The use of mental health care, psychotropic drugs and social services by divorced people: does informal support matter?

Abstract

This study compares the mental health care, psychotropic drugs and social service use of divorced people (re-partnered or single) with that of married people. This paper questions whether the availability of informal support facilitates or substitutes for formal care seeking. Data from the Divorce in Flanders survey of 2009–2010 are used. Logistic regression analyses are performed separately for women (N = 3450) and men (N = 3020). Greater use of mental health care, psychotropic drugs and social services by single divorced men is explained by their higher need for care, while divorced women (especially single divorced) more frequently contact a general practitioner (GP), a psychiatrist, or a psychologist, regardless of their mental health, socio-economic background and informal support. Women who have support from non-family members are more inclined to use social services and to contact a GP, while support from family members is only positively related to GP consultations. With regard to men, informal support from non-family members positively influences each type of formal care seeking. Our results suggest that non-family members (and only among women, family members as well) can provide help and advice about seeking professional mental health care and social services, but they do not have an influence on psychotropic drug use.

Cette étude compare l'utilisation des soins de santé mentale, des médicaments psychotropes et des services sociaux par les divorcés (avec ou sans un nouveau partenaire) avec les mariés. Cet article examine si le soutien informel facilite ou remplace la demande de soins formels. Les données de l'enquête sur la divorce en Flandre 2009–2010 ont été utilisées. Des analyses de régression logistique ont été effectuées séparément pour les femmes (N = 3450) et les hommes (N = 3020). Une plus grande utilisation des soins de santé mentale, des médicaments psychotropes et des services sociaux par des hommes divorcés célibataires s'explique par leur plus grand besoin de soins, tandis que les femmes divorcées (surtout les divorcées célibataires) contactent le plus souvent un médecin généraliste, un psychiatre, ou un psychologue, indépendamment de leur santé mentale, le contexte socio-économique, et le soutien informel. Les femmes qui ont le soutien des membres non-familiaux sont plus tentées d'utiliser les services sociaux et de contacter un médecin, tandis que le soutien de membres de la famille n'est lié positivement qu'aux consultations de médecins généralistes. Quant aux hommes, le soutien des membres non-familiaux affecte positivement tout type d'utilisation de services professionnels. Nos résultats suggèrent que les membres non-familiaux (et uniquement chez les femmes ainsi que chez les membres de la famille) peuvent apporter de l'aide et des conseils sur la demande de soins de santé mentale professionnels et des services sociaux, mais n'ont pas d’ influence sur la consommation de médicaments psychotropes.

Keywords:

• mental health care use
• psychotropic drug use
• social services use
• divorce
• informal support
• gender

Mots-clés:

• L'utilisation des soins de santé mentale
• l'utilisation des médicaments psychotropes
• l'utilisations des services sociaux
• divorce
• le soutien informel

Notes on contributors

Veerle Buffel, Master of Sociology, is a doctoral student in Health Sociology and Social Demography at the Department of Sociology (BOF project), member of the research group Hedera (Health and Demographic Research).

Elien Colman, Master of Sociology, is a scientific assistant in the research group HeDeRa. She participates in the inter-university project, ‘DiF’. Her research focuses on the role of family characteristics for the use of professional help because of mental health problems.

Rozemarijn Dereuddre, Master of Sociology, is a doctoral student in Health Sociology and Social Demography at the Department of Sociology (FWO project), member of the research group Hedera.

Piet Bracke is a professor at the Department of Sociology. He teaches general sociological subjects, in addition to more specialised courses in health sociology. His research focuses on the sociology of the family and sociological epidemiology, with emphasis on mental health and on inter-country comparative research. He is currently involved in the Flemish research project ‘DiF’ and an international investigation into the determinants and consequences of stigma. He is the current president of the European Society of Health and Medical Sociology (ESHMS), member of the Scientific Advisory Board of the European Social Survey (ESS) and until recently professor of medical sociology at Nottingham University.

Notes

1. A dichotomous variable (also called a dummy or binary variable) is a numerical variable that takes only the value 0 or 1 to indicate the absence or presence of a certain characteristic or event (in our case for example, the absence [0] or presence [1] of professional care use). Dummies are also used to distinguish subgroups of the sample, such as the distinction between non-users (0) and users (1) in our study.

2. Interaction models specify moderators that regulate the size of an association. In addition to the external moderators (the most common), there are also internal moderators, which represent differences applicable only to the individuals in a particular situation and that affect outcomes, from which comparisons may also be made with people outside the situation (Mirowsky, 1999).