Determinants of ambulatory treatment mode for mental illness

We estimate a reduced-form bivariate probit model to analyse jointly the ch oice of ambulatory treatment from the specialty mental health sector and/or the use of psychotropic drugs for a nationally representative sample of US household residents. We find significant differences in treatment choice b y education, gender, race and ethnicity, while controlling for several aspe cts of self-reported mental health and treatment attitudes. For example, wh ile women are more likely than men to use the specialty mental health secto r and more likely to take psychotropic medications, this difference between men and women is much greater for psychotropic medications. The estimated differences may reflect patient preferences in a manner traditionally assum ed when interpreting these coefficients in such equations, but we discuss h ow they may also reflect biases and misperceptions on the parts of patients and providers. We also discuss how our results relate to some findings and policies in the general health care sector. Published in 2000 by John Wile y & Sons, Ltd.