223P
Identifying Disparities in Mental Health Service Utilization
Prior research primarily highlighted inadequate mental health service utilization among people with mental illness. The poor correspondence might attribute to limited understanding on factors associated with help seeking. Mental health care service utilization among people with mental illness is often heterogeneous. Meanwhile, factors have been found to be correlated with service utilization often yielded mixed results. The objective of this study is to advance our knowledge of access to care and people with mental illness by investigating correlates of mental health treatments.
Method
Data are from the 2008-2011 National Survey on Drug Use and Health (NSDUH), which is a nationally representative household survey conducted in the 50 states and the District of Columbia. Only people age 18 years or older with a mental illness (N= 40,753) were selected for this analysis. Three questions asking respondents’ past year use of psychotropic medication, inpatient mental health services, and outpatient mental health services were used to create the dependent variable, mental health treatment, which was then dichotomized for analysis. Predictors of utilization include demographics (gender, race, age, and educational level), socioeconomic factors (income, insurance status, and public assistance receipt), clinical needs factors (substance use, HIV status, and severity of illness) and service need factors (perceived need for treatments). SPSS was used to conduct bivariate and multivariate logistic regression. All significance tests were two-tailed, P<.05.
Results
The majority of people with a mental illness (62.2%) did not receive mental health care in the past year. Controlling for perceived need for treatment and severity of illness, demographic factors such as age, gender, race, and education were associated with mental health service utilization. Younger people were approximately half likely to use mental health care than the older individuals. Male (OR=.60) and people who never attended college (.77) were also substantially less likely to get mental health care. The odds of receiving mental health treatment were about 2 times greater for non-Hispanic white than Hispanic. Socioeconomic factors were related to mental health care utilization, too. Having insurance was positively associated with getting mental health treatment. The odds of receiving mental health treatment were 2.54 times higher for public insured persons and 1.68 time higher for privately insured persons. Compared to family income over $75,000, people from lower family income were less likely to receive mental health care (OR=.89 for family income less than 19,999; OR=.93 for family income between $20,000 and $49,000),
Conclusion and Implications
The finding suggests disparities among people with mental illness are ubiquitous as demographic factors are associated with mental health service use. It is useful to build programs that sensitive to individuals’ characteristics. The result also highlights policy-relevant question on equalizing access overall and eliminating family economic strain.