Patterns of seeking help for psychologic problems were investigated using interview and medical record data in a representative community sample and a sample of mental health clinic users from the same eligible population. In multivariate analyses, users of psychiatric services, compared with nonusers, were significantly younger, more likely to be separated or divorced, more psychologically distressed, and physically symptomatic. They were also more likely to use a large multispecialty clinic, compared with satellite clinics, and less likely to have membership in the prepaid medical plan established by the multispecialty clinic. Users had a greater reported propensity to seek help for anxiety and were more likely to know other mental health services users. Confiding social support was not significantly associated with use of mental health services, controlling for psychologic symptoms. Substantial social selection in seeking help was evident at both high and low levels of psychologic distress. Mental health users, compared with nonusers, reported more of most types of symptoms studied, except withdrawal, obsessive-compulsive symptoms, and alcohol consumption. Particular social characteristics and symptoms were associated with seeking help in general and other characteristics were more specifically linked to choice of a particular provider.
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