The use of outpatient mental health services in the United States and Ontario: The impact of mental morbidity and perceived need for care

Steven J. Katz, Ronald C. Kessler, Richard G. Frank, Philip Leaf, Lin Elizabeth, Mark Edlund

Research output: Contribution to journalArticlepeer-review

152 Scopus citations

Abstract

Objectives: This study compared the associations of individual mental health disorders, self-rated mental health, disability, and perceived need for care with the use of outpatient mental health services in the United States and the Canadian province of Ontario. Methods: A cross-sectional study design was employed. Data came from the 1990 US National Comorbidity Survey and the 1990 Mental Health Supplement to the Ontario Health Survey. Results: The odds of receiving any medical or psychiatric specialty services were as follows: for persons with any affective disorder, 3.1 in the United States vs 11.0 in Ontario; for persons with fair or poor self-rated mental health, 2.7 in the United States vs 5.0 in Ontario; for persons with mental health- related disability, 3.0 in the United States vs 1.5 in Ontario. When perceived need was controlled for, most of the between-country differences in use disappeared. Conclusions: The higher use of mental health services in the United States than in Ontario is mostly explained by the combination of a higher prevalence of mental morbidity and a higher prevalence of perceived need for care among persons with low mental morbidity in the United States.

Original languageEnglish (US)
Pages (from-to)1136-1143
Number of pages8
JournalAmerican journal of public health
Volume87
Issue number7
DOIs
StatePublished - Jul 1997
Externally publishedYes

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

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