Date: 05 Apr 2009

Relationships between serious psychological distress and the use of health services in the United States: findings from the Behavioral Risk Factor Surveillance System

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To determine rates of access to and use of health services among adults with Serious Psychological Distress (SPD).


Adults ≥ 18 years in the 2007 BRFSS were stratified based on the presence of SPD, assessed by scores ≥ 13 using the Kessler-6 tool (N = 199,209). Access to and use of general and mental health services were compared for those with scores < 13 and those ≥ 13 using Chi-square analyses and logistic regression models.


Less than half of all adults with SPD indicated receiving mental health treatment. Persons < 65 years and having SPD were significantly less likely to have access to any type of health insurance (0.59 O.R., 0.51–0.68 95% C.I.) compared to persons <65 years without SPD.


These results present a situation which could potentially lead to increased use of emergency departments for possible non-emergent services. Less than half of adults with SPD were receiving mental health treatment and most, regardless of their SPD score, were receiving routine health checkups; presenting an opportunity to identify and treat many mental health issues in the primary care setting.