The Impact of Community Mental Health Services on Psychiatric Medical Service Utilization of Individuals with Psychiatric Disabilities

For individuals with psychiatric disabilities, true recovery requires not only psychiatric healthcare but also access to community-based rehabilitation services that support independent living. However, South Korea’s mental health service system remains treatment-centered, with limited support for community reintegration. Comprehensive community mental health services are essential for recovery and independence in areas like employment, housing, and social participation.

Despite this need, individuals with psychiatric disabilities in South Korea show high reliance on psychiatric medical services, raising concerns about the current care system. This study hypothesizes that excessive psychiatric healthcare utilization is linked to the limited availability of community mental health services.

Using data from the National Health Insurance Service (NHIS) and regional-level data from the Korean Statistical Information Service (KOSIS), this study examines how community mental health services affect psychiatric service use. A hierarchical linear model (HLM) was applied, integrating Andersen’s healthcare utilization model. At the individual level, predisposing factors include gender and age; enabling factors include income and medical aid status; need factors include comorbidities. At the regional level, enabling factors include the number of psychiatric and community facilities, financial autonomy, and mental health budgets, while need factors include the number of individuals with psychiatric disabilities. All regional variables were standardized.

Three main findings emerged. First, inpatient days were longer in regions with more psychiatric hospitals and sanatoriums, and shorter in regions with more mental health rehabilitation facilities. Individual factors such as being male, older, on medical aid, or having more comorbidities were linked to longer hospital stays.

Second, outpatient visits were more frequent in regions with fewer rehabilitation facilities and welfare centers, suggesting these community services can reduce reliance on outpatient care. At the individual level, women, younger individuals, those on medical aid, and those with more comorbidities had more outpatient visits.

Third, the likelihood of accessing outpatient services was higher in regions with more rehabilitation facilities and welfare centers, as well as those with more registered psychiatric disabilities. Women, younger individuals, medical aid recipients, and those with fewer comorbidities were more likely to use outpatient services.

These findings suggest that expanding community mental health services—especially rehabilitation facilities and welfare centers—can reduce psychiatric inpatient days and outpatient visits, while improving access to care. These facilities act both as alternatives to medical services and as complements that enhance continuity and accessibility. Strengthening community-based services can improve the efficiency and responsiveness of South Korea’s mental health care system.