Beyond access to equity: The contribution of predisposing, enabling, and need factors to psychiatric rehabilitation...

People coping with severe mental illnesses (SMI) often face challenges in pursuing their recovery goals, reduced quality of life, and significant barriers to community participation. Psychiatric rehabilitation services (PRS) are intended to support individuals with SMI in leading meaningful lives, fostering autonomy, promoting social inclusion, and enhancing well-being. However, many eligible people do not utilize these services. This study examined factors associated with PRS utilization and how these findings could enhance service delivery and policy development considerations. In this cross-sectional study, 227 people with SMI entitled to PRS filled out an online survey distributed through social media and a psychiatric unit. The survey assessed utilization of PRS, knowledge about PRS, attitudes toward seeking mental health treatment, quality of provider-client relationship, and degree of shared decision making. PRS users showed greater knowledge (M = 8.17) and more positive attitudes (M = 3.40) than nonusers (M = 5.96, M = 2.41; t = -3.97, -8.29, respectively, p < .001). Quality of provider-client relationship (M = 4.77) and shared decision making (M = 31.73) were also higher among users compared to nonusers (M = 2.92, M = 11.96; t = -9.85, -10.68, respectively, p < .001). In the hierarchical logistic regression, positive attitudes (OR = 10.68, p < .001) and stronger provider-client relationships (OR = 2.42, p = .032) significantly predicted PRS utilization (R² = .599). Expanding the use of PRS may reduce hospitalizations, decrease system costs, and enhance community integration for individuals with SMI. Investing in recovery-oriented strategies that center service users as active agents, along with increasing mental health and PRS staffing to improve availability and reduce turnover, may promote help-seeking, improve quality of life, and bridge the gap between eligibility and actual PRS use. (PsycInfo Database Record (c) 2026 APA, all rights reserved).