Mental health service use among those with depression: An exploration using Andersen’s behavioral model of health service use
Abstract
Background Despite positive effects on prognosis, less than half of the people diagnosed with depression access mental health services. Knowledge of what promotes such service use is limited. There is dispute about whether the receipt of mental illness related information encourages or discourages service use among those with depression. Accurate service use models are needed to inform programs designed to facilitate service use by those who would benefit most. We examine the appropriateness of Andersen's Behavioral Model of Health Service Use in this context.Method Data from 451 adults identified through the Australian National Survey of Mental Health and Wellbeing as meeting International Classification of Diseases Ten (ICD-10) criteria for depression were used.Results Confirmatory factor analysis failed to verify Andersen's model. Thus, an empirically derived service use model was developed using exploratory factor analysis and then structural equation modelling. Mental health need was the strongest predictor of service use and the model suggested the importance of social connectedness in promoting service use. Participants who had received helpful mental illness information were significantly more likely to have accessed mental health services than those who had not.Limitations The cross-sectional design and lack of replication preclude definitive conclusions CONCLUSION: Andersen's model is a useful starting point for the exploration of service use among people with depression. It is necessary, however, to develop specific models for this population.
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Need factors tend to be the strongest predictor of physical and behavioral health service use.
“Need factors refer to perceived/evaluated physical and/or behavioral health problem severity and tend to be the strongest predictor of physical [30] and behavioral health service use [31,32].”
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- Authors
- Graham, A., Hasking, P., Brooker, J., Clarke, D., & Meadows, G.
- Affiliations
- Monash Health (AU)
- Curtin University (AU)
- The University of Melbourne (AU)
- Corresponding author
- Graham, Annette
- Venue
- Journal of Affective Disorders
- Publisher
- Elsevier BV
- Published
- 2017-01
- Volume
- 208
- Pages
- 170-176
- ISSN
- 0165-0327 (ISSN-L)
- OpenAlex
- W2533388608
- Cited by
- 70
- References
- 54
- Citations by year
- 2026: 8 · 2025: 16 · 2024: 12 · 2023: 10 · 2022: 3 · 2021: 9 · 2020: 4 · 2019: 3 · 2018: 2 · 2017: 3
- FWCI
- 4.20
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Affective Disorders (publishedVersion)
- PubMed (publishedVersion)
- Victoria University Research Repository (Victoria University) (submittedVersion)
- eSpace (Curtin University) (submittedVersion)
- Topics
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
- Social Sciences › Psychology › Clinical Psychology › Psychology and Mental Health
- Keywords
- depression, mental health service utilization, social connectedness, help-seeking
- MeSH terms
- Adult, Australia, Cross-Sectional Studies, Depression, Female, Health Services Accessibility, Humans, Male, Mental Health Services, Models, Psychological
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