Correlates of Mental Health Service Use Among Young Adults With Mental Illness: Results From the National Survey on Drug Use and Health
Abstract
Objective:
Methods:
Results:
Conclusions:
Methods
Sample
Measures
Demographic, developmental, and other correlates.
Mental health service outcomes.
Data Analysis
Collinearity and Missing Data
Results
Sample Characteristics
Correlate | N | Weighted N (thousands) | Outpatient services | Inpatient services | Psychotropic medication | |||
---|---|---|---|---|---|---|---|---|
% | SE | % | SE | % | SE | |||
Age | ||||||||
18–20 | 8,000 | 2,337 | 19.6 | .6 | 4.5 | .3 | 23.1 | .6 |
21–23 | 8,000 | 2,322 | 20.8 | .6 | 3.6 | .3 | 25.7 | .7 |
24–26 | 6,600 | 2,477 | 20.8 | .8 | 2.7 | .3 | 27.3 | .9 |
Gender | ||||||||
Male | 8,200 | 2,753 | 15.1 | .5 | 3.8 | .3 | 19.5 | .6 |
Female | 14,400 | 4,382 | 23.7 | .5 | 3.4 | .2 | 29.1 | .5 |
Race-ethnicity | ||||||||
Non-Hispanic white | 14,600 | 4,516 | 24.1 | .5 | 3.3 | .2 | 31.8 | .5 |
Non-Hispanic black or African American | 2,400 | 826 | 13.4 | 1.0 | 5.1 | .6 | 12.4 | .9 |
Non-Hispanic Native American/Alaska Native | 300 | 48 | 11.1 | 2.1 | 5.1 | 2.2 | 23.6 | 4.0 |
Non-Hispanic Native Hawaiian or Other Pacific Islander | 100 | 34 | 8.8 | 4.0 | 4.1 | 2.1 | 9.3 | 3.5 |
Non-Hispanic Asian | 800 | 340 | 13.3 | 1.8 | 2.6 | .7 | 9.8 | 1.4 |
Non-Hispanic more than one race | 900 | 158 | 21.4 | 2.3 | 4.4 | 1.0 | 27.4 | 2.9 |
Hispanic | 3,400 | 1,214 | 14.1 | .9 | 3.3 | .4 | 15.3 | 1.0 |
County type | ||||||||
Metropolitan area (large or small) | 18,100 | 6,135 | 20.8 | .4 | 3.5 | .2 | 24.7 | .5 |
Nonmetropolitan area | 4,500 | 1,001 | 18.2 | .9 | 3.9 | .4 | 29.6 | 1.1 |
School enrollment | ||||||||
Middle or high school student | 1,400 | 406 | 19.8 | 1.5 | 6.8 | 1.0 | 22.5 | 1.5 |
College or other postsecondary school student | 8,800 | 2,842 | 23.7 | .6 | 2.5 | .2 | 25.6 | .6 |
High school dropout | 1,700 | 525 | 16.4 | 1.3 | 6.4 | .9 | 26.9 | 1.45 |
High school graduate | 8,600 | 2,575 | 16.8 | .6 | 4.4 | .3 | 25.2 | .7 |
College graduate | 1,900 | 738 | 24.2 | 1.6 | .7 | .2 | 26.7 | 1.8 |
Employment | ||||||||
Full-time | 8,400 | 2,670 | 16.0 | .6 | 2.1 | .2 | 22.7 | .7 |
Part-time | 6,200 | 1,941 | 22.7 | .8 | 2.9 | .3 | 24.5 | .8 |
Unemployed | 3,000 | 951 | 18.7 | 1.0 | 5.5 | .6 | 24.1 | 1.1 |
Disabled, not in the workforce | 600 | 171 | 50.1 | 3.1 | 17.8 | 2.4 | 63.3 | 3.0 |
Full-time student, not in the workforce | 2,300 | 768 | 26.1 | 1.3 | 3.3 | .5 | 26.9 | 1.3 |
Other, not in the workforce (including homemaker and retired) | 2,100 | 634 | 19.5 | 1.2 | 5.4 | .7 | 29.7 | 1.3 |
Past-year residential stability | ||||||||
No moves | 10,100 | 3,319 | 19.6 | .6 | 3.2 | .2 | 25.9 | .7 |
