Organizational context and provider perception as determinants of mental health service use

This study refines and tests an individual client model of service use and contrasts it with a model of service provision based on gateway provider pe rspectives. Structural equation models demonstrate that provider variables account for more service use variation than client variables. The client mo del account for 24% of the variance in service use, while the provider mode l accounts for 55% of the variance. Youth self-reported mental health was n ot positively associated with increased services or with provider perceptio n of youth mental health. The provider model demonstrates the critical role played by provider perceptions, which are influenced more by work environm ent than by client problems.