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Table 2 Description of the analysis process

From: Access to primary and specialized somatic health care for persons with severe mental illness: a qualitative study of perceived barriers and facilitators in Swedish health care

Meaning unit

Code

Category

Barrier/facilitator at individual or organizational level

Theme

When I finally did go to emergency department for help, my blood sugar levels were so high that I really shouldn’t have been able to stay upright. What I mean is, the reason why I waited so long before getting help was that I’m afraid they’re going to tell me you’ve got these problems because of your bipolar illness and the side effects of your drugs. You’re afraid to go to the doctor’s because that’s the last thing you want is to be told.

Afraid of not being taken seriously

Self-stigmatization

Individual-level barrier

Main barrier: the gap between the organization of the health care system and patients’ health care needs.

When our patients seek treatment for their somatic conditions it’s usually got quite advanced. They don’t seek help for the early symptoms and they often aren’t already registered at a health centre. If you need help, it’s very difficult for them to make a phone call, wait in a telephone queue, wait to be phoned back. Which means that I, as the person who is treating them, often make the phone calls for my patients to make things easier.

Making it easier for patients to get in touch with the health services.

Access to a professional contact

Organizational-level facilitator

The main facilitators: the links between the patients with SMI and the health care departments.