Demographic and economic predictors of mental health problems and contact with treatment resources among adults in a low-income primary care setting

Abstract

The purpose of this study was to examine the prevalence of mental health-related problems in a low-income primary care setting, as well as the demographic and economic variables associated with these problems and contact with treatment resources. A total of 346 patient records were randomly selected among patients at an urban Iowa primary care clinic serving lower-income and uninsured individuals. Logistic models examined relationships among demographic factors, poverty level, and insurance status and three outcomes: Lifetime mental health problems, receipt of pharmacological intervention, and contact with psychosocial services. Female gender was associated with reporting mental health problems, and age and ethnicity interacted to predict reported mental health problems. Among those reporting mental health problems, female gender was predictive of contact with psychosocial services, while female gender with Caucasian ethnicity was predictive of receiving pharmacological intervention. Results support the need for primary care providers working with lower-income individuals to be active in discussing mental health issues with patients.

Keywords:

• mental health
• primary health care
• poverty
• urban health
• ethnic groups