Determinants of ambulatory treatment mode for mental illness

We estimate a reduced-form bivariate probit model to analyse jointly the choice of ambulatory treatment from the specialty mental health sector and/or the use of psychotropic drugs for a nationally representative sample of US household residents. We find significant differences in treatment choice by education, gender, race and ethnicity, while controlling for several aspects of self-reported mental health and treatment attitudes. For example, while women are more likely than men to use the specialty mental health sector and more likely to take psychotropic medications, this difference between men and women is much greater for psychotropic medications. The estimated differences may reflect patient preferences in a manner traditionally assumed when interpreting these coefficients in such equations, but we discuss how they may also reflect biases and misperceptions on the parts of patients and providers. We also discuss how our results relate to some findings and policies in the general health care sector.