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To investigate the role of social factors, health status, and psychiatric disorders (DSM-III-R) on mental health services use, we utilized the National Comorbidity Survey (NCS), a nationally representative household survey (1990–1992) of the US (n=5877). Multivariate logistic regression allowed estimation of the adjusted odds ratios and 95% confidence intervals on the likelihood of visiting the health or the specialty mental/addictive service sectors. Significant determinants included: gender, race, household income, work status, and quality of community-level health care resources. Those with greater socioeconomic resources or comorbid psychiatric disorders were more likely to visit the specialty mental health sector.

The effects of distress and social networks on psychiatric help seeking were examined in an adult sample from a community survey of 3,481 adults in Baltimore, Maryland. Data were derived from the Johns Hopkins University site of the NIMH Epidemiologic Catchment Area program. Statistical adjustment for the independent effects of social (age, education, marital status, race, household composition, and sex), economic (employment, income, and insurance), and physical health factors were controlled for in estimating the relative odds of mental health service utilization. Subjects who were young, without full-time employment, or who reported one or more chronic medical problems were more likely to utilize mental health professionals. Married persons and the aging were less likely to seek psychiatric treatment. Social support and psychological distress interact to affect the use of mental health care. Persons with weak family ties were five times more likely to seek professional help than those with strong family ties, while persons with confiding social support were over four times as likely to use mental health services as those lacking confiding relationships. Interventions and other treatment efforts to encourage use of mental health services are recommended.

The last several decades have brought about a paradigm shift in the conceptualization of disability (Fougeyrollas & Beauregard, 2001; Williams, 2001). The traditional medical model considers disability to be a characteristic of the person, situated within the body. In the medical model view, disability, or difficulty functioning in major life domains, results from bodily impairments associated with a medical diagnosis or disorder, and a medical intervention or treatment is required to “correct” the problem of the individual. Alternatively, contemporary social models argue that disability is a social construction. In the social model view, disability is created by social policies, stigma and other barriers within the social and physical environment. Changes in attitudes and policies and the removal of barriers are needed to “correct” these environmental problems.