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Estimating a Model for Mental Healthcare Utilization Using Subjective Unmet Need and Psychological Distress Measures

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Abstract

The objective of this study is to assess the predictive value of self-reported need and psychological distress in mental healthcare service use across racial and ethnic groups in California. Using 2014–2018 data for adults aged 18–64 in the California Health Interview Survey, both logistic and Poisson regression models are used to estimate mental healthcare utilization. Patient-reported outcome measures, such as psychological distress, are commonly used to evaluate healthcare utilization patterns. The Kessler-6 screener for psychological distress is frequently used as a tool for determining whether someone’s level of distress necessitates evaluation by a mental healthcare professional. Serious psychological distress has been widely studied as a predictor of higher healthcare expenditures and use; however, moderate distress and self-reported need has been less examined in the literature. Seventy-two percent of individuals with moderate psychological distress felt like they needed to see a professional for their mental or emotional needs compared to 4% of individuals with serious psychological distress. Individuals with moderate psychological distress had 34% of all healthcare visits for mental or emotional needs during the study period, compared to 17% for those with serious psychological distress. Subjective unmet need for mental healthcare was reported by 77% of those who utilized mental healthcare during the study period. Studying subjective unmet need, in addition to moderate and serious distress, provides additional understanding of the need for mental healthcare and mental healthcare utilization.

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Funding

Funding for this research was provided by Health Assessment Lab/Medical Outcomes Trust (MOT).

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Authors and Affiliations

  1. University of South Carolina, Columbia, SC, USA

    Ebony Toussaint PhD, MPH

  2. University of California, Irvine, CA, USA

    Dylan Roby PhD

  3. University of Maryland, College Park, MD, USA

    Dahai Yue PhD, Luisa Franzini PhD & Neil Sehgal PhD

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  1. Ebony Toussaint PhD, MPH
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  2. Dylan Roby PhD
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  3. Dahai Yue PhD
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  4. Luisa Franzini PhD
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  5. Neil Sehgal PhD
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Correspondence to Ebony Toussaint PhD, MPH.

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Compliance with Ethical Standards

The authors attest that they have no conflicts of interest. The California Health Interview Survey was submitted by the Data Access Center (DAC) at the UCLA Center for Health Policy Research. The UCLA South General Institutional Review Board (IRB) has approved the DAC to conduct analyses of confidential CHIS data (UCLA IRB#17–000362). The DAC operates by policies and procedures approved by the UCLA Office for the Protection of Research Subjects (OPRS) and the State of California’s Committee for the Protection of Human Subjects (CPHS).

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Toussaint, E., Roby, D., Yue, D. et al. Estimating a Model for Mental Healthcare Utilization Using Subjective Unmet Need and Psychological Distress Measures. J Behav Health Serv Res 49, 500–512 (2022). https://doi.org/10.1007/s11414-022-09797-1

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  • DOI: https://doi.org/10.1007/s11414-022-09797-1

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