The two major aims of the proposed study are 1) to develop a comprehensive model of the help-seeking process for men and women across two types of mental health problems--alcohol abuse and depression; and 2) to model rural/urban differences in help-seeking for these mental disorders. Data for the study will come from telephone interviewers with 4,000 respondents, 1,940 selected from respondents to a 1989 survey and the remainder selected to over-represent rural and frontier counties. Data on the availability of health and mental health services available locally to respondents will also be collected. Findings from the study can be expected to answer important theoretical questions regarding the three-way relationship between methods of self-help, the use of informal support networks, and access to formal mental health services, about gender variation in help-seeking pathways, and about differences in the use of formal and informal support across different types of disorder. Because the study includes panel data, results will also be useful in assessing the direction of causality between onset of psychological symptoms, the availability and scope of informal support systems use of formal services, and the subsequent course of illness. Finally, results will provide important basic information about structural and cultural barriers to use of mental health services in rural areas. This information will be of particular relevance to rural health services planners and providers because it will generate more refined models for estimating rural mental health service needs by taking into account both rates of impairment in rural communities and the cultural/ attitudinal barriers which serve as deterrents to the use of formal mental health care and will yield information on preferred sources, types, and settings for treatment.
