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Dissertation. Chung (Final).pdf (1.89 MB)

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Factors associated with mental health service utilization among young adults with mental illness

Chung, Chia-Ling, Chung
http://rave.ohiolink.edu/etdc/view?acc_num=case1499248494469518

Abstract Details

2017, Doctor of Philosophy, Case Western Reserve University, Social Welfare.
This study investigated factors associated with mental health utilization and the role of health insurance in moderating racial/ethnic service utilization disparities, among young adults (aged 18 to 25) with mental illness, as compared with non-elderly adults (aged 26 to 64) with mental illness. Guided by Andersen’s Behavioral Model of Health Services Utilization, predictors were grouped into three categories: predisposing, enabling, and need factors. Race/ethnicity and health belief/attitude factors were identified as predisposing variables. Health insurance, family income, geographic regions, structural barriers, and cost/affordability were operationalized as enabling factors. Need factors such as mental illness severity, substance use problems, and self-rated health status — as well as gender, employment status, education, and criminal history — were statistically controlled. Data from the 2014 National Survey on Drug Use and Health (NSDUH) provided a total sample of 543 young adults and 862 non-elderly adults with moderate or serious mental illness. Binary logistic regression models were used for multivariate analyses; interaction effects of age and focal variables on service utilization were also included. Due to the complex sampling design, both weighted & non-weighted analyses were utilized and reported. Results indicated that young adults are significantly less likely to use mental health services than non-elderly adults. Multivariate analyses indicated that for, both, young adults and non-elderly adults with mental illness, identifying as non-Hispanic White, having health insurance, or having serious mental illness are factors that increase one’s likelihood to use mental health services. Cost is a significant predictor of mental health service use for non-elderly adults, but not for young adults. Moderating effects of health insurance status and insurance plan type on racial/ethnic disparities in mental health service utilization among young adults and non-elderly adults were not found. The findings suggest that enhancement of culturally competent practices is needed to increase young adults’ service use. Policies are also needed to expand or extend health insurance access for young adults. In addition, based on the role of mental illness severity in service utilization, it is recommended that future mental health programs establish early intervention programs during young adults first treatment for psychosis.
David Biegel (Committee Chair)
Hussey David (Committee Member)
Meeyoung Min (Committee Member)
Patrick Runnels (Committee Member)
190 p.
Mental Health; Social Work
Mental Health; Mental Health Disparity; Andersen Behavioral Model; Young Adults; Mental Illness

Recommended Citations

Citations

  • Chung, Chung, C.-L. (2017). Factors associated with mental health service utilization among young adults with mental illness [Doctoral dissertation, Case Western Reserve University]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=case1499248494469518

    APA Style (7th edition)

  • Chung, Chung, Chia-Ling. Factors associated with mental health service utilization among young adults with mental illness. 2017. Case Western Reserve University, Doctoral dissertation. OhioLINK Electronic Theses and Dissertations Center, http://rave.ohiolink.edu/etdc/view?acc_num=case1499248494469518.

    MLA Style (8th edition)

  • Chung, Chung, Chia-Ling. "Factors associated with mental health service utilization among young adults with mental illness." Doctoral dissertation, Case Western Reserve University, 2017. http://rave.ohiolink.edu/etdc/view?acc_num=case1499248494469518

    Chicago Manual of Style (17th edition)

case1499248494469518
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© 2017, all rights reserved.
This open access ETD is published by Case Western Reserve University School of Graduate Studies and OhioLINK.