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.
Pearson
William S
WS
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
Dhingra
Satvinder S
SS
Strine
Tara W
TW
Liang
Yia Wun
YW
Berry
Joyce T
JT
Mokdad
Ali H
AH
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