Can the Behavioral Model of Health Care Utilization Be Used to Predict Completion of a Mental Health Assessment Following Intimate Partner Violence?

• Published in: Journal of interpersonal violence 2021-08, Vol.36 (15-16), p.7371-7392
• Main Authors: Peter, Samuel C., Lipinski, Alexandra J., Savage, Ulysses C., Dodson, Thomas S., Tran, Han N., Majeed, Rimsha, Beck, J. Gayle
• Format: Article
• Language: English
• Subjects: Access; Depression (Psychology); Domestic violence; Evaluation; Family Violence; Health planning; Health problems; Health services utilization; Help seeking behavior; Intimate partner violence; Mental depression; Mental disorders; Mental health; Mental Health Programs; Mental health services; Post traumatic stress disorder; Posttraumatic Stress Disorder; Psychological distress; Survivor; Symptoms; Trauma
• ISSN: 0886-2605; 1552-6518
• DOI: 10.1177/0886260519834995

Survivors of intimate partner violence (IPV) may experience mental health problems. Although some survivors access mental health resources to address these concerns, many discontinue prematurely. One model of health care utilization that has recently gained attention in the trauma literature is the behavioral model of health care utilization (BMHU). This model considers three groups of variables in predicting health care utilization: immutable predisposing variables (e.g., age), enabling resources (e.g., income), and measures of need (e.g., symptom severity). The current study tested the BMHU’s ability to predict completion of a free, multisession mental health evaluation for female survivors of IPV (N = 214). Two models were tested, each assessing a separate need-based predictor: The first model assessed symptoms of depression and the second model assessed symptoms of posttraumatic stress disorder (PTSD). Results were consistent across both models and suggested that younger age and receiving public assistance were both associated with a lower likelihood of completing the evaluation. Contrary to the BMHU’s assumed positive relation between symptom severity and health care utilization, greater severity of depression and PTSD symptoms were both associated with a lower likelihood of completing the evaluation. It is possible that following IPV, experiencing psychological distress may engender help-seeking but too much distress may serve as a barrier to continued utilization. Future research should seek to better understand the complex relation between need and access, in the context of mental health care, and develop strategies for retaining IPV survivors who access mental health resources.