title: The role of social structural factors in treatment of mental health disorder.
abstract: BACKGROUND
  Mental disorder implies a biopsychosocial condition, so adequate mental health treatment involves not just medical and pharmacological care but also psychotherapy or counseling.
  
  
  OBJECTIVE
  The present study determined how social structural factors might explain accessing of primary care providers and specialty care providers in response to mental disorder, hypothesizing that the two broad types of care differ as to the likelihood of offering minimally adequate treatment.
  
  
  METHODS
  We analyzed data from the cross-sectional study called "2000-2001 Healthcare for Communities", employing five imputed data sets to handle missing data and defining minimally adequate treatment of mental disorder as "at least four counseling sessions at any provider and prescribed medication". Results While mental disorder can be treated in primary care or specialty facilities, our results show that minimally adequate treatment (as defined) is most likely to be obtained via specialty care.
  
  
  CONCLUSIONS
  For individuals with mental disorder, accessing only primary care creates social inequity, because care from specialty facilities is comparatively more adequate.
authors.affiliation: School of Social Work, University of Alabama, Tuscaloosa, AL 35487-0314, USA. clo@ua.edu
authors.forename: Celia C
authors.initials: CC
authors.lastname: Lo
authors.forename: Tyrone C
authors.initials: TC
authors.lastname: Cheng
mesh_terms: D003131:Combined Modality Therapy; D003299:Cooperative Behavior; D003376:Counseling / Q000379:methods; D003430:Cross-Sectional Studies; D006297:Health Services Accessibility; D006302:Health Services Research; D006801:Humans; D033183:Interdisciplinary Communication; D001523:Mental Disorders / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D010043:Outcome and Process Assessment, Health Care; D010342:Patient Acceptance of Health Care; D011320:Primary Health Care; D011613:Psychotherapy / Q000379:methods; D011619:Psychotropic Drugs / Q000627:therapeutic use; D012737:Sex Factors; D012959:Socioeconomic Factors; D013038:Specialization; D016896:Treatment Outcome; D014481:United States
chemical_list: D011619:Psychotropic Drugs