Gender and health services use for a mental health problem

This study addresses whether the predictors of seeking help for a mental he alth problem differ by gender. An adaptation of Andersen's Socio-Behavioral Model is used to identify factors associated with seeking care for a menta l health problem. Data are derived from two waves of a community survey und ertaken in 1992-1993 and in 1993-1994 among a probability sample of adults (18-69 years), residing in poor areas of Puerto Rico. Paired data was used from those individuals who responded to both waves of the survey for a tota l of 3221 community respondents. Responses from wave I were used to predict mental health service use in wave 2. The dependent variable is any use of outpatient mental health services in the year preceding the second intervie w. Logistic regression was used to model the effects of the independent var iables on use. Males and females were found to use mental health services i n nearly equal proportions. Gender did not have a main effect on use when o ther covariates were controlled. Significant interactions with gender were found for several predictors of use. The largest intervention effects were encountered in our need for care indicators. Having a definite need for men tal health care and poor self-rated mental health had a larger effect on pr edicting use of services for men than they do for women. It is concluded th at strategies designed to improve access to mental health services for mino rity disadvantaged populations ought to take into account gender difference s in the predictors of use. Studies addressing factors influencing health s ervices utilization for a mental health problem should consider stratifying their sample by gender. Future research should establish whether or not th ese findings are sustained with other population groups. (C) 2001 Elsevier Science Ltd. All rights reserved.