DETERMINANTS OF THE USE OF SPECIALIST MENTAL-HEALTH-SERVICES BY NURSING-HOME RESIDENTS

Objective. This study examines die effects of resident and facility ch aracteristics on the probability of nursing home residents receiving t reatment by mental health professionals. Data Sources/Study Setting. T he study uses data from the Institutional Population Component of the 1987 National Medical Expenditure Survey, a secondary data source cont aining data on 3,350 nursing home residents living in 810 nursing home s as of January 1, 1987. Study Design. Andersen's health services use model (1968) is used to estimate a multivariate logistic equation for the effects of independent variables on the probability that a residen t has received services from mental health professionals. Important va riables include resident race, sex, and age; presence of several behav iors and reported mental illnesses; and facility ownership, facility s ize, and facility certification. Data Collection/Extraction Methods. D ata on 188 residents were excluded from the sample because information was missing on several important variables. For some additional varia bles residents who had missing information were coded as negative resp onses. This left 3,162 observations for analysis in the logistic regre ssions. Principal Findings. Older residents and residents with more AD L limitations are much less likely than other residents to have receiv ed treatment from a mental health professional. Residents with reporte d depression, schizophrenia, or psychoses, and residents who are agita ted or hallucinating are more likely to have received treatment. Resid ents in government nursing homes, homes run by chains, and homes with low levels of certification are less likely to have received treatment . Conclusions. Few residents receive treatment from mental health prof essionals despite need. Older, physically disabled residents need spec ial attention. Care in certain types of facilities requires further st udy. New regulations mandating treatment for mentally ill residents wi ll demand increased attention from nursing home administrators and men tal health professionals.