title: Mental Health Service Utilization Among Natural Disaster Survivors With Perceived Need for Services.
abstract: OBJECTIVE
  This study explored predisposing, illness-related, and enabling factors as predictors of mental health service use among disaster survivors with perceived need for services.
  
  
  METHODS
  Participants (N=658) were part of a three-wave, population-based study of Hurricane Ike survivors. At each wave, participants were asked whether they perceived having a need for mental health services, for example, information about stress reactions and medication for emotional problems. Those with perceived need were asked about use of eight services, such as a psychiatrist or physician, to address needs. Generalized estimating equations examined predisposing, illness-related, and enabling factors as predictors of service use among participants with perceived need (N=304).
  
  
  RESULTS
  More general stressors (predisposing factor) and insurance coverage (enabling factor) predicted service use among participants with perceived need.
  
  
  CONCLUSIONS
  The results suggest that expanded access to services that do not require insurance coverage could better address survivors' mental health needs after a disaster.
authors.affiliation: Dr. Lowe is with the Department of Psychology, Montclair State University, Montclair, New Jersey (e-mail: lowes@mail.montclair.edu ). Dr. Norris is with the Department of Psychiatry, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, and the National Center for PTSD, White River Junction, Vermont. Dr. Galea is with the Department of Epidemiology, Boston University, Boston.
authors.forename: Sarah R
authors.initials: SR
authors.lastname: Lowe
authors.affiliation: Dr. Lowe is with the Department of Psychology, Montclair State University, Montclair, New Jersey (e-mail: lowes@mail.montclair.edu ). Dr. Norris is with the Department of Psychiatry, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, and the National Center for PTSD, White River Junction, Vermont. Dr. Galea is with the Department of Epidemiology, Boston University, Boston.
authors.forename: Fran H
authors.initials: FH
authors.lastname: Norris
authors.affiliation: Dr. Lowe is with the Department of Psychology, Montclair State University, Montclair, New Jersey (e-mail: lowes@mail.montclair.edu ). Dr. Norris is with the Department of Psychiatry, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, and the National Center for PTSD, White River Junction, Vermont. Dr. Galea is with the Department of Epidemiology, Boston University, Boston.
authors.forename: Sandro
authors.initials: S
authors.lastname: Galea
mesh_terms: D004190:Disasters; D005260:Female; D006301:Health Services Needs and Demand / Q000191:economics*; D006801:Humans; D019458:Insurance Coverage / Q000191:economics*; D016015:Logistic Models; D008297:Male; D008603:Mental Health; D008605:Mental Health Services / Q000706:statistics & numerical data*; D010465:Perception; D011569:Psychiatric Status Rating Scales; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis*; D017741:Survivors / Q000523:psychology*