Past-Year Acute Behavioral Health Care Utilization Among Individuals With Mental Health Disorders: Results From the 2008 National Survey on Drug Use and Health

Abstract

Objective: Prevalence and correlates of past-year acute behavioral health care use were examined. Methods: Data are from the 2008 National Survey on Drug Use and Health (N = 10,069 adults with behavioral health disorders). Associations between past-year acute behavioral health care use and factors related to health care use were examined through bivariate and logistic regression analyses per Andersen's behavioral model of health services utilization. Results: Five percent of those with a behavioral health disorder used acute behavioral health care services. Several variables were significantly associated with acute care use in the final logistic regression model (R ² = .179, p < .0001). Individuals with co-occurring mental illness and substance use disorders (OR = 2.58), severe mental illness (OR = 2.89), and co-occurring severe mental illness and substance use disorders (OR = 4.15) were more likely to utilize acute behavioral health care services compared to those with non-severe mental illness only. Individuals with only one type of behavioral health disorder were most likely to receive services targeting only that area of need. However, the majority of those with co-occurring disorders (i.e., > 80%) received acute care for only one of their behavioral health disorders. Those with any past-year criminal justice involvement (OR = 3.19) were also significantly more likely to receive acute behavioral care in the past year. Conclusions: Individuals with co-occurring disorders have the highest rates of acute behavioral health care service utilization. Treatment for both conditions is rarely obtained in acute care facilities, supporting the need for better integration of care in these settings.

Keywords:

• acute behavioral care utilization
• severe mental illness
• substance use disorders
• co-occurring disorders
• dual diagnosis
• National Survey on Drug Use and Health

ACKNOWLEDGMENTS

The study authors would like to acknowledge Dr. Richard Van Dorn at the Department of Mental Health Law and Policy in the Florida Mental Health Institute at the University of South Florida for his assistance and expertise in the conceptualization and execution of study analyses. Additionally, the study authors would like to acknowledge Mr. Ezra Ochshorn for his editorial assistance in the drafting and revision of this manuscript. A version of this article was presented at the 139th annual meeting of the American Public Health Association held in Washington, DC, from October 29 to November 2, 2011.