The role of social network and support in mental health service use: findings from the Baltimore ECA study.

Department of Mental Health, Johns Hopkins School of Public Health, 624 N. Broadway St., Baltimore, MD 21205, USA.
Psychiatric services (Washington, D.C.) (Impact Factor: 1.99). 09/2009; 60(9):1222-9. DOI: 10.1176/
Source: PubMed

ABSTRACT A significant number of people with mental illness do not use mental health services to receive treatment for their symptoms. This study examined the hypothesis that social network and social support affect mental health service use.
Data were from the Baltimore cohort of the Epidemiologic Catchment Area study, a prospective cohort study that gathered data over four time points. This study examined data gathered in 1993-1996 (N=1,920) and 2004-2005 (N=1,071). The study examined indicators of social network and social support in relation to four types of service use (general medical, mental health within general medical, specialty psychiatric, and other human services) with multivariate logistic regression. Examples of other human services include a self-help group or crisis center for help with any psychological problem. Weighted generalized estimating equations were used for the analyses.
Among persons with major depressive disorder, generalized anxiety disorder, panic disorder, or alcohol use disorder in the past year or psychological distress in the past few weeks, general medical service use was reduced when the frequency of contact with relatives or friends occurred less than daily, but it was increased by about 40% when there was a higher than median level of spousal support. In contrast, receiving general medical services for mental health problems was reduced by about 50% when there was a higher than median level of social support from relatives. Specialty psychiatric service use was reduced when there was regular contact with six or more relatives and there was a higher than median level of social support from friends and relatives. None of the social network or social support measures were significantly (p</=.01) associated with use of other human services.
Increased contact with the social network and higher levels of social support were associated with greater use of general medical services. However, more social support was associated with use of fewer services within the specialty psychiatric sector.

Download full-text


Available from: Catherine Bradshaw, Aug 16, 2014
1 Follower
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Different instruments have been used to measure social support in epidemiological studies of which the most widely used is the Medical Outcomes Study Social Support Scale (SSS-MOS). However, these studies lack measures of the level of social support on health risks. We used Latent Class Analysis (LCA) to distinguish subgroups with different levels of perceived social support and tested the consistency of these subgroups by their associations with the prevalence of Common Mental Disorders (CMD). This is a cross-sectional study of 1013 mothers living in the city of Salvador, Brazil in which psychosocial data were collected through home visits using the SSS-MOS and the Self Reporting Questionnaire-20. For each dimension of social support analysed here, we selected models with two classes using LCA. Multivariate logistic regression models were used to estimate the association between participants’ perceived social support and the prevalence of CMD to verify the consistency of the groups defined by LCA. There was a clear difference in the reporting of perceived social support between those classified as high or low using LCA. The probability of perceiving several types of social support was lower in the subgroup classified as low level of social support (13.7% to 59.8%), and it was much higher in the group classified as high level of social support (84.3% to 98%). A greater prevalence of CMD was found among mothers with lower levels of social support. LCA seems to be a useful tool to improve measurement of perceived social support by separation into two levels in which the lower level is associated with an increased prevalence of CMD.
    Social Science Research 11/2014; 50. DOI:10.1016/j.ssresearch.2014.11.009 · 1.27 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Infertility is a discretionary health condition; although it carries with it important life course implications, treatment is rarely necessary for health reasons. Sociological theories of medical help-seeking emphasize demographic factors, perceived need, and enabling conditions in health services utilization, but we find that social cues are also strongly associated with health services utilization for infertility. Adjusted for conventional predictors of medical help-seeking, several social cue indicators have significant associations with utilization, including having friends and family with children, perceiving infertility stigma, and having a partner and/or family member who encourages treatment. Perceived need accounts for the largest portion of the variation in utilization. Enabling conditions explain less of the variance than social cues. Social cues should be especially important for discretionary health services utilization. Studies of service utilization for discretionary health conditions should explicitly incorporate a range of measures of social cues into their models.
    Sociological Inquiry 01/2012; 83(2). DOI:10.1111/soin.12000 · 0.79 Impact Factor
  • Source