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The use of outpatient mental health services in the United States and Ontario: The impact of mental morbidity and perceived need for care

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  • Katz, S.J.
  • Kessler, R.C.
  • Frank, R.G.
  • Leaf, P.
  • Elizabeth, L.
  • Edlund, M.

Abstract

Objectives: This study compared the associations of individual mental health disorders, self-rated mental health, disability, and perceived need for care with the use of outpatient mental health services in the United States and the Canadian province of Ontario. Methods: A cross-sectional study design was employed. Data came from the 1990 US National Comorbidity Survey and the 1990 Mental Health Supplement to the Ontario Health Survey. Results: The odds of receiving any medical or psychiatric specialty services were as follows: for persons with any affective disorder, 3.1 in the United States vs 11.0 in Ontario; for persons with fair or poor self-rated mental health, 2.7 in the United States vs 5.0 in Ontario; for persons with mental health- related disability, 3.0 in the United States vs 1.5 in Ontario. When perceived need was controlled for, most of the between-country differences in use disappeared. Conclusions: The higher use of mental health services in the United States than in Ontario is mostly explained by the combination of a higher prevalence of mental morbidity and a higher prevalence of perceived need for care among persons with low mental morbidity in the United States.

Suggested Citation

  • Katz, S.J. & Kessler, R.C. & Frank, R.G. & Leaf, P. & Elizabeth, L. & Edlund, M., 1997. "The use of outpatient mental health services in the United States and Ontario: The impact of mental morbidity and perceived need for care," American Journal of Public Health, American Public Health Association, vol. 87(7), pages 1136-1143.
    • Handle: RePEc:aph:ajpbhl:1997:87:7:1136-1143_4
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    Cited by:

    1. R.K. Chadda & Vivek Agarwal & Megha Chandra Singh & Deepak Raheja, 2001. "Help Seeking Behaviour of Psychiatric Patients Before Seeking Care At a Mental Hospital," International Journal of Social Psychiatry, , vol. 47(4), pages 71-78, December.
    2. Shervin Assari & Anurima Kumar, 2018. "Social Determinants of Physical Self-Rated Health among Asian Americans; Comparison of Six Ethnic Groups," Societies, MDPI, vol. 8(2), pages 1-9, April.
    3. Ora Nakash & Maayan Nagar & Eli Danilovich & Daphne Bentov-Gofrit & Ido Lurie & Evelyne Steiner & Shiri Sadeh-Sharvit & Henri Szor & Itzhak Levav, 2014. "Ethnic disparities in mental health treatment gap in a community-based survey and in access to care in psychiatric clinics," International Journal of Social Psychiatry, , vol. 60(6), pages 575-583, September.
    4. Ying-Xiu Dai & Mu-Hong Chen & Tzeng-Ji Chen & Ming-Hwai Lin, 2016. "Patterns of Psychiatric Outpatient Practice in Taiwan: A Nationwide Survey," IJERPH, MDPI, vol. 13(10), pages 1-10, September.
    5. Aronson, Brian, 2016. "Peer influence as a potential magnifier of ADHD diagnosis," Social Science & Medicine, Elsevier, vol. 168(C), pages 111-119.
    6. Whitney Witt & Kristin Litzelman & Carmen Mandic & Lauren Wisk & John Hampton & Paul Creswell & Carissa Gottlieb & Ronald Gangnon, 2011. "Healthcare-Related Financial Burden Among Families in the U.S.: The Role of Childhood Activity Limitations and Income," Journal of Family and Economic Issues, Springer, vol. 32(2), pages 308-326, June.
    7. Rhodes, Anne & Liisa Jaakkimainen, R. & Bondy, Susan & Fung, Kinwah, 2006. "Depression and mental health visits to physicians--a prospective records-based study," Social Science & Medicine, Elsevier, vol. 62(4), pages 828-834, February.

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