Date of Graduation

Summer 8-10-2018

Document Access

Project/Capstone - Global access

Degree Name

Master of Science in Behavioral Health (MSBH)


School of Nursing and Health Professions

First Advisor

Dr. Kelly McDermott


Background: Regular access to primary care can positively impact long-term, chronic conditions. However, medically underserved individuals, particularly individuals with Severe Mental Illnesses(SMI), typically underutilize primary care. Root causes include client level factors such as socioeconomic barriers, provider level issues such as lack of training or general knowledge of SMI issues, and system level factors such as a lack of coordinated services. Methods: The present study conducted a needs assessment to identify the most influential of these factors on clients at an Acute Residential Treatment Center in San Francisco, California. The needs assessment consisted of semi-structured client and staff interviews. Results: Both staff members and clients interviewed found that client level factors had the most significant impact on client primary care utilization as compared to provider and system level factors. More specifically, a need for housing was reported to be the greatest client level competing factor in prioritizing primary care utilization. Discussion: Recommendations included a group curriculum focusing on peer-led chronic disease management.