1–2 moves | 9,500 | 2,960 | 20.7 | .6 | 3.3 | .3 | 24.4 | .6 |
≥3 moves | 2,900 | 854 | 22.3 | 1.2 | 6.0 | .6 | 26.8 | 1.2 |
Living situation | ||||||||
With parent or grandparent | 10,700 | 3,501 | 19.1 | .5 | 4.2 | .3 | 23.8 | .6 |
With spouse, significant other, or partnerb | 5,100 | 1,528 | 20.7 | .8 | 2.6 | .4 | 29.9 | 1.0 |
With roommate or others | 3,300 | 1,075 | 24.9 | 1.2 | 2.4 | .4 | 24.3 | 1.2 |
Alone, with child | 1,200 | 392 | 13.2 | 1.4 | 4.5 | .9 | 18.1 | 1.5 |
Alone, without another adult | 2,400 | 639 | 23.8 | 1.3 | 3.9 | .5 | 29.7 | 1.5 |
Past-year criminal justice involvement | ||||||||
Yes | 2,600 | 805 | 21.5 | 1.1 | 8.3 | .8 | 29.1 | 1.3 |
No | 19,900 | 6,311 | 20.3 | .4 | 2.9 | .2 | 24.9 | .4 |
Mental illness | ||||||||
Serious impairment | 4,700 | 1,469 | 36.6 | 1.1 | 8.3 | .6 | 42.7 | 1.1 |
Mild or moderate impairment | 17,900 | 5,666 | 16.2 | .4 | 2.3 | .2 | 20.9 | .4 |
Overall health | ||||||||
Excellent, very good, or good | 20,200 | 6,406 | 20.0 | .4 | 3.0 | .2 | 24.3 | .4 |
Fair or poor | 2,400 | 729 | 24.2 | 1.2 | 8.1 | .9 | 34.9 | 1.4 |
Substance use disorder | ||||||||
Yes | 7,600 | 2,412 | 21.7 | .7 | 5.3 | .4 | 27.9 | .8 |
No | 15,000 | 4,723 | 19.8 | .5 | 2.7 | .2 | 24.2 | .5 |
Health insurance | ||||||||
Private only | 11,100 | 3,555 | 23.7 | .6 | 2.6 | .2 | 28.4 | .6 |
Medicaid only | 3,400 | 975 | 21.5 | 1.0 | 7.1 | .7 | 30.5 | 1.1 |
CHAMPUS, CHAMPVA, or military insurance only | 600 | 177 | 25.9 | 2.6 | 5.0 | 1.2 | 31.1 | 2.7 |
>1 type | 700 | 212 | 34.7 | 2.8 | 8.8 | 1.4 | 40.1 | 2.8 |
Other | 900 | 258 | 15.9 | 1.9 | 2.9 | .7 | 21.5 | 1.9 |
Uninsured | 5,900 | 1,959 | 12.4 | .6 | 3.0 | .3 | 15.8 | .6 |
Correlates of Mental Health Service Use
Outpatient services | Inpatient services | Psychotropic medication | ||||
---|---|---|---|---|---|---|
Correlate | AORa | 95% CI | AORa | 95% CI | AORa | 95% CI |
Age (reference: 18–20) | ||||||
21–23 | 1.1 | 1.01–1.29 | .81 | .63–1.03 | 1.18 | 1.05–1.32 |
24–26 | 1.3* | 1.1–1.44 | .66 | .50–.88 | 1.31* | 1.15–1.49 |
Female (reference: male) | 1.6* | 1.47–1.83 | .89 | .72–1.10 | 1.67* | 1.50–1.85 |
Race-ethnicity (reference: non-Hispanic white) | ||||||
Non-Hispanic black or African American | .5* | .39–.55 | 1.33 | .98–1.80 | .27* | .22–.31 |
Non-Hispanic Native American/Alaska Native | .5* | .27–.72 | 1.01 | .38–2.72 | .59 | .35–1.00 |
Non-Hispanic Native Hawaiian or Other Pacific Islander | .3 | .11–.73 | 1.15 | .38–3.51 | .19* | .08–.48 |
Non-Hispanic Asian | .4* | .32–.60 | 1.28 | .70–2.33 | .24* | .17–.33 |
Non-Hispanic more than one race | .8 | .59–1.09 | 1.04 | .61–1.66 | .78 | .58–1.05 |
Hispanic | .6* | .49–.69 | .99 | .74–1.32 | .41* | .34–.49 |
