Factors related to the use of ambulatory mental health services in three providers plans

Diehr, Paula; Price, Kurt; Matin, Diane P.

doi:10.1016/0277-9536(86)90274-1

Cited by 6 publications

(4 citation statements)

References 19 publications

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“…Seven to eight percent of the NHANES participants reported using mental health services from mental health professionals which is comparable to estimates (5-11%) from previous studies that have used self-reports (Barker et al, 2004;Bland, Newman, & Orn, 1997;Elhai & Ford, 2007;Kessler et al, 1999;Regier et al, 1993;Wang et al, 2006) or administrative records (Diehr, Price, Williams, & Martin, 1986;Simon, Grothaus, Durham, VonKorff, & Pabiniak, 1996). Higher estimates of mental health utilization (8-20%) have been reported in studies that used a broader definition of mental health services that included general practitioners or family physicians, religious or spiritual advisors, or any other healers (chiropractor, herbalist, or spiritualist) as well as psychiatrists, psychologists, social workers, counselors, or mental health professionals (Barker et al, 2004;Bland et al, 1997 Wang et al, 2005).…”

Section: Discussionsupporting

confidence: 76%

Gender, mental health service use and objectively measured physical activity: Data from the National Health and Nutrition Examination Survey (NHANES 2003–2004)

Janney

Richardson

Holleman

et al. 2008

Mental Health and Physical Activity

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OBJECTIVE: To examine the relationship between physical activity levels measured objectively by accelerometry and the use of mental health services (MHS) in a representative sample of males and females. METHOD: NHANES 2003-2004 is a cross-sectional study of the civilian, non-institutionalized US adult population. Participants reported whether or not they had seen a mental health professional during the past 12 months. Three measures of daily physical activity (light minutes, moderate-vigorous minutes, and total activity counts) and sedentary minutes were determined by accelerometry. The relationship between physical activity and use of MHS was modeled with and without adjustments for potential socioeconomic and health confounders. RESULTS: Of the 1846 males and 1963 females included in this analysis, 7 and 8% reported seeing mental health professionals during the past 12 months, respectively. Men who used MHS were significantly less active than men who did not use MHS (227,700 versus 276,900 total activity counts, respectively, p < 0.05). Men who did not use MHS engaged in 38 min (95% CI 16.3, 59.0) more of light or moderate-vigorous physical activity per day than men who used MHS. Physical activity levels of women, regardless of MHS use, were significantly lower than men who did not use MHS. Differences in total physical activity between women who did and did not use MHS were small (1.3, 95% CI - 14.0, 11.4). CONCLUSION: Men and women who used MHS were relatively sedentary. Additional research is warranted to determine if increasing physical activity levels results in improved mental health in individuals who use MHS.

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Section: Discussionsupporting

confidence: 76%

Gender, mental health service use and objectively measured physical activity: Data from the National Health and Nutrition Examination Survey (NHANES 2003–2004)

Janney

Richardson

Holleman

et al. 2008

Mental Health and Physical Activity

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“…Similarly, given previous research on the relationship between problem severity, complexity and clinical needs (Castel, Rush, Urbanoski, & Toneatto, 2006), the relationship between higher overall problem severity and mismatched care might be anticipated. Prior research has shown that once in the system, individuals with low education may actually receive less care (Diehr, Price, Williams, & Martin, 1986;Lorant et al, 2003) -a finding which is consistent with the present study. One possible explanation of this is a lack of resources (e.g., poor housing, financial problems) that prevents individuals from adequately coping with the social impairment of a mental disorder (Aneshensel & Phelan, 1999) which may also impede their capacity to advocate for support (Saxena, Thornicroft, Knapp, & Whiteford, 2007).…”

Section: Discussionsupporting

confidence: 93%

Predictors of mismatched community mental health care among persons with co-occurring substance use and mental disorders

Koegl¹,

Rush

2011

Mental Health and Substance Use

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Prior research demonstrates that persons with co-occurring substance use and mental problems tend to have higher needs and receive less-than-optimal care, yet it is not known what factors predict such mismatch in service need and use. The aim of the article is to explore client characteristics associated with a mismatched level of care for persons with and without co-occurring disorders within a provincial community mental health system. For this, standardized assessments were completed by trained clinical staff for 5051 cases, representing 41,051 individuals enrolled across 407 community mental health programs. Assessments consisted of the Colorado Client Assessment Record and a Support and Service Profile from which co-occurring disorder status and global indices of current and recommended levels of care were derived. Thirteen client-level variables were entered as main effects and as interaction terms (with co-occurring disorder) in a logistic regression to predict whether clients were underserved at two or more levels below recommended levels. Having a co-occurring disorder significantly increased the odds of under-service nearly tenfold (OR ¼ 9.94). Six other variables predicted under-service: having a personality disorder, not working, not completing high school, having criminal justice system involvement, high overall problem severity and being male (OR range ¼ 2.95-1.35). Within the cooccurring disorder group, only two variables, having schizophrenia and not being on medication, emerged as significant independent predictors of underservice. While having a co-occurring disorder is associated with receiving less overall care in general, the findings illustrate that schizophrenia and medication use are important contributing factors.

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“…The authors found that no differences existed in the proportion of persons who used mental health services by plan, but that the reliance on primary care providers in the managed care plans resulted in two to three times fewer mental health visits and lower costs (Diehr et al 1986). In another study of case management for a community-based mentally ill population, case-managed patients were found to use more services and to have higher costs, with little effect on their quality of life (Franklin, Solovitz, Mason, et al 1987).…”

Section: Effects Of Case Management On Utilization and Costsmentioning

confidence: 96%

“…A study on outpatient mental health services utilization examined the effect of primary care providers in managed care plans compared to that of Blue Cross physicians in an FFS plan (Diehr et al 1986). The authors found that no differences existed in the proportion of persons who used mental health services by plan, but that the reliance on primary care providers in the managed care plans resulted in two to three times fewer mental health visits and lower costs (Diehr et al 1986).…”

Section: Effects Of Case Management On Utilization and Costsmentioning

confidence: 99%

Managed Care for Preventive Services: A Review of Policy Options

Schauffler

Rodriguez²

1993

Medical Care Review

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Factors related to the use of ambulatory mental health services in three providers plans

Cited by 6 publications

References 19 publications

Gender, mental health service use and objectively measured physical activity: Data from the National Health and Nutrition Examination Survey (NHANES 2003–2004)

Gender, mental health service use and objectively measured physical activity: Data from the National Health and Nutrition Examination Survey (NHANES 2003–2004)

Predictors of mismatched community mental health care among persons with co-occurring substance use and mental disorders

Managed Care for Preventive Services: A Review of Policy Options

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