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J Nerv Ment Dis. 2010 Mar;198(3):187-93. doi: 10.1097/NMD.0b013e3181d13faf.

Mediating effect of mental disorders in the pathway between life events and mental health services use: results from the Baltimore Epidemiologic Catchment Area study.

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  • 1Department of Mental Health, Johns Hopkins School of Public Health, Baltimore, MD 21205, USA.


This study assessed the role of some common mental health conditions as mediators in the pathway between suffering life events and using mental health services. The participants were from the Baltimore Epidemiologic Catchment Area cohort, interviewed in 1993 to 1996 and 2004 to 2005. Longitudinal data analysis was used to identify models with significant mediation. Only alcohol abuse/dependence disorder was a significant mediator in the pathway between suffering a life-threatening illness and using mental health services in a general medical setup. Female gender, being more than 65 years old, prior use of services and availability of health insurance were some of the factors that significantly predicted service use in that model. Some of other factors like social networks and social support, attitudes towards services, and stigma, may play a role in determining service use. Future research should investigate the role of such factors as mediators for mental health service use.

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