Personality traits and mental health care utilization: Longitudinal findings from the MIDUS
Ayla J Goktan, Sara J Weston, Jing Luo, Eileen K Graham, Daniel K Mroczek
*Journal of Research in Personality*
Why we asked
Many people with a mental illness in the United States do not get treatment. If we knew more about who seeks help and how that changes over time, we could design better ways to get people into care and keep them there. Personality traits, especially emotional stability (the low end of neuroticism), had been linked to mental health care use in cross-sectional studies. Much less was known about how personality and care use change together across adulthood, and whether using care goes along with later changes in personality.
What we did
We used three waves of the Midlife in the United States study (MIDUS), collected between 1994 and 2014. Participants rated their Big Five traits and reported three kinds of mental health care: visits to professionals, psychiatric medication, and self-help groups. We combined these into one measure of mental health care use. Then we fit latent growth curve models, which estimate each person’s starting level and rate of change on each variable. In other words, we could ask whether people who started higher on one thing changed differently on the other. We accounted for depression, anxiety, and panic disorder, along with demographics and insurance.
What we found
At the start of the study, people who used more mental health care were lower in emotional stability, and to a lesser degree lower in extraversion and conscientiousness. Over time, higher care use was associated with increases in emotional stability. Higher emotional stability at the start was associated with decreases in care use, although that association was small. People who became more emotionally stable, more extraverted, or more conscientious also tended to decrease their care use. The link from care use to later emotional stability held for medication and professional help but not for self-help groups.
We cannot tell which direction these associations run. One reading is that care helps people become more stable. Another is that people who are becoming more stable need less care, and both may be true.
What it means
The MIDUS personality scales are short and imperfectly reliable, care use is self-reported, and the sample is more than 90% White. Personality and mental health care use move together over adulthood, and the direction remains to be tested.