County located in metropolitan area (large or small) (reference: nonmetropolitan area) | 1.2* | 1.08–1.41 | 1.04 | .79–1.36 | .91 | .81–1.02 |
School enrollment (reference: high school dropout) | ||||||
Middle or high school student | 1.3 | .94–1.69 | 1.19 | .76–1.86 | .84 | .63–1.09 |
College or other postsecondary school student | 1.5* | 1.16–1.86 | .60 | .40–.91 | .99 | .80–1.22 |
High school graduate | 1.1 | .85–1.32 | .97 | .68–1.37 | .92 | .76–1.12 |
College graduate | 1.7* | 1.3–2.3 | .3* | .15–.63 | 1.02 | .77–1.36 |
Employment (reference: unemployed) | ||||||
Full-time | .6* | .5–.8 | .5* | .4–.8 | .7* | .6–.9 |
Part-time | 1.0 | .8–1.2 | .7 | .5–1.0 | .8 | .7–.9 |
Full-time student, not in the workforce | 1.2 | .9–1.4 | .8 | .6–1.2 | 1.0 | .9–1.3 |
Disabled, not in the workforce | 3.3* | 2.4–4.5 | 2.6* | 1.7–4.0 | 3.6* | 2.6–5.0 |
Other, not in the workforce (including homemaker and retired) | .9 | .8–1.1 | 1.1 | .8–1.6 | 1.0 | .9–1.3 |
Past-year residential stability (reference: 0 moves) | ||||||
1–2 moves | 1.0 | .9–1.2 | 1.1 | .9–1.4 | .9* | .8–.9 |
≥3 moves | 1.2 | 1.0–1.4 | 1.5 | 1.2–2.0 | .9 | .8–1.0 |
Living situation (reference: alone, without another adult) | ||||||
With parent or grandparent | .8 | .7–1.0 | .8 | .6–1.2 | .8 | .7–1.0 |
With spouse, significant other, or partner | .9 | .7–1.1 | .6 | .4–1.0 | 1.0 | .8–1.2 |
With roommate or others | .9 | .8–1.2 | .7 | .4–1.0 | .8 | .6–1.0 |
Alone, with child | 1.0 | .7–1.5 | .6 | .3–1.1 | 1.0 | .7–1.4 |
Past-year criminal justice involvement (reference: no) | 1.4* | 1.2–1.6 | 2.0* | 1.5–2.5 | 1.5* | 1.3–1.7 |
Mental illness, serious impairment (reference: mild or moderate impairment) | 2.9* | 2.6–3.2 | 3.4* | 2.8–4.1 | 2.8* | 2.5–3.1 |
Overall health fair or poor (reference: excellent, very good, or good) | 1.1 | 1.0–1.3 | 1.6* | 1.2–2.1 | 1.5* | 1.3–1.7 |
Substance use disorder (reference: no) | 1.1 | 1.0–1.2 | 1.7* | 1.4–2.1 | 1.2* | 1.1–1.3 |
Health insurance (reference: uninsured) | ||||||
Private only | 2.0* | 1.8–2.3 | 1.3 | 1.0–1.8 | 2.2* | 2.0–2.5 |
Medicaid only | 1.7* | 1.5–2.0 | 2.0* | 1.4–2.7 | 2.2* | 1.9–2.5 |
CHAMPUS, CHAMPVA, or military insurance only | 2.0* | 1.5–2.7 | 1.8 | 1.0–3.3 | 2.2* | 1.6–2.8 |
>1 type | 3.3* | 2.5–4.4 | 2.5* | 1.6–4.0 | 3.4* | 2.6–4.4 |
Other | 1.2 | .9–1.7 | 1.1 | .6–1.9 | 1.5 | 1.1–1.9 |
Outpatient mental health services.
Inpatient mental health services.
Psychotropic medication.
Discussion
Conclusions
References
Information & Authors
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Authors
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Funding Information
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