Predictors of the use of community mental health services

Background: Healthcare systems worldwide are struggling to keep up with the demand created by rising rates of mental health problems. There is a push to increase provision of mental health services in community settings to reduce the strain on hospitals and primary care. However, there is currently very limited evidence on predictors of community mental health service use. This limits our ability to direct resources to people and areas with greater needs, and to identify inequalities in access to services.<br/><br/>Methods: We obtained data on use of community mental health services for 22,277 adult respondents in England from three nationally representative survey data sets. We used logistic regression to relate service use to 14 individual and three area characteristics, and explored whether predictors of service use have changed over time. We then discuss whether the findings suggest variations in access or needs.<br/><br/>Results: In addition to poor mental and physical health, we find that being younger, single, and not employed are associated with higher likelihood of community mental health service use. These findings likely indicate greater need for services. We also find that living in a rural area, the North West region, or being of Asian ethnicity are predictors of lower use. We contend that these results highlight potential inequalities in access. Despite rising rates of service use, these patterns of predictors are consistent over time.<br/><br/>Conclusions: These findings can help inform where additional resources for community mental health services are best directed to reduce the strain on services, and improve access and outcomes.