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Self-Reliance, Mental Health Need, and the Use of Mental Healthcare Among Island Puerto Ricans

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Mental Health Services Research

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.

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Authors and Affiliations

  1. Division of Health Policy and Administration, Department of Epidemiology and Public Health, Yale University School of Medicine, New Haven, Connecticut

    Alexander N. Ortega

  2. Department of Health Services Administration and the Center for Evaluation and Sociomedical Research, Graduate School of Public Health, University of Puerto Rico, San Juan, Puerto Rico

    Margarita Alegría

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  1. Alexander N. Ortega
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  2. Margarita Alegría
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Correspondence to Alexander N. Ortega.

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Ortega, A.N., Alegría, M. Self-Reliance, Mental Health Need, and the Use of Mental Healthcare Among Island Puerto Ricans. Ment Health Serv Res 4, 131–140 (2002). https://doi.org/10.1023/A:1019707012403

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