| Description |
In 1991, the National Advisory Mental Health Council issued a national research priority to identify the capacities of individuals with severe mental illness to engage in ordinary personal techniques of preventive medicine that would protect and promote their overall well-being. In this study, the model of care-seeking behavior was used to examine the capacity of individuals with severe mental illness to participate in tuberculosis skin testing. Eighty-five clients with severe mental illness, ages 20 to 76 and enrolled in a large inner-city community mental health center, participated in the study. A questionnaire measuring each of the care-seeking behavior model components (i.e., affect, beliefs, norms, habits, and barriers) was administered to participants. Over a 4-month period, 66% of the participants volunteered to be skin tested, and 13% tested positive. Compliance with return for skin test reading was 95%. Logistic regression analyses revealed strong support for three care-seeking behavior model components. Clients whose social network (norms) supported their decisions to be tested were more likely to receive a skin test (odds ratio: 2.77, p < .01). There was also a significant interaction between beliefs and barriers on participation in skin testing. For individuals with one or more barriers, positive beliefs about the worth and expectations of tuberculosis skin testing were related to actual participation. For those with no barriers, no significant relationship was found between beliefs and participation in skin testing. Other main model variables of affect and habits did not explain care seeking behavior. Demographic, clinical, and other health behavior-related variables did not explain participation in tuberculosis skin testing after controlling for model variables. Findings from this study suggest that implementing on-site health screening clinics at community mental health centers might play an important role in promoting risk reduction and improving the physical health of this vulnerable population. Intervention techniques that promote positive beliefs and expectations regarding health screening, make use of important social influences (e.g., therapists, psychiatrists, and friends), and minimize environmental barriers associated with health screening are recommended. |
