Economic indicators of mental health service utilization in rural Appalachia

This exploratory study examined the relative predictive strengths of selected economic factors (welfare cases, banking activity, unemployment, retail sales, motor vehicle sales) for utilization of mental health services (hotline calls, intake at community mental health centers and admissions at mental hospitals) over a 78-month period in rural Appalachia. Monthly data were tested for autocorrelation and adjusted for seasonality and inflation. Regression analyses indicated that (a) economic factors did account for a considerable portion of variance in mental health factors; (b) these factors predicted mental hospital admissions and hotline calls; (c) strengths of these relationships were quite consistent across the areas sampled, but the directions sometimes were different; (d) welfare factors were the best predictors of utilization; (e) Aid to Families with Dependent Children was generally the best single predictor of utilization, especially when mental health factors were lagged by 3 months. A causative model describing the decision-making process involved in the utilization of mental health services was presented. This research was supported by grant number 1R01 MH34382 01 from the National Institute of Mental Health, Division of Biometry and Epidemiology, 1980–1981. The empirical data were collected with the help of the Shawnee Mental Health Services of Marietta, Ohio, Western District Guidance Center of Parkersburg, West Virginia, the Ohio Department, the Administrative Office of the U.S. Court, the Federal Reserve Banks of Public Welfare, the West Virginia Department of Health, the West Virginia Tax DEpartment, the Administrative Office of the U.S. Court, the Federal Reserve Banks of Cleveland and of Richmond, and Parkersburg National Bank. Robert Kirkbride of Marietta College and Robert Evans of People's Bank of Marietta, Ohio, provided economic advice. The computer facilities of Marietta College were used to store and analyze data. Barrie Gardner and Lucinda Pyatt, as research assistants, collected and analyzed much of the data.