Relationships between serious psychological distress and the use of health services in the United States: findings from the Behavioral Risk Factor Surveillance System.
OBJECTIVE
To determine rates of access to and use of health services among adults with Serious Psychological Distress (SPD).


METHODS
Adults > or = 18 years in the 2007 BRFSS were stratified based on the presence of SPD, assessed by scores > or = 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 > or = 13 using Chi-square analyses and logistic regression models.


RESULTS
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.


CONCLUSIONS
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.
Behavioral Surveillance Branch, Division of Adult and Community Health, Centers for Disease Control and Prevention, 4770 Buford Highway N.E., Atlanta, GA 30341, USA. Wpearson@cdc.gov
William S
WS
Pearson
Satvinder S
SS
Dhingra
Tara W
TW
Strine
Yia Wun
YW
Liang
Joyce T
JT
Berry
Ali H
AH
Mokdad
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D040343:Behavioral Risk Factor Surveillance System; D016009:Chi-Square Distribution; D005260:Female; D006296:Health Services / Q000191:economics / Q000706:statistics & numerical data; D006297:Health Services Accessibility / Q000191:economics; D006801:Humans; D019458:Insurance Coverage / Q000191:economics / Q000592:standards; D007348:Insurance, Health / Q000191:economics / Q000706:statistics & numerical data; D016015:Logistic Models; D008297:Male; D001523:Mental Disorders / Q000188:drug therapy / Q000191:economics / Q000453:epidemiology*; D008605:Mental Health Services / Q000191:economics / Q000706:statistics & numerical data*; D008875:Middle Aged; D012959:Socioeconomic Factors; D013315:Stress, Psychological / Q000188:drug therapy / Q000191:economics / Q000453:epidemiology; D014481:United States / Q000453:epidemiology; D055815:Young Adult