of Photoplethysmography in the Assessment of Mental Health: Scoping Review.JMIR mental health · 2023Article
- The impact of the COVID-19 pandemic on people who inject drugs accessing harm reduction services in an rural American state.Harm reduction journal · 2022Article
- Dissemination of a telehealth cardiovascular risk service: The CVRS live protocol.Contemporary clinical trials · 2021Article
- Prevalence of and factors associated with depression among hill tribe individuals aged 30 years and over in Thailand.Heliyon · 2020Article
Corrections and comments
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Authors and funding
3 authors at 1 institution in 1 country.
Funding
Abstract
objectivesIndividuals in rural areas face critical health disparities, including limited access to mental healthcare services and elevated burden of chronic illnesses. While disease outcomes are often worse in individuals who have both physical and mental comorbidities, few studies have examined rural, chronically-ill older adults' experiences accessing mental health services. The aim of the study was to determine barriers to finding, receiving and adhering to mental health treatments in this population to inform future interventions delivering services.
designWe conducted a qualitative study of barriers and facilitators to mental healthcare access. 19 interviews were analysed deductively for barriers using a modified version of Penchansky and Thomas's theory of access as an analytical framework.
settingThis study was conducted remotely using telephonic interviews. Patients were located in various rural Iowa towns and cities.
participants15 rural Iowan older adults with multiple physical comorbidities as well as anxiety and/or depression.
resultsWe found that while patients in this study often felt that their mental health was important to address, they experienced multiple, but overlapping, barriers to services that delayed care or broke their continuity of receiving care, including limited knowledge of extant services and how to find them, difficulties obtaining referrals and unsatisfactory relationships with mental health service providers.
conclusionsOur findings indicate that intervention across multiple domains of access is necessary for successful long-term management of mental health disorders for patients with multiple chronic comorbidities in Iowa.
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