The space of access to primary mental health care: A qualitative case study

• Published in: Health & place Vol. 18; no. 3; pp. 536 - 551
• Main Authors: Kovandžić, Marija, Funnell, Emma, Hammond, Jonathan, Ahmed, Abdi, Edwards, Suzanne, Clarke, Pam, Hibbert, Derek, Bristow, Katie, Dowrick, Christopher
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01-05-2012
• Subjects: Access; Access to health care; Adolescent; Adult; Aged; Aged, 80 and over; Common mental illness; Disadvantaged people; England; Ethnic minorities; Ethnicity; Female; Health Services Accessibility; Health technology assessment; Humans; Male; Mapping; Mental health; Mental Health Services; Mental illness; Middle Aged; Models, Theoretical; Positioning; Poverty; Primary care; Primary Health Care; Primary mental health care; Qualitative Research; Social sciences; Socioeconomic status; Somali; Somalia - ethnology; Spatial analysis; United Kingdom; Wellbeing; Young Adult; England; Somalia; Access; Common mental illness; Ethnicity; Somali; Primary care
• ISSN: 1353-8292; 1873-2054
• DOI: 10.1016/j.healthplace.2012.01.011

Guided by theoretical perspectives of relational social science, this paper draws on reanalyses of multiple qualitative datasets related to a multi-ethnic, economically disadvantaged area in Liverpool, UK, with the aim to advance general understanding of access to primary mental health care while using local Somali minority as an instrumental focus.
The findings generate a novel concept: the space of access. The shape and dynamics of the space of access are determined by at least four fields of tensions: understandings of area and community; cognitive mapping of mental well-being, illness and care; positioning of primary care services; and dynamics of resources beyond the ‘medical zone’ of care.
The conclusions indicate a need for de-centring and re-connecting the role of medical professionals within primary care which itself needs to be transformed by endorsement of multiple avenues of access to diverse support and intrepid communication among all involved actors.