This exploratory study examined the relative predictive strengths of selected economic factors (welfare cases, banking activity, unemployment, retail sales, motor vehicle sales) for utilization of mental health services (hotline calls, intake at community mental health centers and admissions at mental hospitals) over a 78-month period in rural Appalachia. Monthly data were tested for autocorrelation and adjusted for seasonality and inflation. Regression analyses indicated that (a) economic factors did account for a considerable portion of variance in mental health factors; (b) these factors predicted mental hospital admissions and hotline calls; (c) strengths of these relationships were quite consistent across the areas sampled, but the directions sometimes were different; (d) welfare factors were the best predictors of utilization; (e) Aid to Families with Dependent Children was generally the best single predictor of utilization, especially when mental health factors were lagged by 3 months. A causative model describing the decision-making process involved in the utilization of mental health services was presented.
This exploratory study examined the relative predictive strengths of selected economic factors (welfare cases, banking activity, unemployment, retail sales, motor vehicle sales) for utilization of mental health services (hotline calls, intake at community mental health centers and admissions at mental hospitals) over a 78-month period in rural Appalachia. Monthly data were tested for autocorrelation and adjusted for seasonality and inflation. Regression analyses indicated that (a) economic factors did account for a considerable portion of variance in mental health factors; (b) these factors predicted mental hospital admissions and hotline calls; (c) strengths of these relationships were quite consistent across the areas sampled, but the directions sometimes were different; (d) welfare factors were the best predictors of utilization; (e) Aid to Families with Dependent Children was generally the best single predictor of utilization, especially when mental health factors were lagged by 3 months. A causative model describing the decision-making process involved in the utilization of mental health services was presented.
As a follow-up to an aggregate study of the relationship of economic factors to the utilization of mental health facilities, this study, using individual data, attempted to determine the associative strengths of income factors--welfare and unemployment--for utilization of community mental health centers (CMHCs) in rural Appalachia. On the basis of the earlier study and of previous studies of social class and utilization of CMHCs it was hypothesized that for this sample of 151 clients of eight CMHCs in Ohio and West Virginia, unemployment and welfare factors would be most strongly associated with utilization. A multiple regression analysis indicated that when compared to other independent variables, such as life satisfaction, demographic, and personal factors, receipt of food stamps was the most important factor in relating to utilization; this relationship was considerably stronger when the more rural areas were separated for analysis. Some relationship between employment status and utilization was also found. The results are discussed in terms of unique patterns of social service dependency in more rural Appalachia.
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