THE EFFECTS OF MENTAL-HEALTH FACTORS ON AMBULATORY CARE VISITS BY RURAL TEENS

This study sought to determine the effects of mental health variables on rural adolescents' use of ambulatory health care services and wheth er these effects varied across common outpatient settings. Using a cro ss-sectional survey design, 2,297 adolescents who attended public scho ols in grades 7 through 12 in one isolated rural Mississippi River Del ta country were assessed via a standardized health behavior survey. Th is self-report measure inquired about relevant health behaviors such a s alcohol use, depressive symptoms, and health service use. The studen ts' mean age was 15 years and 58 percent of the sample were black. App roximately 11 percent of the sample reported symptoms of depression, 1 6.5 percent reported problem drinking, and slightly fewer than 6 perce nt reported both. After controlling for predisposing, enabling, and ne ed factors, the reporting of depressive symptoms, problem drinking, or both was related to an increased number of outpatient visits in three of four sites examined. However, differences among sites were observe d. These data suggest that mental health problems are associated with increased visits to ambulatory settings, and these problems affect ser vice use differentially. Thus, effective interventions and better link ages between ambulatory settings and mental health providers may reduc e unnecessary use.