PS 1997; 48:826-832
Copyright © 1997 by American Psychiatric Association
Factors influencing utilization of mental health and substance abuse services by American Indian men and women
RW Robin, B Chester, JK Rasmussen, JM Jaranson and D Goldman
Laboratory of Neurogenetics, National Institute on Alcohol Abuse and Alcoholism, Rockville, MD, USA.
OBJECTIVE: This study investigated the effects of gender, number of
lifetime psychiatric diagnoses, and childhood victimization on utilization
of mental health and substance abuse treatment services in a Southwestern
American Indian tribe. METHODS: A total of 582 individuals were recruited
based on tribal enrollment and membership in large multigenerational
pedigrees. Subjects were interviewed using a modified version of the
Schedule for Affective Disorders and Schizophrenia-Lifetime Version, a
semistructured psychiatric interview. For this study the definition of
childhood victimization was limited to childhood sexual abuse. RESULTS:
Fifty-six percent of the subjects had received mental health treatment,
substance abuse treatment, or both. Patterns of service utilization
differed by gender with the odds of inpatient and substance abuse treatment
higher for men than for women. Women were more likely than men to receive
mental health treatment. Subjects who had been sexually abused as children
were more likely to have three or more psychiatric diagnoses and to have
received extensive treatment, compared with subjects who reported no
childhood sexual abuse history. Logistic regression demonstrated strong
relationships between number of psychiatric diagnoses and the likelihood of
treatment among both men and women. CONCLUSIONS: Gender, number of
psychiatric diagnoses, and childhood sexual abuse are strong predictors of
utilization of mental health and substance abuse treatment services. These
factors should be considered in designing treatment interventions.
