Social Networks and Patterns of Use among the Poor with Mental Health Problems in Puerto Rico

Bernice A. Pescosolido, Eric R. Wright, Margarita Alegría, Mildred Vera

    Research output: Contribution to journalArticle

    138 Citations (Scopus)

    Abstract

    Objectives. This study uses the recently developed Network-Episode Model (NEM) to examine the nature and correlates of utilization among Puerto Ricans reporting mental health problems. The NEM highlights two issues: (1) examining the patterns or combinations of lay and formal use that individuals employ and (2) reformulating how the availability and content of social networks influences patterns of care. Methods. Using data from the 1989 Mental Health Care Utilization Among Puerto Ricans Study (probability sample of 1,777 individuals living in low-income areas of the island), the authors focus on the patterns and correlates of use for 365 Puerto Ricans reporting service use for mental health problems in the previous year. Results. A combination of clustering and multinomial logit techniques indicates that there are six unique care patterns. Two patterns include the use of mental health providers and are associated with different contingencies. Conclusions. In general, patterns of use are shaped by age, education, gender, and illness severity. Larger, more supportive networks decrease the use of patterns of care that include formal health care providers, and decrease direct entry into the mental health sector. These results are in line with NEM's predictions for lower class populations and help clarify inconsistencies in previous research on social networks. The implications of this perspective for health services research and treatment are discussed.

    Original languageEnglish
    Pages (from-to)1057-1072
    Number of pages16
    JournalMedical Care
    Volume36
    Issue number7
    StatePublished - Jul 1998

    Fingerprint

    Puerto Rico
    Social Support
    Mental Health
    social network
    mental health
    Hispanic Americans
    Patient Acceptance of Health Care
    Sampling Studies
    utilization
    Health Services Research
    health care
    Mental Health Services
    Islands
    Health Personnel
    lower class
    Cluster Analysis
    contingency
    Education
    health service
    low income

    Keywords

    • Mental health
    • Social networks
    • Utilization

    ASJC Scopus subject areas

    • Public Health, Environmental and Occupational Health
    • Nursing(all)
    • Health(social science)
    • Health Professions(all)

    Cite this

    Pescosolido, B. A., Wright, E. R., Alegría, M., & Vera, M. (1998). Social Networks and Patterns of Use among the Poor with Mental Health Problems in Puerto Rico. Medical Care, 36(7), 1057-1072.

    Social Networks and Patterns of Use among the Poor with Mental Health Problems in Puerto Rico. / Pescosolido, Bernice A.; Wright, Eric R.; Alegría, Margarita; Vera, Mildred.

    In: Medical Care, Vol. 36, No. 7, 07.1998, p. 1057-1072.

    Research output: Contribution to journalArticle

    Pescosolido, BA, Wright, ER, Alegría, M & Vera, M 1998, 'Social Networks and Patterns of Use among the Poor with Mental Health Problems in Puerto Rico', Medical Care, vol. 36, no. 7, pp. 1057-1072.
    Pescosolido BA, Wright ER, Alegría M, Vera M. Social Networks and Patterns of Use among the Poor with Mental Health Problems in Puerto Rico. Medical Care. 1998 Jul;36(7):1057-1072.
    Pescosolido, Bernice A. ; Wright, Eric R. ; Alegría, Margarita ; Vera, Mildred. / Social Networks and Patterns of Use among the Poor with Mental Health Problems in Puerto Rico. In: Medical Care. 1998 ; Vol. 36, No. 7. pp. 1057-1072.
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