Patterns of Health Care Service Utilization by Individuals with Mental Health Problems: a Predictive Cluster Analysis

Psychiatr Q. 2018 Sep;89(3):675-690. doi: 10.1007/s11126-018-9568-5.


This study aimed at identifying and characterizing clusters of mental health service users based on various characteristics in a sample of individuals with mental health problems. Data were collected in the epidemiological catchment area of South-West Montreal, Quebec in 2011 and 2014. Among the 746 participants who reported experiencing a mental health problem (high psychological distress and/or a mental disorder), 29% had used mental health services. A Two-Step cluster analysis was carried out to generate participant profiles based on their visit to mental health professional. Four clusters were identified: 1) young males with high quality of life and social support and who were less likely to have mental health problems and to utilize mental health services; 2) older females living with a partner and having a family doctor who were less likely to have mental health problems and to utilize mental health services; 3) single females with generalized anxiety disorder and somatic illness who were more likely to utilize mental health services, and 4) depressed females with high psychological distress, low quality of life and social support who were likely to utilize mental health services. The results reinforce the importance to develop programs that target the specific needs of subgroups of people experiencing mental health problems, given their considerable heterogeneity.

Keywords: Cluster analysis; Mental disorders; Mental health care services; Psychological distress; Utilization.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Catchment Area, Health
  • Cluster Analysis*
  • Female
  • Humans
  • Longitudinal Studies
  • Male
  • Mental Disorders / epidemiology
  • Mental Disorders / therapy*
  • Mental Health Services / statistics & numerical data*
  • Middle Aged
  • Patient Acceptance of Health Care*
  • Predictive Value of Tests
  • Quebec / epidemiology
  • Stress, Psychological / epidemiology
  • Stress, Psychological / etiology
  • Young Adult