The Role of Social Network and Support in Mental Health Service Use: Findings From the Baltimore ECA Study

A Prospective Examination of Service Use by Abused and Neglected Children Followed Up Into Adulthood

Initiation and Use of Public Mental Health Services by Persons With Severe Mental Illness and Limited English Proficiency

A significant number of people with mental illness do not use mental health services to receive treatment for their symptoms. This study examined the hypothesis that social network and social support affect mental health service use. Data were from the Baltimore cohort of the Epidemiologic Catchment Area study, a prospective cohort study that gathered data over four time points. This study examined data gathered in 1993-1996 (N=1,920) and 2004-2005 (N=1,071). The study examined indicators of social network and social support in relation to four types of service use (general medical, mental health within general medical, specialty psychiatric, and other human services) with multivariate logistic regression. Examples of other human services include a self-help group or crisis center for help with any psychological problem. Weighted generalized estimating equations were used for the analyses. Among persons with major depressive disorder, generalized anxiety disorder, panic disorder, or alcohol use disorder in the past year or psychological distress in the past few weeks, general medical service use was reduced when the frequency of contact with relatives or friends occurred less than daily, but it was increased by about 40% when there was a higher than median level of spousal support. In contrast, receiving general medical services for mental health problems was reduced by about 50% when there was a higher than median level of social support from relatives. Specialty psychiatric service use was reduced when there was regular contact with six or more relatives and there was a higher than median level of social support from friends and relatives. None of the social network or social support measures were significantly (p</=.01) associated with use of other human services. Increased contact with the social network and higher levels of social support were associated with greater use of general medical services. However, more social support was associated with use of fewer services within the specialty psychiatric sector.

Social Networks and Their Relationship to Mental Health Service Use and Expenditures Among Medicaid Beneficiaries

Do Canada and the United States Differ in Prevalence of Depression and Utilization of Services?

This study assessed patterns of mental health service use among adolescents who had attempted suicide and examined factors associated with their service use at individual, family, and community levels. Bivariate and multiple logistic regression analyses were conducted with data from 877 adolescents aged 12-17 who had attempted suicide in the past 12 months and who participated in the 2000 National Household Survey on Drug Abuse. Of the 877 adolescents, less than half (45%) reported that they had used mental health services in the past 12 months. Adolescents from racial-ethnic minority groups were less likely than whites to receive inpatient or outpatient mental health treatment, even when the analyses controlled for other demographic, individual, and family and community characteristics. Poor self-perceived health and living in a single-parent family were associated with use of inpatient services. Female gender, higher family income, participation in extracurricular activities, and the presence of symptoms of anxiety or disruptive disorders were associated with use of outpatient services. Use of school-based mental health services was associated only with participation in extracurricular activities. The mental health service needs of suicidal adolescents, especially those from ethnic minority groups and lower-income families, too frequently remain unmet. Larger racial-ethnic disparities were found in use of inpatient and outpatient mental health services than in use of school-based services. Mental health services offered within school settings can reach suicidal adolescents who need services but may experience barriers to standard types of care.

Patterns of Public Mental Health Service Use by Age in Patients With Schizophrenia

Mental health service use among individuals with traumatic brain injury: Exploring the role of social support, employment, and insurance.

Concern over rising health care costs has put pressure on providers to reduce costs, purportedly by reducing inpatient care and increasing outpatient care. Inpatient and outpatient claims were analyzed for adult users of mental health services (180,000/year on average) from a national study group of 3.9 million privately insured individuals per year from 1993 to 1995. Costs and treatment days per patient were compared across diagnostic groups and stratified by whether patients were hospitalized. Inpatient mental health costs fell $2,507 (30.4%) over the period, driven primarily by decreases in hospital days per patient per year (19.9%), with smaller changes in the proportion of enrollees who received inpatient care (increase of 0.8%) and a decrease in per diem costs (9.1%). Outpatient mental health costs also declined over the period, falling 13.6% for patients also using inpatient services and 14.6% for patients receiving only outpatient care. Patients whose primary diagnosis was mild to moderate depression saw the largest decreases in inpatient cost per patient (42.8%); those diagnosed with schizophrenia experienced the smallest decrease (23.5%). For patients using outpatient services only, those diagnosed with substance abuse experienced the largest decrease in costs (23.5%); those diagnosed with schizophrenia experienced the smallest decrease (8.6%). Substantial cost reductions for mental health services are primarily a result of reductions in inpatient and outpatient treatment days. Declines in inpatient service use were not accompanied by increases in outpatient service use, even for severely ill patients requiring hospitalization. Managed care has not caused a shift in the pattern of care but an overall reduction of care.

