The wider social environment and mental health service use.
OBJECTIVE
Previous studies associating neighbourhood context with mental health service use typically included limited sets of confounders.


METHODS
A data set including patients registered in a Case Register and population controls was subjected to multilevel analyses, including neighbourhood exposures and individual level confounders. In addition, days of care consumption of patients was addressed.


RESULTS
The association between socioeconomic deprivation and social capital on the one hand and mental health service use rates on the other could be attributed to individual level differences. However, number of days of service consumption was higher in neighbourhoods with more informal social control. In residentially stable neighbourhoods only, socioeconomic deprivation was associated with lower levels of service consumption.


CONCLUSIONS
Higher levels of social control may induce patients to remain in contact with mental health services. Furthermore, higher levels of deprivation in neighbourhoods with little population mobility may result in reduced expectations of recovery and/or increased tolerance.
Drukker
M
M
Department of Psychiatry and Neuropsychology, South Limburg Mental Health Research and Teaching Network, EURON, Maastricht University, Maastricht, The Netherlands.
Driessen
G
G
Krabbendam
L
L
van Os
J
J
D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D015986:Confounding Factors, Epidemiologic; D005260:Female; D006801:Humans; D007182:Income; D008297:Male; D001523:Mental Disorders / Q000628:therapy*; D008605:Mental Health Services / Q000706:statistics & numerical data*; D008875:Middle Aged; D009426:Netherlands; D012042:Registries / Q000706:statistics & numerical data*; D012111:Residence Characteristics; D012923:Social Class; D012924:Social Conditions