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The Role of Adverse Physical Health Events on the Utilization of Mental Health Services

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Keywords: Mental health care utilization; physical and mental health interplay; quasi-experiment; difference-in-differences estimators; propensity scores


To test the degree to which adverse physical health events may subsequently increase the utilization of mental health services.

Methods: A quasi-experimental pretest–posttest design was employed on a nationally representative sample of adults from the Medical Expenditure Panel Surveys for years 2004 and 2005. We constructed a 2-year balanced-panel dataset on 6,017 U.S. adults who did not have any adverse physical health events in 2004. We calculated difference-in-differences estimators that capture the effect of adverse physical health events on provider visits and prescription drug use for the treatment of mental health conditions.

Principal Findings: Our most rigorous analytic model shows that an adverse physical health event is significantly associated with more than a threefold increase in the likelihood of provider visits and prescribed medication use for the treatment of mental health problems. These increases are mainly through office-based physician visits for nonsevere mental health conditions. This relationship is greater among those who experience more severe physical health events.

Conclusion: An adverse physical health event substantially increases the utilization of mental health care. Mental health service use increases with the severity of a physical health condition.

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