This study compared the prevalence of depression and the determinants of mental health service use in Canada and the United States. The study used data from preliminary analyses of the 2003 Joint Canada/United States Survey of Health, which measured Canadian (N=3,505) and United States (N=5,183) resident ratings of health and health care services. Cross-national comparisons were made for the 12-month prevalence of DSM-IV major depression, 12-month service use for mental health reasons according to the type of professional seen, and determinants of service use. The rates of depression were similar in Canada (8.2%) and the United States (8.7%). However, U.S. respondents without medical insurance were twice as likely as Canadian respondents and U.S. respondents with medical insurance to meet the criteria for depression. Rates of mental health service use did not differ between Canada (10.1%) and the United States (10.6%). In the United States, medical insurance was not a determinant factor of service use. However, U.S. respondents with no medical insurance were more likely than the other two groups to report an unmet need. Also, among those with depression, U.S. respondents with no medical insurance were less likely to use any type of mental health service (36.5%) than U.S. respondents with medical insurance (55.7%) and Canadians (55.7%). Further, a positive correlation between a mental health need and service use was observed in Canada but not for those without medical insurance in the United States. There was no difference in the prevalence of depression and mental health service use between Canada and the United States. Among those with depression, however, disparities in treatment seeking were found to be associated with medical insurance in the United States. Both Canada and the United States need to improve access to health services for those with mental disorders, and special attention is needed for those without medical insurance in the United States.

ObjectivesMental disorders and suicidality among adolescents have been identified as a major public health concern worldwide; however, they often do not get the necessary attention from parents, school and health professional, and therefore are left untreated. This study aimed to investigate the factors associated with the use of mental health services among Australian adolescents aged 13–17 with mental disorders and/or suicidality.MethodsAdolescents aged 13–17 (n = 2134) from Young Minds Matter (YMM): the Second Australian Child and Adolescent Survey of Mental Health and Wellbeing were included in this study. The YMM is a cross-sectional nationwide survey, in which information was collected from both parents and adolescents (aged 13–17 years). Both bivariate and multivariate analyses were conducted to identify the factors that have an impact on the use of mental health services (outcome variable) in two subsamples: (1) adolescents with mental disorder and (2) adolescents with suicidality.ResultsOverall, 740 (34.7%) and 168 (7.9%) adolescents reported a mental disorder and/or suicidality, respectively. The incidence of seeking any service was higher among adolescents with suicidality (approximately 50%) compared to those with a mental disorder (about 30%). Girls, older age-group (15–17), adolescents living with disadvantaged families (lower-income, less educated and unemployed parents), those who had multiple mental disorders and history of substance use were most likely to use mental health services regardless of mental disorder and suicidality. Health services and online services were the most popular type of mental health service among adolescents aged 13–17 across two subgroups, while, school and telephone services were less utilized.ConclusionsMany adolescents with mental disorders and/or suicidality do not use mental health services. The findings indicate differences in factors associated with the use of mental health services among adolescents with mental disorder and suicidality. Further research is needed to address the specific barriers that limit the use of the services.

Patterns of Service Use in Two Types of Managed Behavioral Health Care Plans

Predictors of Likelihood and Intensity of Past-Year Mental Health Service Use in an Active Canadian Military Sample

Opportunities in mental health services research.

Mental health service use in Australia: The role of family structure and socio-economic status