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Triple jeopardy: impact of partner violence perpetration, mental health and substance use on perceived unmet need for mental health care among men

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Abstract

Objectives

To examine the relationship between intimate partner violence (IPV) perpetration, serious mental illness, and substance use and perceived unmet need for mental health treatment in the past year among men in the general population using the behavioral model for health-care use (Aday and Anderson in Health Serv Res 9:208–220, 1974; Andersen in A behavioral model of families’ use of health services, 1968; Andersen in Med Care 46:647–653, 2008).

Methods

Non-Hispanic black, Hispanic, and non-Hispanic white males aged 18–49 years and cohabiting with a spouse/partner were included in this analysis of the 2002 National Survey on Drug Use and Health. Adjusted odds ratios (AOR) and 95% confidence intervals (CI) were calculated using logistic regression.

Results

The proportion of men reporting unmet treatment need was greater among IPV perpetrators than nonperpetrators (12.1 vs. 3.4%, respectively). Hazardous drinking, illicit drug use, alcohol and drug abuse/dependence, and SMI were also more common among perpetrators. Perpetrators were twice as likely to report unmet need for treatment after taking predisposing, enabling, and need factors into account (AOR 2.00, CI 1.13–3.55). Alcohol abuse/dependence (AOR 2.96, CI 1.79–4.90), drug abuse/dependence (AOR, 1.79, CI 1.01–3.17), substance abuse treatment (AOR 3.09, CI 1.18–8.09), and SMI (AOR 8.46, CI 5.53–12.94) were independently associated with perceived unmet need for treatment.

Conclusions

These findings suggest that men who perpetrate IPV are at increased risk of perceived unmet need for mental health care. This study also emphasizes the need to identify substance use disorders and mental health problems among IPV perpetrators identified in health, social service, or criminal justice settings. Further research should address barriers to care specific to men who perpetrate IPV beyond economic factors.

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Acknowledgments

This work was supported by Grant Number K01AA015187 from the National Institute on Alcohol Abuse and Alcoholism to the University of Washington, Seattle. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute on Alcohol Abuse and Alcoholism or the National Institutes of Health. The authors would like to thank Qian Qiu for her assistance in the preparation of this manuscript.

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Authors and Affiliations

  1. Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, USA

    Sherry Lipsky & Peter Roy-Byrne

  2. University of Texas School of Public Health, Dallas Regional Campus, Dallas, USA

    Raul Caetano

  3. Center for Healthcare Improvement for Addictions, Mental Illness and Medically Vulnerable Populations (CHAMMP), University of Washington at Harborview Medical Center, 325 Ninth Ave, Box 359911, Seattle, WA, 98104-2499, USA

    Sherry Lipsky

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  1. Sherry Lipsky
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Correspondence to Sherry Lipsky.

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Lipsky, S., Caetano, R. & Roy-Byrne, P. Triple jeopardy: impact of partner violence perpetration, mental health and substance use on perceived unmet need for mental health care among men. Soc Psychiatry Psychiatr Epidemiol 46, 843–852 (2011). https://doi.org/10.1007/s00127-010-0258-3

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