Original ArticlesA Qualitative Evaluation of Barriers to Care for Trauma-Related Mental Health Problems Among Low-Income Minorities in Primary CareChung, Joyce Y. MD*; Frank, Lori PhD†; Subramanian, Asha MD‡; Galen, Steve MSHA,MSABS§; Leonhard, Sarah MD∥; Green, Bonnie L. PhD¶Author Information *Intramural Research Program, National Institute of Mental Health, Bethesda, MD; †Patient-Centered Outcomes Research Institute, Washington, DC; ‡Department of Family Medicine, Georgetown University Medical School, Washington, DC; §Primary Care Coalition, Silver Spring, MD; ∥Greater Baden Medical Services, Brandywine, MD; and ¶Department of Psychiatry, Georgetown University Medical School, Washington, DC. The views expressed are those of the Dr. Chung and do not reflect the official position or views of the US Federal Government, National Institutes of Health, or the National Institute of Mental Health. The views expressed in this article are those of Dr. Frank and do not necessarily reflect the official position or views of the Patient-Centered Outcomes Research Institute. Send reprint requests to Joyce Y. Chung, MD, NIMH, NIH/DHHS, 10 Center Drive 6-5340 MSC 1276, Bethesda, MD 20892-1276. E-mail: firstname.lastname@example.org. The Journal of Nervous and Mental Disease: May 2012 - Volume 200 - Issue 5 - p 438-443 doi: 10.1097/NMD.0b013e31825322b3 Buy Metrics Abstract This study aimed to identify barriers and facilitators of mental health care for patients with trauma histories via qualitative methods with clinicians and administrators from primary care clinics for the underserved. Individual interviews were conducted, followed by a combined focus group with administrators from three jurisdictions; there were three focus groups with clinicians from each clinic system. Common themes were identified, and responses from groups were compared. Administrators and clinicians report extensive trauma histories among patients. Clinician barriers include lack of time, patient resistance, and inadequate referral options; administrators cite reimbursement issues, staff training, and lack of clarity about the term trauma. A key facilitator is doctor-patient relationship. There were differences in perceived barriers and facilitators at the institutional and clinical levels for mental health care for patients with trauma. Importantly, there is agreement about better access to and development of trauma-specific interventions. Findings will aid the development and implementation of trauma-focused interventions embedded in primary care. © 2012 Lippincott Williams & Wilkins, Inc.