ECONOMIC DECLINE AND PSYCHOSOCIAL IMPAIRMENT

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The two major aims of the proposed research are: 1) to develop and test a comprehensive model that links local economic conditions to depression, alcohol abuse, impairments of social roles brought about by these disorders, and help seeking behavior; and (2) to model rural/urban differences in the way economic variables affect psychosocial functioning. Data for the study will come from an existing two-wave panel study of Nebraskans' mental health and from the proposed addition of a third-wave of panel data and a time- series of county-level economic indicators and mental health system utilization rates. Analyses will make use of structural equation model techniques and the time-series methods that have been devel- oped for combined time-series and cross-sectional data sets. Findings from the study can be expected to answer important theoretical questions regarding the interface of local economic conditions and individual stress/distress processes, the causal relationship between alcohol abuse and depression, the role of social support in buffering economic distress, and the linkage between standard community survey depression scales and depression, as identified by the Diagnostic Interview Schedule (DIS). Results will also provide important basic information about the prevalence of psychosocial impairment in rural areas and about changes in the need for mental health care in communities undergoing economic decline. Of particular relevance to mental health planners will be analyses of the relationships between estimated need for services (based on DIS). Results will also provide important basic information about the prevalence of psychosocial impairment in rural areas and about changes in the need for mental health care in communities undergoing economic decline. Of particular relevance to mental health planners will be analyses of the relationships between estimated need for services (based on DIS), treated cases, individual help seeking (including indicators of the amount and types of services sought) and the availability of formal support systems. Results will be explicated in both a rural and urban context.