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The influence of state mental health perceptions and spending on an individual’s use of mental health services

Abstract

Purpose  

To explore the possible contextual effects of state-level mental health perceptions and public spending for mental health
treatment on an individual’s use of mental health services, independent of the individual’s own perceptions.

Methods  

Cross-sectional data from the 2007 Behavioral Risk Factor Surveillance System were used. A total of 216,514 participants from
35 states and the District of Columbia were included in the study. Logistic regression and multilevel modeling were used to
estimate the effects of individual-level characteristics and three state-level factors—per capita spending on community mental
health services, aggregated perceptions of the effectiveness of mental health treatment and the stigma of mental illness—on
the individual’s current use of mental health services.

Results  

Adjusting for the individual’s perceptions and characteristics, state-level perception of treatment effectiveness was positively
associated with the use of mental health services [odds ratio (OR) for 5 % increase in the percentage perceiving effectiveness = 1.08;
95 % confidence interval (CI): 1.01, 1.16]. This association was strongest for individuals who experienced 1–4 days of mental
distress in the past 30 days (OR = 1.17; 95 % CI 1.06, 1.29). State-level public spending on community mental health services
was also positively associated with an individual’s use of mental health services (OR for a $40 increase in spending = 1.09;
95 % CI 1.01, 1.17); however, state-level perceptions of mental-illness stigma was not.

Conclusions  

Our findings suggest there may be contextual effects of state-level perceptions of treatment effectiveness and state spending
on community mental health services on the use of mental health services.

  • Content Type Journal Article
  • Category Original Paper
  • Pages 1-11
  • DOI 10.1007/s00127-012-0520-y
  • Authors
    • John Richardson, Thomson Reuters, Washington, DC 20008, USA
    • Hal Morgenstern, Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI 48109-2029, USA
    • Raquel Crider, Department of Economics and Finance, School of Business and Social Science, Shepherd University, Shepherdstown, WV 25443-5000, USA
    • Olinda Gonzalez, Division of State and Community Systems Development, Center for Mental Health Services, Substance Abuse and Mental Health Services Administration, Rockville, MD 20847-2345, USA
    • Journal Social Psychiatry and Psychiatric Epidemiology
    • Online ISSN 1433-9285
    • Print ISSN 0933-7954
Posted in: Journal Article Abstracts on 06/06/2012 | Link to this post on IFP |
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