The Impact of Usual Care Source on Mental Health Service Use Among Adults with Disabilities and Psychological Distress: Evidence from the National Health Interview Series, 2013 to 2015

Background and Purpose:  Previous research supports the view that delayed detection and treatment of health conditions jeopardize health status and overall prognosis.  Mental health utilization among persons with disabilities in the United States has relevance in the nation’s present efforts to uncover and subsequently eliminate barriers to health care and improve service delivery to this vulnerable group whose service delivery is often fragmented. The main objective of this study was to examine the impact that having a usual source of care has on mental health service use among people with disabilities and comorbid psychological distress. 

Methods:  This cross-sectional study examined associations between mental health service utilization and a usual source of health care among adults 18 years and older with disabilities and co-occurring psychological distress. The dependent variable mental health use was defined as visiting a mental health service provider in the past 12 months.  The independent variable, usual care, was determined as having a usual source of care.  Other covariates include being a mother, sociodemographic factors (race, age, education, marital status, poverty and poverty status) and health factors (diabetes and self-rated health).  Data from the National Health Interview Series 2013 to 2015 were analyzed (N=1,647) using Logistic regressions. 

Results: After adjusting for significant variables, the results show persons with disabilities and co-occurring psychological distress that had a usual source of care were more than 3.3 times more likely of reporting using mental health services compared to those without a usual care source. Compared to mothers without disabilities, mothers with disabilities were significantly more likely to underutilize mental health services. Significant associations were also found between Black race and persons with diabetes and poor self-rated health. 

Conclusion: These findings suggests underlying sociodemographic and health factors contribution to differences in mental health service use among persons with disabilities, particularly mothers with disabilities. They are important in the context of mental health utilization among adults in the U.S with chronic and comorbid health conditions.  Future research might investigate whether results are similar in longitudinal studies given the limitation of cross-section studies.