Factors Associated with Mental Health Services Use among Disconnected African-American Young Adult Population

Abstract

Research related to mental health service use among vulnerable young adults is limited. This study used an expanded version of Andersen's Behavioral Model of Health Services Use to evaluate factors associated with the use of different types of mental health services among a sample of predominantly African-American 16-24 year olds (n = 500) in an employment training program in Baltimore City. Results indicated that participants were more likely to have received mental health services in correctional facilities than in community- or school-based contexts. Use of mental health services in correctional facilities was significantly greater among males, those less than 18 years, and those who experienced more stressful events. Findings illustrate the need to develop seamless mental health services for vulnerable young adults in multiple contexts, including the criminal justice system.

Predictors of Mental Health Service Use by Young Adults: A Systematic Review

“…Regarding perceived need, participants in clinical samples who reported a need for mental health support were almost five times more likely to access services than those who perceived no need for professional help (61,63). This significant relationship was also found in a nonclinical sample (65).…”

“…Psychological distress (as measured by Adult Self-Report and the DSM-IV) was the only significant predictor for the clinical group (63,64), whereas depression (as measured by Center for Epidemiological Studies Depression Scale [CES-D] and Patient Health Questionnaire [PHQ-9]), anxiety (as measured by the Beck Anxiety Inventory and PHQ-9), and psychological distress (as measured by the dysphoria domain of the Trauma Symptom Inventory) were each significant predictors of service use among the general (nonclinical) young adult population (26,43,51,60,65). Notably, probable diagnoses of depression (based on CES-D screening) significantly increased the odds of service use in the longer term among the nonclinical group (Table 2).…”

Predictors of lifestyle behaviors, trust of health care provider, and utilization of health services among adolescents living in a rural area.

“…Of the studies identifying a conceptual model when measuring adolescents' utilization of health services, ABM was the most frequently used model (Adams, Newacheck, Park, Brindis, & Irwin, 2013;Marcell et al, 2007;Maulik, Mendelson, & Tandon, 2011;Wu, Blazer, Li, & Woody, 2011;Wu, Pilowsky, Schlenger, & Hasin, 2007). Additional studies appear to have been organized according to ABM, but did not specify the conceptual model used (McKee, Fletcher, & Schechter, 2006;Youngblade, Curry, Novak, Vogel, & Shenkman, 2006).…”

“…When polling adolescents , USOC rates drop to 63% among Hispanics in Connecticut (Rew et al, 1999), 64% of rural minority high school students in Mississippi (Bradford & O'Sullivan, 2006), 75.8% of African-American adolescent males in Maryland (Maulik et al, 2011), 80% among minority adolescent females in New York, and 81% of adolescent CHIP recipients in Florida and New York. These results seem to indicate that low income and minority adolescents are less likely to report a USOC than reported by parents of American adolescents in general.…”

“…Health care provider visits and emergency room visits were measured individually. A review of other studies measuring utilization of health services among adolescents indicated that 12 months was the most frequent timeframe used (Berdahl et al, 2013;Klein et al, 2006;Maulik et al, 2011;Mulye et al, 2009;Probst et al, 2005;Rew et al, 1999;Simpson et al, 2005;Simpson et al, 2004;Wu et al, 2007). Other timeframes used to evaluate utilization of health services were a three-month timeframe (Bradford & O'Sullivan, 2006, 2007 and a twoyear timeframe (Elliott & Larson, 2004).…”