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Soc Psychiatry Psychiatr Epidemiol. 2014 Jun 15. [Epub ahead of print]

Frequencies and predictors of barriers to mental health service use: a longitudinal study of Hurricane Ike survivors.

Author information

  • 1Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 W. 168th St, Room 720F, New York, NY, 10032, USA, srl2143@columbia.edu.

Abstract

BACKGROUND:

The majority of disaster survivors suffering from psychological symptoms do not receive mental health services. Research on barriers to service use among disaster survivors is limited by a lack of longitudinal studies of representative samples and investigations of predictors of barriers. The purpose of this study was to address these limitations through analysis of a three-wave population-based study of Hurricane Ike survivors (N = 658).

METHODS:

Frequencies of preference, outcome expectancy, resource, and stigma barriers among participants with unmet mental health needs were documented and logistic regression using a generalized estimating equations approach explored predisposing (e.g., age), illness-related (e.g., posttraumatic stress) and enabling (e.g., insurance coverage) factors as predictors of each type of barrier.

RESULTS:

Preference barriers were most frequently cited at each wave, whereas stigma barriers were least frequently cited. Older age and higher emotional support predicted preference barriers; being a parent of a child under 18-years old at the time of the hurricane, higher generalized anxiety, and lack of insurance predicted resource barriers; and higher posttraumatic stress predicted stigma barriers.

CONCLUSIONS:

These findings suggest that postdisaster practices targeting subpopulations most likely to have barriers to service use may be indicated.

PMID:
24929355
[PubMed - as supplied by publisher]
PMCID:
PMC4266627
[Available on 2015/12/15]
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