title: Moderate to severe psychological distress, disability, and non-receipt of past year visits to a mental health professional.
abstract: Studies of mental health care received by persons with disabilities who make up a significant group of the U.S. population are limited.
  
  
  
  This cross-sectional study examined the relationship between disability and non-receipt of past year visits to a mental health professional among individuals with moderate to severe psychological distress.
  
  
  
  Study participants included a nationally representative sample of 5,566 people with moderate to severe psychological distress, extracted from 2011 to 2013 Integrated Health Interview using the 6-item Kessler Psychological Distress Scale. Self-reported disability domains included vision, hearing, mobility, upper body self-care difficulty, learning difficulty, communication difficulty, and cognition difficulty.
  
  
  
  Sixty-four percent of participants reported a disability. Logistic regression analyses showed that (adjusting for nativity, other mental health conditions, and chronic pain) people aged 18-64 years old with disabilities have significantly lower odds (OR = 0.52, p < 0.001) of unmet mental health care services than people without disabilities. However, foreign-born respondents have significantly higher odds (OR = 2.91; p < 0.001) of unmet mental health care services than U.S. born Americans. After controlling for gender, other mental health conditions and chronic pain, people aged 65 and above with disabilities have higher non-significant odds (OR = 1.34, p = 0.361) of unmet mental health care services than people without disabilities. Additionally, females have significantly higher odds (OR = 1.63, p = 0.039) than males.
  
  
  
  Findings indicate the importance of identifying demographic characteristics associated with an increased risk for psychological distress and increased unmet mental health care services among people with and without disabilities.
authors.affiliation: Department of Sociology, State University of New York at Albany, 351 Arts & Sciences, 1400 Washington Ave., Albany, NY 12222, USA. Electronic address: ahouston@albany.edu.
authors.forename: Allison
authors.initials: A
authors.lastname: Houston
authors.affiliation: School of Social Welfare, State University of New York at Albany, 316 Richardson Hall, 135 Western Ave., Albany, NY 12222, USA.
authors.forename: Anne-Marie
authors.initials: AM
authors.lastname: Gomes
authors.affiliation: Department of Social Work, California State University, East Bay, 4073 Meiklejohn Hall, 25800 Carlos bee Blvd., Hayward, CA 94542, USA.
authors.forename: Toni
authors.initials: T
authors.lastname: Naccarato
mesh_terms: D000328:Adult; D000367:Age Factors; D001007:Anxiety / Q000150:complications / Q000628:therapy; D003430:Cross-Sectional Studies; D003863:Depression / Q000150:complications / Q000628:therapy; D006233:Persons with Disabilities / Q000523:psychology*; D005260:Female; D006297:Health Services Accessibility; D006301:Health Services Needs and Demand; D006306:Health Surveys; D054625:Healthcare Disparities; D006801:Humans; D016015:Logistic Models; D008297:Male; D001523:Mental Disorders / Q000150:complications / Q000628:therapy; D008603:Mental Health; D008605:Mental Health Services; D008875:Middle Aged; D016017:Odds Ratio; D012720:Severity of Illness Index; D013315:Stress, Psychological / Q000150:complications* / Q000628:therapy; D014481:United States
keywords: Disability; Psychological distress; Unmet mental health care services