Minority stress factors as mediators of sexual orientation disparities in mental health treatment: a longitudinal population-based study

Objectives: Prevalence estimates of mental disorders were designed to provide an indirect estimate of the need for mental health services in the community. However, recent studies have demonstrated that meeting criteria for a DSM-based disorder does not necessarily equate with need for treatment. The current investigation examined the relation between self-perceived need for mental health treatment and DSM diagnosis, with respect to quality of life (QoL) and suicidal ideation. Methods: Data came from an Ontario population-based sample of 8116 residents (aged 15 to 64 years). The University of Michigan Composite International Diagnostic Interview was used to diagnose mood, anxiety, substance use, and bulimia disorder according to DSM-III-R criteria. We categorized past-year help seeking for emotional symptoms and (or) perceiving a need for treatment without seeking care as self-perceived need for treatment. We used a range of variables to measure QoL: self-perception of mental health status, a validated instrument that measured well-being, and restriction of activities (current, past 30 days, and long-term). Results: Independent of subjects' meeting criteria for a DSM-III-R diagnosis, self-perceived need for treatment was significantly associated with poor QoL (on all measures) and past-year suicidal ideation. Conclusions: Self-perceived need for mental health treatment, in addition to DSM diagnosis, may provide valuable information for estimating the number of people in the population who need mental health services. The relation between self-perceived need for treatment and objective measures of treatment need requires future study.

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The Participants

Criminal Genius ◽

10.1525/california/9780520282414.003.0004 ◽

2016 ◽

Author(s):

James C. Oleson

Keyword(s):

Mental Health ◽

Mental Illness ◽

Sexual Orientation ◽

Mental Health Treatment ◽

Control Group ◽

Eysenck Personality Questionnaire ◽

Personality Questionnaire ◽

Health Treatment ◽

Crime Seriousness ◽

And Control

This chapter describes the index and control group respondents. It describes their demographics: IQ, sex, age, ethnicity/race, nationality, religion, education, occupation, income, marital status, and sexual orientation. It relates these variables to self-reported offending. The characteristics of the most criminal 20 percent (using measures that include crime frequency and crime seriousness) are compared with those of the least criminal 20 percent (including abstainers, who claim to have committed no offenses). The chapter also describes respondents’ personality traits (as measured by the revised Eysenck Personality Questionnaire) and their experiences with mental illness and mental health treatment, as well as the books, movies, and famous figures that shaped the respondents’ thinking and influenced their behavior.

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Sexual orientation disparities in mental health: the moderating and mediating role of sociodemographic and minority stress factors

European Journal of Public Health ◽

10.1093/eurpub/ckw170.047 ◽

2016 ◽

Vol 26 (suppl_1) ◽

Cited By ~ 2

Author(s):

R Bränström ◽

ML Hatzenbuehler ◽

JE Pachankis

Keyword(s):

Mental Health ◽

Sexual Orientation ◽

Minority Stress ◽

Stress Factors ◽

Mediating Role

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Investigation of population-based mental health staffing and efficiency-based mental health productivity using an information-theoretic approach

PLoS ONE ◽

10.1371/journal.pone.0256268 ◽

2021 ◽

Vol 16 (8) ◽

pp. e0256268

Author(s):

Matt Boden ◽

Clifford A. Smith ◽

Jodie A. Trafton

Keyword(s):

Mental Health ◽

Mental Health Treatment ◽

Population Based ◽

Treatment Quality ◽

Theoretic Approach ◽

Health Treatment ◽

Information Theoretic ◽

Staffing Ratios ◽

Information Theoretic Approach ◽

Best Fit

Background Healthcare systems monitor and improve mental health treatment quality, access, continuity and satisfaction through use of population-based and efficiency-based staffing models, the former focused on staffing ratios and the latter, staff productivity. Preliminary evidence suggests that both high staffing ratios and moderate-to-high staff productivity are important for ensuring a full continuum of mental health services to indicated populations. Methods & findings With an information-theoretic approach, we conducted a longitudinal investigation of mental health staffing, productivity and treatment at the largest integrated healthcare system in American, the Veterans Health Administration (VHA). VHA facilities (N = 140) served as the unit of measure, with mental health treatment quality, access, continuity and satisfaction predicted by facility staffing and productivity in longitudinal mixed models. An information-theoretic approach: (a) entails the development of a comprehensive set of plausible models that are fit, ranked and weighted to quantitatively assess the relative support for each, and (b) accounts for model uncertainty while identifying best-fit model(s) that include important and exclude unimportant explanatory variables. In best-fit models, higher staffing was the strongest and most consistent predictor of better treatment quality, access, continuity and satisfaction. Higher staff productivity was often, but not always associated with better treatment quality, access, continuity and satisfaction. Results were further nuanced by differential prediction of treatment by between- and within-facility predictor effects and variable interactions. Conclusions A population-based mental health staffing ratio and an efficiency-based productivity value are important longitudinal predictors of mental health treatment quality, access, continuity and satisfaction. Our longitudinal design and use of mixed regression models and an information-theoretic approach addresses multiple limitations of prior studies and strengthen our results. Results are discussed in terms of the provision of mental health treatment by healthcare systems, and analytical modeling of treatment quality, access, continuity and satisfaction.

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