Clinical Need, Perceived Need, and Treatment Use: Estimating Unmet Need for Mental Health Services in the Adult Population.

Estimates of unmet need for mental health services in the adult population are too high because many recover without treatment. Untreated recovery suggests that individuals accurately perceive professional help as unnecessary and do not pursue it. If so, perceived need for treatment should predict service use/nonuse more strongly than the presence or seriousness of disorder.

Successful supportive encounters from the peer supporter's perspective: Do status similarities to support recipients matter?

Experientially similar others, or "peer supporters," are persons who have faced a support recipient's stressor before. Theory suggests that peer supporters' understanding of and empathy for support recipients will be heightened when they match recipients not only in stressor experience but on one or more social statuses (e.g.

"I'm Not Mentally Ill": Identity Deflection as a Form of Stigma Resistance.

Mental illness identity deflection refers to rebuffing the idea that one is mentally ill. Predictors of identity deflection and its consequences for well-being were examined for individuals with mental disorders in the National Comorbidity Study-Replication (N = 1,368). Respondents more often deflected a mental illness identity if they had a nonsevere disorder, had low impairment in functioning, had no treatment experience, viewed possible treatment as undesirable, and held multiple social roles, consistent with theory about stigma resistance.

Mechanisms linking social ties and support to physical and mental health.

Over the past 30 years investigators have called repeatedly for research on the mechanisms through which social relationships and social support improve physical and psychological well-being, both directly and as stress buffers. I describe seven possible mechanisms: social influence/social comparison, social control, role-based purpose and meaning (mattering), self-esteem, sense of control, belonging and companionship, and perceived support availability. Stress-buffering processes also involve these mechanisms.

Stress and health: major findings and policy implications.

Forty decades of sociological stress research offer five major findings. First, when stressors (negative events, chronic strains, and traumas) are measured comprehensively, their damaging impacts on physical and mental health are substantial. Second, differential exposure to stressful experiences is a primary way that gender, racial-ethnic, marital status, and social class inequalities in physical and mental health are produced.

Personal agency in the stress process.

Stress researchers have typically controlled for the role of personal agency, or self-selection, in the stress process, rather than examining it. People in better mental health (those with high levels of coping resources and low levels of distress or disorder) should be more likely to exercise agency. Such individuals should, through problem-solving efforts and purposeful acts, experience fewer negative controllable events and more positive controllable events in their lives and be able to transform or compensate for stressors that they cannot avoid or eliminate.

Depression in the United States and Japan: gender, marital status, and SES patterns.

A number of investigators have claimed that higher depression scores and higher rates of depressive disorder are found worldwide in women, unmarried persons, and people of low socioeconomic status (SES). A closer look, however, indicates that patterns for Asian countries are less consistent than claimed. As a case in point, using comparable data from the National Family Research of Japan '98 survey (N=6985) and the National Survey of Families and Households in the US (N=8111), we examine the distributions of depressive symptoms by gender, marital status, and SES, with a short form of the CES-D Scale.

Differential labeling of mental illness by social status: a new look at an old problem.

Whether the higher rates of mental hospitalization and involuntary treatment for marginal social groups are due to differential labeling or simply to the occurrence of higher rates of disorder in these groups remains unresolved. I reexamine this issue with data from the National Comorbidity Survey (N = 5,877) that allow comparisons between disturbed individuals living in the community untreated and disturbed persons who have been hospitalized or seen a professional for their mental health problems under pressure or voluntarily. Contrary to labeling theory, members of lower status groups are not consistently overrepresented among those who have been hospitalized or seen a professional against their will.