The role of physical health functioning, mental health, and sociodemographic factors in determining the intensity of mental health care use among primary care medical patients.

Abstract

Baylor College of MedicineThepresentstudyexaminedsociodemographicandattitudinalpredisposingfactors(gender,age, marital status, health insurance, household income, attitudes about mental health care),andneed/illnessvariables(depressionseverity,physicalandmentalhealthfunctionalstatus)aspredictorsofpast-yearmentalhealthcareuseintensity(i.e.,visitcounts)anduse/nonuse.The sample included 283 adult primary care patients from the Midwestern United States ina cross-sectional study. Nonlinear regression models demonstrated that past-year treatmentuse intensity was signiÞcantly associated with both married status and poorer physicalhealth functioning, while the use (vs. nonuse) of treatment was associated with depressionseverity. A sociodemographic and attitudinal multivariate predictor model only explained5% of the variance in treatment use intensity, but a need/illness model signiÞcantlycontributed an additional 23% variance. Poorer physical health functioning was signiÞcantin predicting treatment use intensity, while depression severity was signiÞcant in predictingthe use (vs. nonuse) of treatment. Results demonstrate the particular importance of physicalhealth problems in determining the intensity of mental health care use, and depressionseverity in determining the use/nonuse of treatment, notwithstanding the restricted socio-demographic contour of the sample.Keywords: