Gender and health services use for a mental health problem

• Published in: Social science & medicine (1982) Vol. 53; no. 7; pp. 865 - 878
• Main Authors: Albizu-Garcia, Carmen E, Alegrı́a, Margarita, Freeman, Daniel, Vera, Mildred
• Format: Journal Article
• Language: English
• Published: Oxford Elsevier Ltd 01-10-2001; Elsevier; Pergamon Press Inc
• Series: Social Science & Medicine
• Subjects: Adolescent; Adult; Aged; Biological and medical sciences; Female; Gender; Gender differences; Gender Services use Mental health Puerto Rico; Health care access; Health Care Utilization; Health Problems; Health services; Health Services Research; Help Seeking Behavior; Helpseeking; Humans; Low Income Areas; Male; Medical sciences; Medical sociology; Medicine; Mental Disorders - therapy; Mental health; Mental Health Services; Mental Health Services - statistics & numerical data; Mental illness; Mentally ill people; Middle Aged; Minority & ethnic groups; Miscellaneous; Outpatients; Patient Acceptance of Health Care - psychology; Poverty Areas; Prevention and actions; Public health. Hygiene; Public health. Hygiene-occupational medicine; Puerto Rico; Regression Analysis; Services use; Sex Differences; Sex Factors; Social sciences; Central America; Puerto Rico; America; West Indies; Services use; Puerto Rico; Gender; Mental health; Human; Poverty; Use; Therapeutical request; Sex; Mental disorder; Health service; Ambulatory; Public health
• ISSN: 0277-9536; 1873-5347
• DOI: 10.1016/S0277-9536(00)00380-4

This study addresses whether the predictors of seeking help for a mental health problem differ by gender. An adaptation of Andersen's Socio-Behavioral Model is used to identify factors associated with seeking care for a mental health problem. Data are derived from two waves of a community survey undertaken in 1992–1993 and in 1993–1994 among a probability sample of adults (18–69 years), residing in poor areas of Puerto Rico. Paired data was used from those individuals who responded to both waves of the survey for a total of 3221 community respondents. Responses from wave 1 were used to predict mental health service use in wave 2. The dependent variable is any use of outpatient mental health services in the year preceding the second interview. Logistic regression was used to model the effects of the independent variables on use. Males and females were found to use mental health services in nearly equal proportions. Gender did not have a main effect on use when other covariates were controlled. Significant interactions with gender were found for several predictors of use. The largest intervention effects were encountered in our need for care indicators. Having a definite need for mental health care and poor self-rated mental health had a larger effect on predicting use of services for men than they do for women. It is concluded that strategies designed to improve access to mental health services for minority disadvantaged populations ought to take into account gender differences in the predictors of use. Studies addressing factors influencing health services utilization for a mental health problem should consider stratifying their sample by gender. Future research should establish whether or not these findings are sustained with other population groups.