The primary objectives of this project are: 1) to establish direct-survey prevalence rates of need for alcohol, drug abuse, and mental health (ADM) services for the rural population of a western state (Colorado); 2) to describe rural utilization of specialty and general-medical sector ADM services for these problems; 3) to establish specific need and utilization rates for three of Colorado's important rural subpopulations: Whites, Mexican-Americans, and American Indians. Using data from a 1985 large-scale, statewide survey of the ADM service needs of Colorado, the ADM problems of the state's rural and urban areas will be analyzed in terms of the three basic need measures used -- diagnosable disorders, everyday dysfunction, and demoralization -- and of the composites of these, such as persons with two or more need """"""""caseness"""""""" criteria, severe and chronic mental illness, and co-occurring psychiatric and substance abuse disorders. Need rates and service utilization rates will be determined for rural towns, rural non-towns, and rural metropolitan (exurban) areas. The influence of such factors as rural/urban status, ethnic or racial minority status, stresses, felt impairment, and availability and accessibility of ADM services on use of such services in the respondent's home region will be explored. Data will be collected from databases maintained by Colorado mental health and substance abuse agencies, private medical and psychiatric groups, and federal databases containing reported data for Colorado between 1980 and 1986. The researchers will also conduct 200 additional interviews with American Indian reservation residents to assess the ADM needs of this group and to incorporate American Indian data into the survey database.
