Abstract
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.
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.
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.
- 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