Citation

Lowe SR, Fink DS, Norris FH, Galea S. Soc. Psychiatry Psychiatr. Epidemiol. 2014; 50(1): 99-108.

Affiliation

Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 W. 168th St, Room 720F, New York, NY, 10032, USA, srl2143@columbia.edu.

Copyright

(Copyright © 2014, Holtzbrinck Springer Nature Publishing Group)

DOI

10.1007/s00127-014-0908-y

PMID

24929355

Abstract

BACKGROUND: The majority of disaster survivors suffering from psychological symptoms do not receive mental health services. Research on barriers to service use among disaster survivors is limited by a lack of longitudinal studies of representative samples and investigations of predictors of barriers. The purpose of this study was to address these limitations through analysis of a three-wave population-based study of Hurricane Ike survivors (N = 658).

METHODS: Frequencies of preference, outcome expectancy, resource, and stigma barriers among participants with unmet mental health needs were documented and logistic regression using a generalized estimating equations approach explored predisposing (e.g., age), illness-related (e.g., posttraumatic stress) and enabling (e.g., insurance coverage) factors as predictors of each type of barrier.

RESULTS: Preference barriers were most frequently cited at each wave, whereas stigma barriers were least frequently cited. Older age and higher emotional support predicted preference barriers; being a parent of a child under 18-years old at the time of the hurricane, higher generalized anxiety, and lack of insurance predicted resource barriers; and higher posttraumatic stress predicted stigma barriers.

CONCLUSIONS: These findings suggest that postdisaster practices targeting subpopulations most likely to have barriers to service use may be indicated.

Language: en