The Effect of Social Networks and Social Support on Mental Health Services Use, Following a Life Event, among the Baltimore Epidemiologic Catchment Area Cohort

Abstract

The study examined the association between life events and mental health services use, accounting for social networks and social support. Main and stress-buffering effects were estimated using longitudinal data from the Baltimore Epidemiologic Catchment Area cohort (1,920 participants in 1993-1996, of whom 1,071 were re-interviewed in 2004-2005). Following a life event, the odds of using general medical services were increased by almost 50% when there was increased social support from spouse/partner (referral function). The odds of using mental health services within general health setup were reduced by 60% when there was increased support from relatives (stress-reduction function). Increased social support from friends and relatives was associated with a 40-60% decreased odds of using specialty psychiatric services after experiencing different life events (stress-reduction function). Overall, social support rather than social networks were more strongly associated with increased mental health service use following a life event. The implications for service delivery and program development are discussed.

The Relationship between Drug User Stigma and Depression among Inner-City Drug Users in Baltimore, MD

“…Link and colleagues 34 conclude that the stigma associated with belonging to a stigmatized group may be expressed through discrimination, separation, and loss of status. Lack of social support may lead to depression 37 and drug use relapse. 38 Drug user stigma may also lead to rejection by non-drug users 34 and greater affiliation with other drug users.…”

Social networks, mental health problems, and mental health service utilization in OEF/OIF National Guard veterans

“…This argument is supported by studies that have found that perceived support mediates the effect of structural support on mental health problems or is a stronger predictor of mental health problems [16,17,21,[58][59][60][61] or of health care utilization [62,63] than structural support. However, concerns have arisen that perceived social support might be influenced by negative mood states [64].…”

Age-Related Concomitants of Obtaining Mental Health Care in Adulthood

“…Additionally, more social support has been associated with less use of mental health services. 13 Older adults tend to report fewer social contacts than other age groups do, 22 suggesting that the association between social support and obtaining mental health may be significant for old er but not younger adults. The existing research on predisposing and need factors associated with obtaining mental health care has yet to examine the interaction of age with these factors.…”

“…For example, among individuals with depression, those with broader social support were less likely to obtain mental health care. 8,13 In dividuals with more social support may not obtain mental health care as frequently as those with low levels of social support due to receiving more in formal support from friends and family members. 6 Thus, smaller networks and less support appear to be predisposing factors for use of mental health services.…”