Zuvekas Samuel H, Fleishman John A
Center for Financing, Access, and Cost Trends, Agency for Healthcare Research and Quality, Rockville, Maryland 20850, USA.
Med Care. 2008 Sep;46(9):915-23. doi: 10.1097/MLR.0b013e31817919e5.
Studies of health service use for emotional problems show that the majority of those with disorders do not seek professional help. In addition, mental health service use is lower among members of minority communities, compared with non-Hispanic whites.
To examine the role of self-reported mental health as an indicator of awareness of mental conditions and as an influence in the process of seeking mental health care.
We conducted cross-sectional analyses of nationally representative data from the Medical Expenditure Panel Survey (MEPS) for 2000-2004.
In-person interviews obtained data on self-rated mental health (SRMH), ambulatory mental health visits, and purchase of prescription medications to treat mental conditions. Respondents completed the SF-12 health status survey; analyses included the SF-12 mental component summary (MCS) as a measure of emotional symptoms. Analyses included only those who provided self-reports of MCS and SRMH.
SRMH was related to any ambulatory visit and any medication purchase for mental health treatment, controlling for MCS, and other sociodemographic and clinical variables. The association between SRMH and service use was weaker for black and Hispanic respondents than for whites. In addition, the magnitude of the association between SRMH and MCS was weaker for black and Hispanic respondents than for whites.
Racial/ethnic differences in service use may arise in part from different propensities to interpret emotional symptoms as reflecting one's mental health and then to seek professional intervention for emotional problems. SRMH may be useful as an indicator of the extent to which people acknowledge the existence of emotional problems.
针对情绪问题的卫生服务利用情况研究表明，大多数患有情绪障碍的人并未寻求专业帮助。此外，与非西班牙裔白人相比，少数族裔社区成员的心理健康服务利用率较低。
探讨自我报告的心理健康作为心理状况认知指标以及对寻求心理保健过程的影响所起的作用。
我们对2000 - 2004年医疗支出面板调查（MEPS）的全国代表性数据进行了横断面分析。
通过面对面访谈获取有关自评心理健康（SRMH）、门诊心理健康就诊以及购买治疗心理疾病处方药的数据。受访者完成了SF - 12健康状况调查；分析中将SF - 12心理成分总结（MCS）作为情绪症状的一项测量指标。分析仅纳入那些提供了MCS和SRMH自我报告的受访者。
在控制了MCS以及其他社会人口学和临床变量后，SRMH与任何心理健康治疗的门诊就诊和任何药物购买均相关。黑人与西班牙裔受访者中，SRMH与服务利用之间的关联比白人弱。此外，黑人与西班牙裔受访者中，SRMH与MCS之间关联的强度也比白人弱。
服务利用方面的种族/族裔差异可能部分源于将情绪症状解读为反映个人心理健康并进而针对情绪问题寻求专业干预的不同倾向。SRMH可能作为人们承认情绪问题存在程度的一个指标。
