Can mortality studies change clinical care and health policy?: Commentary on “Psychological distress, physical illness, and mortality risk,” by Farhat Rasul, MSc, Stephen Stansfield, PhD, Carole Hart, PhD, Charles Gillis, MD

Abstract

Purpose: To test the extent to which adolescent victimization predicts subsequent use of mental health services in a prospectively assessed nationwide sample of high school students.Methods: Data were analyzed from 4590 adolescents participating in Waves I and II of the National Longitudinal Survey of Adolescent Health. In-home self-report data were collected on four types of personal victimization, mental health service use, demographics, psychological symptoms/needs, and family connectedness. Using logistic regression analysis, adolescents’ victimization and background variables at Wave I were entered as predictors of subsequent mental health service use, measured at Wave II.Results: In this national sample, 19.6% of the respondents stated that they had experienced at least one of four forms of personal victimization in the prior year. Of those reporting personal victimization, 11.0% stated they had used mental health services at 1-year follow-up, as compared to 9.2% of those who did not report any personal victimization. After controlling for background variables in logistic regression analyses, however, adolescents’ victimization reported at Wave I was associated with significantly lower odds of subsequent mental health service use at Wave II.Conclusions: Evidence does not indicate that adolescents’ victimization prompts mental health service use, and rather indicates that in some instances victimization is associated with lower odds of subsequent mental health service use. These findings raise questions about the degree to which adolescents receive needed professional mental health supports in the wake of serious violence exposure.