Table 3.
Association between Mental Health Service Use and Predisposing, Enabling and Mental Health Need Factors
| Model 1 | Model 2 | Model 3 | Model 4 | |||||
|---|---|---|---|---|---|---|---|---|
| OR [95% CI] | p | OR [95% CI] | p | OR [95% CI] | p | OR [95% CI] | p | |
| Predisposing factors | ||||||||
| Gender | ||||||||
| Male (Reference) | ||||||||
| Female | 1.06 [.61, 1.84] | .84 | 1.03 [.62, 1.73] | .90 | .99 [.58, 1.68] | .96 | 1.09 [.65, 1.81] | .75 |
| Age | ||||||||
| 60–64 (Reference) | ||||||||
| 65–74 | .58 [.34, .97] | .04 | .60 [.36, .99] | .05 | .60 [.35, 1.02] | .06 | .56 [.34, .93] | .03 |
| 75+ | .52 [.29, .94] | .03 | .55 [.30, 1.00] | .05 | .53 [.28, .97] | .04 | .50 [.28, .90] | .02 |
| Omnibus test (p-value) | .09 | .12 | .12 | .14 | ||||
| Race/Ethnicity | ||||||||
| White (Reference) | ||||||||
| Black | .36 [.11, 1.15] | .08 | .28 [.10, .78] | .02 | .27 [.09, .84] | .02 | .32 [.07, 1.47] | .14 |
| Asian | .15 [.10, .22] | <.01 | .06 [.03, .11] | <.01 | .06 [.04, .10] | <.01 | .08 [.05, .14] | <.01 |
| Latinx | .35 [.23, .54] | <.01 | .20 [.13, .30] | <.01 | .17 [.11, .26] | <.01 | .34 [.22, .53] | <.01 |
| Omnibus test (p-value) | <.01 | <.01 | <.01 | <.01 | ||||
| Education | ||||||||
| <HS (Reference) | ||||||||
| HS, GED or more | 1.27 [.88, 1.85] | .20 | 1.33 [.88, 1.99] | .17 | 1.33 [.87, 2.05] | .19 | 1.27 [.87, 1.85] | .21 |
| Mental Health Need | ||||||||
| Paykel | ||||||||
| Not triggered (Reference) | ||||||||
| Triggered | 1.24 [.54, 2.87] | .62 | 1.17 [.51, 2.73] | .71 | 1.24 [.54, 2.82] | .62 | 1.25 [.54, 2.90] | .60 |
| GAD-7 Score | 1.12 [1.04, 1.22] | <.01 | .98 [.92, 1.04] | .43 | 1.12 [1.04, 1.21] | <.01 | 1.12 [1.04, 1.22] | <.01 |
| GDS score | 1.05 [1.00, 1.10] | .04 | 1.05 [.99, 1.11] | .08 | .89 [.82, .97] | <.01 | 1.04 [.99, 1.10] | .11 |
| PC-PTSD | ||||||||
| 0 symptoms (Reference) | ||||||||
| 1+ symptoms | 2.11 [1.42, 3.14] | <.01 | 2.09 [1.42, 3.08] | <.01 | 2.09 [1.39, 3.14] | <.01 | 1.46 [.71, 3.01] | .30 |
| Enabling Factors | ||||||||
| MoCA score | .96 [.91, 1.00] | .06 | .96 [.91, 1.00] | .05 | .95 [.91, 1.00] | .06 | .96 [.91, 1.00] | .06 |
| Interactions | ||||||||
| Interaction with Anxiety | ||||||||
| GAD-7 Score x Black | 1.09 [.98, 1.21] | .12 | ||||||
| GAD-7 Score x Asian | 1.23 [1.14, 1.34] | <.01 | ||||||
| GAD-7 Score x Latinx | 1.16 [1.09, 1.24] | <.01 | ||||||
| Omnibus test (p-value) | <.01 | |||||||
| Interaction with depression | ||||||||
| GDS-15 Score x Black | 1.09 [.96, 1.24] | .17 | ||||||
| GDS-15 Score x Asian | 1.24 [1.14, 1.35] | <.01 | ||||||
| GDS-15 Score x Latinx | 1.23 [1.07, 1.41] | <.01 | ||||||
| Omnibus test (p-value) | <.01 | |||||||
| Interaction with PC-PTSD | ||||||||
| 1+ symptoms x Black | 1.30 [.39, 4.28] | .67 | ||||||
| 1+ symptoms x Asian | 2.88 [1.29, 6.41] | <.01 | ||||||
| 1+ symptoms x Latinx | 1.19 [.45, 3.17] | .73 | ||||||
| Omnibus test (p-value) | .01 | |||||||
Note. OR = Odds ratio; CI = Confidence interval; PC-PTSD = Primary Care PTSD 4-item Screen (Cameron & Gusman, 2003); GAD-7 = Generalized Anxiety Disorder 7-item (Spitzer et al., 2006); GDS-15 = Geriatric Depression Scale 15-item (Sheikh & Yesavage, 1986); MoCA = Montreal Cognitive Assessment (Nasreddine et al., 2005); HS = High school; GED = General Education Development test.