Bridging the Gap Between Common Mental Disorders and Service Use: The Role of Self-Rated Mental Health Among African Americans.
OBJECTIVE
The unmet need for mental health care in racial/ethnic minorities has been a major public health concern. Using a sample of African Americans, this study questioned whether self-rated mental health (SRMH), an individual's subjective assessment of personal mental and emotional status, modifies the link between mental disorders and service use.


METHODS
Cross-sectional analyses of the Milwaukee African American oversample of the Midlife Development in the United States (MIDUS II) study, 2005-2006.


METHODS
In-home personal interviews.


METHODS
Self-identified African American/black participants aged 40 to 85 years (N = 460).


METHODS
Participants were assessed if they met the diagnostic criteria for three common mental disorders (major depression, generalized anxiety disorder, and panic disorder) in the prior 12 months, using the Composite International Diagnostic Interview (CIDI). Response to a single-item SRMH was dichotomized (excellent/very good/good or fair/poor). Service use was indicated by the use of any services in the past year (mental health specialist, general doctor, and clergy).


RESULTS
Multivariate analyses identified a significant interaction between mental disorder and SRMH in predicting service use. The likelihood of service use increased substantially when individuals with a disorder reported their mental health to be fair/poor.


CONCLUSIONS
Reflecting its subjective nature, SRMH enhances our understanding of individual variations in self-recognition and help-seeking behaviors. Findings suggest that interventions that enhance an individual's self-awareness of mental health problems may help bridge the gap between mental health care needs and service use in African Americans.
School of Social Work, The University of Texas at Austin, TX. Electronic address: yjang12@austin.utexas.edu.
Yuri
Y
Jang
School of Social Work, The University of Texas at Austin, TX.
Hyunwoo
H
Yoon
Department of Child and Family Studies, University of South Florida, Tampa, FL.
David A
DA
Chiriboga
School of Aging Studies, University of South Florida, Tampa, FL.
Victor
V
Molinari
Department of Sociology, The University of Texas at Austin, TX.
Daniel A
DA
Powers
D000328:Adult; D001741:Black or African American / Q000523:psychology*; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D059026:Diagnostic Self Evaluation; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006301:Health Services Needs and Demand; D000066505:Help-Seeking Behavior; D006801:Humans; D016015:Logistic Models; D008297:Male; D001523:Mental Disorders / Q000145:classification*; D008603:Mental Health; D008605:Mental Health Services / Q000706:statistics & numerical data*; D008875:Middle Aged; D015999:Multivariate Analysis; D011569:Psychiatric Status Rating Scales; D014481:United States
African Americans; Mental disorder; self-rated mental health; service use