Journal of Contemporary Psychotherapy

, Volume 42, Issue 1, pp 45–54 | Cite as

Examining Factors Associated with Primary Care and Continuity of Care Among Adults with Severe Mental Illness

  • Carolyn S. Dewa
  • Lorne Tugg
  • Vicky Stergiopoulos
  • Abbas Ghavam-Rassoul
  • Wayne K. deRuiter


A number of studies have consistently reported that there is a greater prevalence of mental illness among the most socioeconomically disadvantaged. At the same time, there is evidence that services are not optimally accessed by the most socioeconomically disadvantaged; the most in need of care are also the most likely to have unmet healthcare needs. Of people with mental illnesses, those with severe mental illnesses (SMI) are the most at risk of poverty and the least likely to have optimal care. In the past, specialized community mental health services have been identified as the primary provider for people with SMI. However, there is growing interest in using the primary care setting as the main source of mental health care where both medical treatment and psychotherapy can be accessed. In this paper, we examine factors related to primary care use (and in turn, pharmacologic and psychotherapies) for people who are socioeconomically disadvantaged and who have a SMI.


Severe mental illness Continuity of care Schizophrenia Socioeconomic disadvantage 



The authors would like to thank the anonymous reviewers for their helpful suggestions. The authors are also grateful for the excellent research assistance provided by Nancy Chau, Desmond Loong, Lucy Trojanowski and Halina Trojanowska. This project was funded by the Canadian Institutes of Health Research. Dr. Dewa also gratefully acknowledges the support provided by her CIHR/PHAC Applied Public Health Chair. The Centre for Addiction and Mental Health receives funding from the Ontario Ministry of Health and Long-Term Care to support research infrastructure.


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Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  • Carolyn S. Dewa
    • 1
    • 2
  • Lorne Tugg
    • 2
    • 3
  • Vicky Stergiopoulos
    • 2
    • 3
  • Abbas Ghavam-Rassoul
    • 3
    • 4
  • Wayne K. deRuiter
    • 1
  1. 1.Work & Well-Being Research & Evaluation ProgramCentre for Addiction and Mental HealthTorontoCanada
  2. 2.Department of PsychiatryUniversity of TorontoTorontoCanada
  3. 3.St. Michael’s HospitalTorontoCanada
  4. 4.Department of Family and Community MedicineUniversity of TorontoTorontoCanada

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