Abstract
Demand for mental health services in the United States has increased, but epidemiological research shows 50 to 60 percent of patients in treatment do not meet criteria for a past-year disorder, the indicator of “true” or “legitimate” clinical need. Thus, many seem to be inappropriately consuming services already in limited supply. However, if clinical need indicators were broadened to incorporate histories of disorder (including those recovering) and serious psychological distress, most patients should exhibit true clinical need—a disorder history, serious distress, or both. Self-labeling and treatment-seeking theories add that voluntary treatment use is especially likely when individuals correctly recognize their clinical symptoms as a mental health problem. Tests with National Survey on Drug Use and Health 2019 data (N = 41,528) showed a majority of patients indeed had broadened clinical needs that they accurately identified as mental health problems. Consuming limited services for nonclinical reasons is less common than previously thought.
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