Selection Into Mental Health Services Among Persons With Depression
Abstract
Objective:
Methods:
Results:
Conclusions:
Methods
Data
Measures
Analyses
Results
Medication only (N=371) | Counseling only (N=1,012) | Medication and counseling (N=2,786) | Total (N=4,169) | |||||
---|---|---|---|---|---|---|---|---|
Characteristic | N | % | N | % | N | % | N | % |
Pathway into care | ||||||||
Independent | 236 | 86.1 | 513 | 80.4 | 2,132 | 82.5 | 2,744 | 82.4 |
Asked by someone | 58 | 12.2 | 104 | 14.5 | 350 | 12.5 | 517 | 12.8 |
Ordered | 22 | 1.7 | 33 | 5.1 | 164 | 5.1 | 230 | 4.8 |
Race-ethnicity | ||||||||
Non-Hispanic white | 270 | 74.6 | 651 | 66.6** | 2,140 | 80.5 | 3,061 | 76.9 |
Non-Hispanic black/African American | 26 | 7.1 | 105 | 10.3 | 196 | 7.2 | 327 | 7.9 |
Latinx/Hispanic | 46 | 14.0 | 158 | 15.0 | 249 | 7.9 | 453 | 10.0 |
Other | 29 | 4.3 | 98 | 8.1* | 201 | 4.4 | 328 | 5.2 |
Age | ||||||||
18–25 years | 124 | 14.5 | 428 | 23.2 | 807 | 12.4 | 1,359 | 15.0 |
26–34 years | 63 | 13.6 | 218 | 20.6 | 578 | 15.5 | 859 | 16.4 |
35–49 years | 101 | 23.8 | 253 | 27.7 | 926 | 31.2 | 1,280 | 29.7 |
50–64 years | 59 | 34.3 | 94 | 23.5** | 362 | 29.6 | 515 | 28.7 |
≥65 years | 24 | 13.8 | 19 | 5.0** | 113 | 11.4 | 156 | 10.2 |
Sex | ||||||||
Male | 106 | 30.1 | 299 | 32.7 | 698 | 28.1 | 1,103 | 29.3 |
Female | 265 | 69.9 | 713 | 67.3 | 2,088 | 71.9 | 3,066 | 70.7 |
Residential area | ||||||||
Large metro | 135 | 42.8 | 486 | 60.7* | 1,158 | 51.5* | 1,779 | 52.7 |
Small metro | 146 | 41.4 | 364 | 28.7** | 1,029 | 32.5 | 1,539 | 32.5 |
Nonmetro | 90 | 15.8 | 162 | 10.6 | 599 | 16.0 | 851 | 14.8 |
Education | ||||||||
Less than high school | 52 | 13.9 | 122 | 12.3 | 280 | 10.3 | 454 | 11.0 |
High school graduate | 107 | 31.3 | 220 | 20.5 | 645 | 21.0 | 972 | 21.8 |
Some college | 143 | 33.6 | 405 | 36.7 | 1,164 | 40.5 | 1,712 | 39.0 |
College graduate | 69 | 21.2 | 265 | 30.5*** | 697 | 28.2 | 1,031 | 28.1 |
Employment | ||||||||
Employed full-time | 140 | 32.9 | 443 | 44.5* | 996 | 32.5 | 1,579 | 35.2 |
Employed part-time | 72 | 17.6 | 243 | 20.1 | 508 | 14.2 | 823 | 15.8 |
Unemployed | 31 | 6.1 | 62 | 5.1 | 188 | 4.7 | 281 | 4.9 |
Not in labor force | 128 | 43.4 | 264 | 30.2 | 1,094 | 48.5 | 1,486 | 44.1 |
Poverty level | ||||||||
<100% FPL | 88 | 22.1 | 254 | 23.7 | 684 | 21.6 | 1,026 | 22.1 |
100%–199% FPL | 98 | 22.6 | 243 | 24.1 | 662 | 22.7 | 1,003 | 23 |
≥200% FPL | 185 | 55.3 | 491 | 52.2 | 1,414 | 55.8 | 2,090 | 54.9 |
Health insurance | ||||||||
No | 43 | 11.0 | 104 | 11.1 | 208 | 6.2** | 355 | 7.7 |
Yes | 328 | 89.0 | 908 | 88.9 | 2,578 | 93.8* | 3,814 | 92.3 |
Self-rated health | ||||||||
Fair or poor | 136 | 31.4 | 505 | 43.5* | 998 | 30.5 | 1,639 | 33.5 |
Good, very good, or excellent | 235 | 68.6 | 507 | 56.5* | 1,788 | 69.5 | 2,530 | 66.5 |
Substance use disorder | ||||||||
No | 278 | 81.1 | 775 | 79.6 | 2,101 | 80.0 | 3,154 | 80.0 |
Yes | 93 | 18.9 | 237 | 20.4 | 685 | 20.0 | 1,015 | 20.0 |
Probability of severe mental illness (mean±SE)b | 0.26±0.03 | 0.19±0.02 | 0.49±0.01** | 0.27±0.02 | ||||
Received inpatient treatment | ||||||||
No | 351 | 95.3 | 985 | 98.2 | 2,494 | 91.7 | 3,830 | 93.5 |
Yes | 20 | 4.7 | 25 | 1.8* | 291 | 8.3* | 336 | 6.5 |
Counseling only | Medication and counseling | |||
---|---|---|---|---|
Characteristic | RO | SE | RO | SE |
Pathway into care (reference: independent) | ||||
Asked by someone | 1.25 | .33 | 1.02 | .22 |
Ordered | 3.64* | 1.77 | 3.53*** | 1.25 |
Race-ethnicity (reference: non-Hispanic white) | ||||
Non-Hispanic Black/African American | 1.04 | .46 | .49 | .22 |
Latinx/Hispanic | 3.37* | 1.60 | 1.21 | .51 |
Other | 2.15 | 1.13 | .89 | .45 |
Age (reference: 18–25 years) | ||||
26–34 years | .83 | .24 | 1.28 | .29 |
35–49 years | .66 | .16 | 1.40 | .30 |
50–64 years | .39* | .15 | .98 | .26 |
≥65 years | .12*** | .07 | .81 | .31 |
Sex (reference: male) | ||||
Female | .75 | .18 | .97 | .19 |
Residential area (reference: large metro) | ||||
Small metro | .66 | .16 | .73 | .16 |
Nonmetro | .43** | .10 | .84 | .17 |
Education (reference: <high school) | ||||
High school graduate | .58 | .24 | .62 | .21 |
Some college | 1.04 | .41 | 1.34 | .39 |
College graduate | 1.46 | .70 | 1.44 | .49 |
Employment (reference: full-time) | ||||
Employed part-time | .81 | .25 | .83 | .21 |
Unemployed | .56 | .21 | .92 | .27 |
Not in labor force | .84 | .23 | 1.48 | .37 |
Poverty level (reference: <100% FPL)a | ||||
100%–199% FPL | .99 | .29 | 1.02 | .29 |
≥200% FPL | .84 | .32 | 1.13 | .37 |
Health insurance (reference: insured) | ||||
Uninsured | 1.11 | .37 | 1.42 | .35 |
Self-rated health (reference: good, very good, or excellent) | ||||
Fair or poor | .67 | .15 | 1.01 | .18 |
Substance use problem (reference: no) | ||||
Yes | .94 | .24 | 1.00 | .21 |
Probability of severe mental illness | .98 | .31 | 1.21** | .18 |
Received inpatient treatment (reference: no) | ||||
Yes | 2.04 | .91 | .64 | .27 |
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