Associations between multi-level contextual factors and mental health service utilization in adolescents with comorbid depression and substance-use: Moderating role of school connectedness on racial/ethnic disparities in service utilization

Hdl Handle:
http://hdl.handle.net/10675.2/622055
Title:
Associations between multi-level contextual factors and mental health service utilization in adolescents with comorbid depression and substance-use: Moderating role of school connectedness on racial/ethnic disparities in service utilization
Authors:
Thornton, Kate
Abstract:
Background: Comorbid depression and substance use has been a prevalent issue in adolescent health. Although rates have remained relatively stable, their level is still alarming and efforts to see a decrease have led leaders and organizations to call for research to better understand factors related to both depression and substance use as well as how these factors may change when these disorders occur together. Methods: Data from the National Survey on Drug Use and Health (NSDUH) were utilized to pursue the research objectives for this study. The NSDUH is an ongoing cross-sectional survey of the civilian and non-institutionalized population of the United States. Multi-level logistic regression procedures were used to determine the relationship between mental health care utilization and research variables in adolescents with comorbid depression and substance-use. Results: Multi-level modeling showed that the model that controlled for individual-level and family-level factors was able to best predict mental health care use (model 4, -2LL=945,303, p << 0.001). In addition, school attachment was shown to be positively associated with mental health care use in all models tested, including the best-fit model selected (OR=2.18;(95% CI 2.13, 2.22). Other contextual factors that were significantly associated with mental health care use were gender (OR=1.92;95% CI 1.88, 1.94), parental attachment (OR=1.72; 95% CI 1.70, 1.74), and poverty (OR=1.59; 95% CI 1.58, 1.62). In addition, the school attachment and race/ethnicity interaction term was found to be significant with an odds ratio of 3.02 (95% CI 2.96, 3.22). Conclusions: This research has shown the importance of contextual factors, specifically the school environment, on the service use of comorbid adolescents. Particularly interesting in the world of mental health promotion is the use of schools as key coordinators in providing specialty mental health services to adolescents, especially for those who suffer from service use disparities.
Affiliation:
Georgia State University
Publisher:
Georgia Public Health Association
Journal:
Journal of the Georgia Public Health Association
Issue Date:
2017
URI:
http://hdl.handle.net/10675.2/622055
Type:
Article
Language:
en
Appears in Collections:
jGPHA Volume 7, Number 1

Full metadata record

DC FieldValue Language
dc.contributor.authorThornton, Kateen
dc.date.accessioned2019-01-30T04:44:35Z-
dc.date.available2019-01-30T04:44:35Z-
dc.date.issued2017-
dc.identifier.urihttp://hdl.handle.net/10675.2/622055-
dc.description.abstractBackground: Comorbid depression and substance use has been a prevalent issue in adolescent health. Although rates have remained relatively stable, their level is still alarming and efforts to see a decrease have led leaders and organizations to call for research to better understand factors related to both depression and substance use as well as how these factors may change when these disorders occur together. Methods: Data from the National Survey on Drug Use and Health (NSDUH) were utilized to pursue the research objectives for this study. The NSDUH is an ongoing cross-sectional survey of the civilian and non-institutionalized population of the United States. Multi-level logistic regression procedures were used to determine the relationship between mental health care utilization and research variables in adolescents with comorbid depression and substance-use. Results: Multi-level modeling showed that the model that controlled for individual-level and family-level factors was able to best predict mental health care use (model 4, -2LL=945,303, p << 0.001). In addition, school attachment was shown to be positively associated with mental health care use in all models tested, including the best-fit model selected (OR=2.18;(95% CI 2.13, 2.22). Other contextual factors that were significantly associated with mental health care use were gender (OR=1.92;95% CI 1.88, 1.94), parental attachment (OR=1.72; 95% CI 1.70, 1.74), and poverty (OR=1.59; 95% CI 1.58, 1.62). In addition, the school attachment and race/ethnicity interaction term was found to be significant with an odds ratio of 3.02 (95% CI 2.96, 3.22). Conclusions: This research has shown the importance of contextual factors, specifically the school environment, on the service use of comorbid adolescents. Particularly interesting in the world of mental health promotion is the use of schools as key coordinators in providing specialty mental health services to adolescents, especially for those who suffer from service use disparities.en
dc.language.isoenen
dc.publisherGeorgia Public Health Associationen
dc.subjectcomorbiden
dc.subjectdepressionen
dc.subjectmental healthen
dc.subjectsubstance useen
dc.titleAssociations between multi-level contextual factors and mental health service utilization in adolescents with comorbid depression and substance-use: Moderating role of school connectedness on racial/ethnic disparities in service utilizationen
dc.typeArticleen
dc.contributor.departmentGeorgia State Universityen
dc.identifier.journalJournal of the Georgia Public Health Associationen
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