Self-reliance, mental health need, and the use of mental healthcare among island Puerto Ricans

Ment Health Serv Res. 2002 Sep;4(3):131-40. doi: 10.1023/a:1019707012403.

Abstract

This paper examines the relationship between self-reliance (preference to solve emotional problems on one's own) and 5 mental healthcare utilization outcomes for Puerto Ricans living in low-income areas. A random probability community sample of noninstitutionalized Puerto Ricans, ages 18-69, living in low-income areas of the island were selected and interviewed in 1992-93 and 1993-94. A series of logistic regression models tested the association between self-reliance and 5 mental health utilization measures, after adjusting for covariates measuring predisposing, enabling, need and barrier factors: any use of mental health services, any use of general health services for mental healthcare, any use of specialty care, use of psychotropic medications, and retention in mental healthcare. Self-reliance was found to be negatively associated with all 5 dependent service utilization measures. Those with a positive self-reliant attitude were 40% less likely to use care on any of the 5 outcome measures. An interaction was also observed between definite need for mental healthcare and having a self-reliant attitude when predicting mental health service use. Definite needers with a self-reliant attitude were 54%-58% less likely to use mental health services compared with definite needers who did not have a self-reliant attitude. Further, decreases in self-reliant attitude over the two data collection periods were associated with increases in mental health service use. Our findings suggest that self-reliance is a significant and robust predictor of mental healthcare utilization among Puerto Ricans living in low-income areas of the island.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Aged
  • Female
  • Health Knowledge, Attitudes, Practice*
  • Health Services Accessibility*
  • Humans
  • Logistic Models
  • Male
  • Mental Health Services / statistics & numerical data*
  • Middle Aged
  • Odds Ratio
  • Patient Acceptance of Health Care / psychology*
  • Poverty Areas
  • Puerto Rico