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.
This paper presents a theoretical framework and pilot study that examines the social context of the mental health treatment system and its impact on the spread of HIV…
This paper presents a theoretical framework and pilot study that examines the social context of the mental health treatment system and its impact on the spread of HIV among people with serious mental disorders. Recent epidemiological evidence indicates that mental illness clients may be at especially high risk of contracting HIV/AIDS. Mental health professionals' efforts to respond to the emerging epidemic, however, have been limited and focused primarily on individual-level interventions to change risk behavior. Virtually no consideration has been given to how treatment environments influence client risk behavior and/or the effectiveness of HIV prevention efforts. The perspective outlined in this paper builds on existing clinical research and proposes a general sociological framework for researching mental illness clients' HIV risk that emphasizes the clinical sexual culture of treatment programs. In an effort to develop preliminary measures and test key assumptions of the proposed framework, a small pilot study was conducted at a large state psychiatric hospital in the Midwest. The results suggest that clinical sexual culture does have a significant impact on the way both the patients and staff think about the management of patient sexual expression and HIV/AIDS at the hospital. More generally, the findings provide preliminary support for the theoretical framework presented.