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.