@article{ref1,
title="Frequencies and predictors of barriers to mental health service use: a longitudinal study of Hurricane Ike survivors",
journal="Social psychiatry and psychiatric epidemiology",
year="2014",
author="Lowe, Sarah R. and Fink, David S. and Norris, Fran H. and Galea, Sandro",
volume="50",
number="1",
pages="99-108",
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). <br><br>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. <br><br>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. <br><br>CONCLUSIONS: These findings suggest that postdisaster practices targeting subpopulations most likely to have barriers to service use may be indicated.<p /> <p>Language: en</p>",
language="en",
issn="0933-7954",
doi="10.1007/s00127-014-0908-y",
url="http://dx.doi.org/10.1007/s00127-014-0908-y"
}