title: Mental health service use among those with depression: an exploration using Andersen's Behavioral Model of Health Service Use.
abstract: Despite positive effects on prognosis, less than half of the people diagnosed with depression access mental health services. Knowledge of what promotes such service use is limited. There is dispute about whether the receipt of mental illness related information encourages or discourages service use among those with depression. Accurate service use models are needed to inform programs designed to facilitate service use by those who would benefit most. We examine the appropriateness of Andersen's Behavioral Model of Health Service Use in this context.
  
  
  
  Data from 451 adults identified through the Australian National Survey of Mental Health and Wellbeing as meeting International Classification of Diseases Ten (ICD-10) criteria for depression were used.
  
  
  
  Confirmatory factor analysis failed to verify Andersen's model. Thus, an empirically derived service use model was developed using exploratory factor analysis and then structural equation modelling. Mental health need was the strongest predictor of service use and the model suggested the importance of social connectedness in promoting service use. Participants who had received helpful mental illness information were significantly more likely to have accessed mental health services than those who had not.
  
  
  
  The cross-sectional design and lack of replication preclude definitive conclusions CONCLUSION: Andersen's model is a useful starting point for the exploration of service use among people with depression. It is necessary, however, to develop specific models for this population.
authors: Department of Psychiatry, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Australia. Electronic address: Annette.Graham@monash.edu.
authors: Annette
authors: A
authors: Graham
authors: Department of Psychiatry, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Australia; School of Psychology and Speech Pathology, Curtin University, Perth, Australia.
authors: Penelope
authors: P
authors: Hasking
authors: Department of Psychiatry, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Australia; Szalmuk Family Psycho-Oncology Research Unit, Melbourne, Australia.
authors: Joanne
authors: J
authors: Brooker
authors: Department of Psychiatry, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Australia; Mental Health Program, Monash Health, Melbourne, Australia.
authors: David
authors: D
authors: Clarke
authors: Department of Psychiatry, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Australia; Mental Health Program, Monash Health, Melbourne, Australia; Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia.
authors: Graham
authors: G
authors: Meadows
mesh_terms: D000328:Adult; D001315:Australia; D003430:Cross-Sectional Studies; D003863:Depression / Q000523:psychology*; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D008605:Mental Health Services / Q000706:statistics & numerical data*; D008960:Models, Psychological
keywords: Andersen's Behavioral Model of Health Service Use; Depression; National Survey; Service use