Barriers, Facilitators, and Preferences for Mental Health Services Among Patients With Systemic Lupus Erythematosus: A Qualitative Study

• Published in: Arthritis care & research (2010) Vol. 76; no. 7; pp. 914 - 925
• Main Authors: Goldschen, Lauren, Peng, Cynthia S., Mufson, Michael J., Feldman, Candace H., Case, Siobhan M., Costenbader, Karen H., Amonoo, Hermioni L.
• Format: Journal Article
• Language: English
• Published: Boston, USA Wiley Periodicals, Inc 01-07-2024; Wiley Subscription Services, Inc
• Subjects: Adult; Aged; Anxiety disorders; Female; Health care; Health services; Health Services Accessibility; Humans; Interviews as Topic; Lupus; Lupus Erythematosus, Systemic - psychology; Lupus Erythematosus, Systemic - therapy; Male; Mental health; Mental health care; Mental Health Services; Middle Aged; Patient Preference; Patients; Population studies; Qualitative Research; Social Stigma; Systemic lupus erythematosus
• ISSN: 2151-464X; 2151-4658; 2151-4658
• DOI: 10.1002/acr.25321

Objective
Although patients with systemic lupus erythematosus (SLE) experience high levels of depression and anxiety disorders, evidence concerning patient perceptions of facilitators and barriers to effective uptake of mental health services (eg, referral to therapists and psychiatrists, psychoeducational interventions, or support groups) is limited.
Methods
We conducted semistructured qualitative interviews with 15 adults with SLE to explore patient experiences and perceptions of mental health services to identify facilitators and barriers to accessing mental health care among patients with SLE. Qualitative interviews were conducted via telephone and audio recorded for transcription and directed content analysis using NVivo software by two coders.
Results
The median age of the 15 participants was 48 years, 87% were female, 33% identified as Black or African American, and 33% identified as Hispanic or Latino. Qualitative themes were organized into three domains: barriers, facilitators, and preferences for mental health services. Barriers to the use of mental health services include mental health stigma, sociodemographic factors, lack of autonomy, and time commitment. Facilitators to the use of mental health services included strong relationships with their rheumatologists and mental health care clinician experience with patients with SLE. Preferences for mental health services included education‐based formats, mental health providers who work with patients with SLE, peer group formats, demographically and disease‐matched psychological resources, and an emphasis on non–disease‐related activities.
Conclusion
In the setting of persistent unmet psychosocial needs of patients living with SLE, data from this qualitative study will inform the development and refinement of mental health interventions that bolster psychological wellbeing in the SLE population.