Effects of Sexual Orientation and Gender on Perceived Need for Treatment by Persons With and Without Mental Disorders

Abstract

Objective Research has shown that some individuals with sexual minority status have a higher prevalence of psychiatric disorders (both mental health and substance use) and also tend to seek treatment at higher rates as compared with similar heterosexuals. Relationships among treatment need and treatment use, however, are not well understood. This paper examines the relationship of sexual orientation and gender to perceptions of need and unmet need for treatment among individuals with and without mental health or substance use disorders. Methods Data were obtained from a probability sample of California residents that oversampled for sexual minorities (unweighted N = 2,079). Bivariate analyses compared perceived treatment need and treatment use among groups defined by sexual orientation, gender, and presence of a mood, anxiety, or substance use disorder. Logistic regression models were fit predicting absence of treatment among those who perceived a need for it (unmet need), testing the interactive effects of gender, disorder, and sexual orientation and controlling for socio-demographics. Results Sexual minority women had about half the odds of unmet need for treatment compared with other women, but there was no interaction between sexual minority status and unmet treatment need for men. Among individuals without any of the disorders measured, sexual minorities had lower odds of unmet need for treatment compared with others. Heterosexual men and women were most likely to have unmet treatment needs. Conclusions Sexual orientation and gender differentially influence treatment utilization, particularly among those who do not have a diagnosed disorder but perceive a need for treatment. Diagnostic criteria appear to be less relevant to understanding treatment use among sexual minorities.

The Influence of Gender on Perceived Treatment Need among a Community Sample of Substance Users

“…Gender and sexual minority status were found to have a significant relationship with perceived treatment need in a secondary data analysis of a survey with a community-based single state probability sample (Grella et al, 2011). Among those who did not receive treatment during the prior year, women with mental disorders (mood, anxiety and/or substance use), regardless of sexual orientation, were more likely than men to perceive a need for treatment.…”

“…A number of studies have sought to identify the predictors of perceived treatment need among community samples of individuals who meet criteria for SUDs (Grella, Cochran, Greenwell & Mays, 2011;Grella, Karno, Warda, Moore & Niv, 2009;Mojtabai et al, 2002;Tucker, Wenzel, Golinelli, Zhou & Green, 2011;Wu & Ringwalt, 2004), however, none have explicitly examined the moderating influence of gender on the relationship between substance use problem severity and perceived treatment need despite the fact that it has been suggested that gender impacts health and help seeking (Courtenay, 2000a). The purpose of the proposed study is to understand how gender impacts the relationship between substance use problem severity and perceived treatment need among a community sample of individuals who meet criteria for SUDs.…”

“…Basically, these studies aim to primarily determine the individual-level predisposing factors (correlates of perceived need or those factors which are associated with perceived need) that can contribute to eventual help-seeking and service utilization (Andersen & Newman, 1973. There are studies which focus solely on the factors leading to perceived treatment need for mental health disorders such as depression or anxiety (Farabee et al, 2002;van Beljouw et al, 2010), for co-occurring mental health and SUDs (Grella et al, 2011), and a body of others for SUDs alone (Grella et al, 2009;Mojtabai et al, 2002;Ryan et al, 1995;Wu & Ringwalt, 2004).…”

“…Research suggests that gender is potentially related to perceived need for treatment, with women being equally (Grella et al, 2009) or more likely (Edlund et al, 2006;Grella et al, 2011;Mojtabai et al, 2002) to believe they need substance use treatment than men. Yet more research is needed because this discrepancy could be the result of different sampling and methodological issues in these studies.…”

“…Demographically, the sample consists of men and women over the age of 18 who reside in all 50 states and the District of Columbia. Although there are several studies in the literature that measure the perceived treatment need of substance users (Grella et al, 2009;Grella et al, 2011;Mojtabai et al, 2002;Wu & Ringwalt, 2004), none have explored the potential differences between those who meet criteria for abuse, those who meet criteria for dependence, and those who meet criteria for multiple SUDs.…”