Re-engagement into mental health care: A longitudinal analysis of mechanisms to service use for persons with psychological distress.

摘要

Objective. The study examines elements of service system and patient level factors individually and their interactions on service use to manage mental health needs for individuals with recurrent episodes of depression. Method. Using data form the 12-month and 57-month follow-up study of the Partners in Care Project (PIC), the study examines direct and moderating effects of reported 12-months social support and treatment satisfaction with the PIC trial on service use for mental health needs at 57-months for an adult sample, minorities and non-Hispanic Whites (n=991). Results . Direct effects were supported for sociocultural and enabling variables. In review of moderation effects, satisfaction and social support at 12-months significantly moderated the relationship between health impairment and service use at 57-months. When accounting for individuals with high health need, satisfaction negatively moderated the relationship with service use, while social support positively moderated the relationship with service use. In the post hoc analysis on individuals with high health need, both moderating effects were maintained but minorities also had significant increased odds of service use when social support was high. Conclusion . Findings inform and extend the understanding of the role of social support and treatment satisfaction on decisions to manage depression over time. Profiling risk factors for under use such as low support for minority populations and those with high health needs assists practitioners in improving screening and outreach to those least likely to seek mental health care independently as episodes reoccur over the life span.