Understanding Factors Associated with Mental Health Service Use of Racial/Ethnic Minority Public Housing Residents

Background and Purpose: Racial/ethnic minority groups residing in public housing settings are exposed to multiple stressors impacting their mental health—they are likely to suffer from high prevalence of mental illness. For example, previous literature reported that African Americans in public housing were 1.7 times more likely to suffer from anxiety, mood, and/or substance use disorders in the past 12 months than their counterparts in non-public housing. Yet, mental health service use by public housing residents remains low. Untreated mental illness might result in disruptive behaviors, eviction, or serious harm to themselves or their neighbors. Little is known about the predictors of mental health service use by racial/ethnic minority public housing residents, which could help to promote early intervention. This study examined the factors associated with mental health service use of Black public housing residents.

Methods: A nationally representative sample of 455 Black public housing residents from the Collaborative Psychiatric Epidemiology Surveys was included in a weighted logistic regression. Mental health service use was assessed whether a respondent had visited any mental health specialty services, general medicine, or alternative services in the past 12 months for mental health problems. Based on the Andersen’s behavioral model of health services use and previous literature on mental health service utilization, data analysis included the following hypothesized predictors: perceived need for mental health service; mental illness including mood disorder, anxiety disorder, and substance use disorder; household income; health insurance; health clinic availability; region; and demographics including gender, age, and marital status.

Findings: The results of the logistic regression analysis indicated that perceived need for mental health service, anxiety disorder, region, and gender are significantly associated with mental health service use. The higher perceived need was, the more likely Black public housing residents used mental health services (OR=3.6, p < .05). Residents with anxiety disorders were more likely to use mental health services than their counterparts (OR=4.6, p < .01). Northeast Black residents were more likely to use mental health services than South Black residents (OR=3.7, p < .01). Male residents were less likely to use mental health services than female residents (OR=.30, p < .05).  

Implications: Findings indicate that perceived need for mental health service has a strong impact on mental health service use among Black public housing residents. This result adds support to previous literature suggesting that racial/ethnic minority groups with lower perceived need are less likely to access mental health care and more likely to wait longer to seek services. Mental health education may help increase awareness of mental illness symptoms and mental health services, and improve perceived need. Collaborative partnerships between public housing authorities and social workers, particularly in south region, are needed to disseminate mental health education to public housing residents. Further mental health research with more diverse racial/ethnic minority groups in public housing settings is recommended.