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| Code | Definition |
|
| (A) Leadership | Leadership does/does not provide direction, coordinate between different services, obtain needed resources, make timely decisions, communicate with staff. |
| (B1) Resources (space) | Lack of space includes barriers due to physical structure of facility, includes lack of space and distance barriers. |
| (B1) Resources (staffing) | Not enough staff available to provide coordinated mental health care. |
| (B1) Resources (knowledge and skills) | Specific mention of staff knowledge, skills, or abilities. It includes general comments such as “good staff” |
| (B2) Training | Training for MH procedures, including training of admin personnel |
| (B3) Work design | Intentional choices regarding how care is provided; description of how tasks are divided between staff and/or clinics including informal systems work systems designed to overcome other barriers, including mandated tasks and same day appointments |
| (C1) PC/MH boundaries | Perceived physical and/or psychological barriers between primary care and mental health clinics provide barriers to care. |
| (C2) Time pressure | Overworked staff, working through admin/lunch time |
| (C3) Staff participation | Staff “buy-in”, perceptions of mutual PC and MH participation, comfort with PC/MH referrals. It includes the use of formal and informal meetings to increase participation. |
| (D) Referral systems | Processes used to coordinate care may include specific barriers to the referral process. It including the use of electronic medical record, paging systems, checklists. |
| (E) Communication | Interpersonal communication, communication between PC and MH. |
| Patient complexity | Challenges due to complicated mental health conditions and/or medical comorbidities; patients have many health needs, including noncompliance issues |
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