title: Patterns of mental health utilization among island Puerto Rican poor.
abstract: BACKGROUND
  This paper describes utilization of mental health services by poor Puerto Ricans living on the island. It examines the utilization rates, within health sectors, and settings for the provision of mental health services.
  
  
  METHODS
  Data are based on an islandwide probability sample of 18- to 64-year-old respondents living in low socioeconomic areas. We assessed need with the Psychiatric Symptom and Dysfunction Scales.
  
  
  RESULTS
  Approximately one-third of our study population (31.5%) met criteria for need. Of these, only 32% had received any mental health care in the past year. Need was significantly associated with use of physical or mental health services for mental health problems. We found those who needed services to be five times more likely than those who did not need services to have used one or both sectors of care at least once in the past year. Among the first group 21.8% used the physical health sector to deal with mental health problems in contrast with 17.9% who sought care in the mental health sector. In the physical health sector, subjects used the public and private settings equally. In the mental health sector, 70% of subjects used the public setting.
  
  
  CONCLUSIONS
  This suggests the nonpsychiatric physician as a main provider for mental health treatment.
authors.affiliation: Center for Evaluation and Sociomedical Research, University of Puerto Rico School of Public Health 00936-5067.
authors.forename: M
authors.initials: M
authors.lastname: Alegría
authors.forename: R
authors.initials: R
authors.lastname: Robles
authors.forename: D H
authors.initials: DH
authors.lastname: Freeman
authors.forename: M
authors.initials: M
authors.lastname: Vera
authors.forename: A L
authors.initials: AL
authors.lastname: Jiménez
authors.forename: C
authors.initials: C
authors.lastname: Ríos
authors.forename: R
authors.initials: R
authors.lastname: Ríos
mesh_terms: D000293:Adolescent; D000328:Adult; D002755:Choice Behavior; D005260:Female; D006297:Health Services Accessibility / Q000191:economics / Q000592:standards; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008605:Mental Health Services / Q000706:statistics & numerical data*; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D011203:Poverty; D011320:Primary Health Care / Q000592:standards / Q000706:statistics & numerical data; D011569:Psychiatric Status Rating Scales; D011634:Public Health / Q000592:standards; D011647:Puerto Rico; D012017:Referral and Consultation / Q000706:statistics & numerical data; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014478:Unemployment / Q000706:statistics & numerical data