Organizational context and provider perception as determinants of mental health service use.
This study refines and tests an individual client model of service use and contrasts it with a model of service provision based on gateway provider perspectives. Structural equation models demonstrate that provider variables account for more service use variation than client variables. The client model accounts for 24% of the variance in service use, while the provider model accounts for 55% of the variance. Youth self-reported mental health was not positively associated with increased services or with provider perception of youth mental health. The provider model demonstrates the critical role played by provider perceptions, which are influenced more by work environment than by client problems.
Stiffman
A R
AR
Washington University, George Warren Brown School of Social Work, Campus Box 1196, One Brookings Drive, St. Louis, MO 63130, USA. arstiff@gwbmail.wustl.edu
Striley
C
C
Horvath
V E
VE
Hadley-Ives
E
E
Polgar
M
M
Elze
D
D
Pescarino
R
R
D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology; D016497:Adolescent Health Services / Q000706:statistics & numerical data*; D000704:Analysis of Variance; D015984:Causality; D005163:Factor Analysis, Statistical; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility; D006302:Health Services Research; D006801:Humans; D008297:Male; D008605:Mental Health Services / Q000706:statistics & numerical data*; D008923:Missouri; D008960:Models, Psychological; D015233:Models, Statistical; D020380:Needs Assessment; D015279:Organizational Culture; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D000297:Psychology, Adolescent / Q000706:statistics & numerical data; D012017:Referral and Consultation; D011795:Surveys and Questionnaires