Perceived Need and Receipt of Outpatient Mental Health Services

Abstract

The finance and provision of care have been suggested as variables that affect the utilization of mental health services. This study compared perceived need and receipt of outpatient mental health services in a staff-model health maintenance organization (HMO) and in three HMOs with preferred provider organization (PPO) arrangements. A national random phone survey (n = 1,394) of perceived need for and receipt of mental health assistance was conducted in Israel in 1995. Health care is provided by four HMOs that differ in mental health benefits, utilization management (i.e., prior authorization and referral requirements), and availability of mental health services (i.e., pool of providers and geographic dispersal). About one-quarter of the respondents had perceived a need for help at some time in their life. Significantly fewer respondents from the HMO with a small pool of providers got help (20%) than respondents from the other HMOs, which had almost identical rates of obtaining care (40.3%, 37.3% and 40.3%). Providing generous outpatient mental health care benefits does not appear to increase the proportion of persons in need who get help. However, severely limiting the availability of services does reduce the proportion of persons getting care. Implications for regulating insurers are discussed.

Primary Care Physicians' Discussion of Emotional Distress and Patient Satisfaction

“…To establish face validity, the question on emotional distress was reviewed by the researchers, colleagues from the Bar-Ilan University School of Social Work, and from the Health Policy Research Unit at the Myers-JDC-Brookdale Institute, and members of the steering committee for the large study. Structure validity was ascertained in previous studies we conducted, which have confirmed the expected correlations between self-reported emotional distress and other variables [26][27][28]. c) Selfreports on physician's discussion of emotional distress were elicited by the question "During the past year, has your family physician asked you about, or discussed with you, feelings of distress or depression?"…”

“…However, single item measures of health are routinely used in population surveys in which health is only one among many issues measured and which have to be covered in a short interview [38]. Furthermore, the specific question used in this study was found to have high face and construct validity [26][27][28] as was depicted in the methods section above. Third, the cross-sectional design of the study did not permit us to draw conclusions about causality.…”

Factors Associated with Mental Health Service Utilization Among Korean American Immigrants

“…The few studies that have specifically focused on KAs (Jang et al 2005; Jang et al 2009) have measured propensity to use, or attitudes toward the use of, mental health services, not the actual use thereof. In addition, there has been growing attention to the role of self-recognized need for treatment as a mediator between mental illness and use of mental health services (Kessler et al 2001; Kim et al 2010; Mojtabai et al 2002; Rabinowitz et al 2003). These studies suggest that the main reason people with mental illness do not seek mental health services is that they do not acknowledge having mental health problems.…”