Summary of generated themes
| Levesque’s stage in episode of care | Levesque’s characteristic of health system | Theme produced from thematic analysis | Levesque’s characteristic of patient | Theme produced from thematic analysis |
| Perceiving health needs and desire for care | Approachability | Difficulties detecting mental health concerns | Ability to perceive | Mental health literacy |
| Unpreparedness for referral conversations | Denial, stoicism and self-reliance coping methods | |||
| Attribution of causality | ||||
| Seeking healthcare | Acceptability | - | Ability to seek | Stigma surrounding mental healthcare |
| Reaching healthcare | Availability and accommodation | Limited types of mental health services available | Ability to reach | Inconvenience of in-person delivery |
| Inconsistent pathways to mental health services | ||||
| Poorly timed mental health services | ||||
| Using healthcare | Affordability | Limited human resources due to underinsurance of mental healthcare | Ability to pay | Lack of full insurance coverage and high cost of psychological services |
| Healthcare consequences | Appropriateness | Underresourced system does not allow for choice or finding fit | Ability to engage | - |
| Insufficiency of generic mental health services |