The Role of Life Course Adversity on Mental Health Services Utilization Among Women

Introduction: Women are more likely to experience certain social adversities across the life span and have a higher risk of developing several leading mental health conditions. As such, better understanding the role of social factors on mental health services use (MHSU) is necessary to enhance the provision of quality care among this population. Objectives: This dissertation project explored the risk patterns and interrelationships among adverse childhood experiences (ACEs), intimate partner violence (IPV), and everyday discrimination on MHSU among women in the U.S. Methods: Waves I and III-V of The National Longitudinal Study of Adolescent to Adult Health restricted-use data files were analyzed. Latent class and joint effects analyses were performed to assess relationships between 1) patterns of ACEs and MHSU; 2) ACEs and IPV on MHSU; and 3) IPV and discrimination on MHSU (overall and by race/ethnicity). Results: Five classes of ACEs were identified including: 1) Childhood Maltreatment and Household Dysfunction (CM/HD), 2) High ACEs, 3) Low ACEs, 4) Childhood Maltreatment (CM), and 5) Household Dysfunction (HD). CM/HD, High ACEs, and CM classes exhibited a higher odds of MHSU than the Low ACEs class. A positive joint effect was observed between ACEs and IPV, while a negative joint effect was observed between IPV and discrimination on MHSU, although not statistically significant. The latter also varied by race/ethnicity. Conclusion: Overall, findings underscore the importance of providing equitable access to culturally sensitive, IPV-, and trauma-informed mental health services to meet the demand for care among women with compounded social risk profiles