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Administration and Policy in Mental Health and Mental Health Services Research

Published in:

01-03-2006

Poor and Depressed, The Tip of the Iceberg: The Unmet Needs of Enrollees in an Indigent Health Care Plan

Authors: Roger A. Boothroyd, Katherine A. Best, Julienne A. Giard, Paul G. Stiles, Janet Suleski, Rhonda Ort, Ronnie White

Published in: Administration and Policy in Mental Health and Mental Health Services Research | Issue 2/2006

Abstract

Depression is a leading cause of disability [World Health Organization (WHO), 2001] with economic costs exceeding $63 billion per year in the US [U.S. Department of Health and Human Services (DHHS), 1999]. The challenges of treating depression among the poor are compounded by broader social needs. This study examined the prevalence of depression and psychosocial needs among enrollees in an indigent health care plan. Results indicated clinical levels of depression were present in 28.6% of respondents (n=1,405). Depressed respondents were significantly more likely (p<0.001) to have co-occurring alcohol (OR=1.78; CI₉₅=1.32–2.40), drug (OR=2.67; CI₉₅=1.80–3.98), and health (OR=5.44; CI₉₅ = 4.12–7.19) problems compared to non-depressed respondents. Significantly more social needs were also associated with depression. Depressed respondents averaged 7.8 needs compared to 3.6 among non-depressed respondents. Needs included a significantly increased likelihood (p<0.001) of lacking sufficient food (OR=2.56; CI₉₅=1.97–3.34), shelter (OR=3.67; CI₉₅=2.23–6.05), or money (OR=3.18; CI₉₅= 2.39–4.23) and having more legal (OR=2.95; CI₉₅=2.22–3.92) and family (OR=3.00; CI₉₅=2.32–3.86) problems. The high rates of co-occurring social needs among individuals with clinical depression underscores the need for comprehensive, coordinated care in order to improve their quality of life and also reduce high utilization of crisis management services.

The degrees of freedom have been adjusted to correct for unequal variances within the two groups.

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Title: Poor and Depressed, The Tip of the Iceberg: The Unmet Needs of Enrollees in an Indigent Health Care Plan
Authors: Roger A. Boothroyd
Katherine A. Best
Julienne A. Giard
Paul G. Stiles
Janet Suleski
Rhonda Ort
Ronnie White
Publication date: 01-03-2006
Publisher: Springer US
Published in: Administration and Policy in Mental Health and Mental Health Services Research / Issue 2/2006
Print ISSN: 0894-587X
Electronic ISSN: 1573-3289
DOI: https://doi.org/10.1007/s10488-006-0030-x

At a glance: The STEP trials

Springer Medicine

Poor and Depressed, The Tip of the Iceberg: The Unmet Needs of Enrollees in an Indigent Health Care Plan

Abstract

At a glance: The STEP trials

Springer Medicine

Abstract

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