THE USE OF OUTPATIENT MENTAL-HEALTH-SERVICES IN THE UNITED-STATES ANDONTARIO - THE IMPACT OF MENTAL MORBIDITY AND PERCEIVED NEED FOR CARE

Objectives. This study compared the associations of individual mental health disorders, self-rated mental health, disability, and perceived need for care with the use of outpatient mental health services in the United States and the Canadian province of Ontario. Methods. A cross- sectional study design was employed. Data came from the 1990 US Nation al Comorbidity Survey and the 1990 Mental Health Supplement to the Ont ario Health Survey. Results. The odds of receiving any medical or psyc hiatric specialty services ere as follows: for persons with any affect ive disorder, 3.1 in the United States vs 11.0 in Ontario; for persons with fair or poor self-rated mental health. 2.7 in the United States vs 5.0 in Ontario; for persons with mental health-related disability, 3.0 in the United States vs 1.5 in Ontario. When perceived need was co ntrolled for, most of the between-country differences in use disappear ed. Conclusions. The higher use of mental health services in the Unite d States than in Ontario is mostly explained by the combination of a h igher prevalence of mental morbidity and a higher prevalence of percei ved need for care among persons with low mental morbidity in the Unite d States.