title: Australian women seeking counseling have higher use of health services.
abstract: OBJECTIVE
  Despite a high prevalence of psychological distress and poor mental health in the Australian community, use of counseling services is very low. There has been only limited research examining the profile of those who do access counseling services, mainly in terms of demographic and health behavior variables. To extend our understanding of those who currently access counseling services, this study aimed to examine the broader pattern of health service utilization by women who consulted counselors, psychologists, or social workers in the past year compared with those who did not among a population-based sample of middle-aged Australian women, and to determine whether health service utilization was independently associated with use of counseling services, controlling for other known predictors.
  
  
  METHODS
  The cross-sectional population-based mail survey data for this study came from the third survey of the mid-aged cohort of the Australian Longitudinal Study on Women's Health, conducted in 2001. The sample comprised 11,201 women aged 50-55. The main study variable was a question asking whether they had consulted a counselor/psychologist/social worker in the past year.
  
  
  RESULTS
  Only 6.9% of women had consulted a counselor/psychologist/social worker in the past year. After controlling for self-reported mental health status, health behaviors and demographic variables in multivariate analysis, consulting a counselor/psychologist/social worker in the past year was significantly and positively associated with consultations with general practitioners (> or =5 consultations; odds ratio [OR], 4.14; 95% confidence interval [CI], 2.35-7.27; p < .0001), specialist (> or =3 consultations; OR, 2.09; 95% CI, 1.66-2.63; p < .0001), and hospital doctor (OR, 1.35; 95% CI, 1.10-1.66; p = .004). Use of counseling services was not associated with use of other allied and complementary health services in multivariate analyses.
  
  
  CONCLUSIONS
  Further research is needed to determine whether the strong independent link between self-reported use of counseling and other medical and health services among middle-aged women is best explained by general practice referral patterns, availability of services, economic factors, or different help-seeking patterns among women.
authors.affiliation: School of Public Health, La Trobe University, Melbourne, Australia. m.schofield@latrobe.edu.au
authors.forename: Margot
authors.initials: M
authors.lastname: Schofield
authors.forename: Asaduzzaman
authors.initials: A
authors.lastname: Khan
mesh_terms: D000328:Adult; D001315:Australia / Q000453:epidemiology; D015331:Cohort Studies; D003156:Community Mental Health Services / Q000706:statistics & numerical data*; D016001:Confidence Intervals; D003376:Counseling / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D005260:Female; D006266:Health Education / Q000706:statistics & numerical data*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008137:Longitudinal Studies; D008875:Middle Aged; D016017:Odds Ratio; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D011314:Preventive Health Services / Q000706:statistics & numerical data; D012947:Social Work / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D014932:Women's Health Services / Q000706:statistics & numerical data*