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We analyzed pooled data from six waves (2019\u20132024) of the National Health Interview Survey (NHIS), comprising 128,261 adults aged \u226540 years. Comorbidity burden was the primary predictor, categorized as none, one, or \u22652 chronic conditions, while together with additional predictors was organized according to the predisposing, enabling, and need domains of Andersen\u2019s Behavioral Model of Health Services Use. MHC utilization, the outcome, was defined as counseling or psychotherapy, mental health medication use, or visits to a mental health specialist within the previous 12 months. Survey-weighted multivariable logistic regression accounted for the complex survey design and sampling weights. Overall, approximately one in five adults utilized MHC services. Utilization was higher among females, non-Hispanic White adults, unmarried adults, smokers, overweight or obese adults, those with lower income, those with health insurance coverage, or residence in the Midwest, and those with one or \u22652 comorbidities, depression, or anxiety. In contrast, utilization was lower among adults aged 50\u201364, 65\u201374, and \u226575 years, non-Hispanic Black and Asian adults, and those with higher educational attainment. Taken together, these findings indicate that MHC utilization is shaped by comorbidity burden alongside predisposing, enabling, and need-related factors, underscoring the need for targeted and culturally responsive strategies to improve equitable access to MHC among this ageing population.<\/jats:p>","DOI":"10.1371\/journal.pmen.0000744","type":"journal-article","created":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T18:06:25Z","timestamp":1791569185000},"page":"e0000744","update-policy":"https:\/\/doi.org\/10.1371\/journal.pmen.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Mental health care utilization among middle-aged and older U.S. adults: Findings from the National Health Interview Survey"],"prefix":"10.1371","volume":"3","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-3778-1318","authenticated-orcid":true,"given":"Charllote","family":"Boateng","sequence":"first","affiliation":[{"name":"The University of Memphis","place":["Memphis, Tennessee, United States of America"],"department":["Division of Epidemiology, Biostatistics, and Environmental Health, School of Public Health"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4501-8602","authenticated-orcid":true,"given":"Isaiah","family":"Osei Duah Junior","sequence":"additional","affiliation":[{"name":"College of Science, Kwame Nkrumah University of Science and Technology","place":["Kumasi, Ghana"],"department":["Department of Optometry and Visual Science"]},{"name":"John R. and Kathy R. Hairston College of Health and Human Sciences, North Carolina Agricultural and Technical State University","place":["Greensboro, North Carolina, United States of America"],"department":["Department of Psychology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-4986-606X","authenticated-orcid":true,"given":"Brandy Swati","family":"Bonnah","sequence":"additional","affiliation":[{"name":"The University of Memphis","place":["Memphis, Tennessee, United States of America"],"department":["Division of Epidemiology, Biostatistics, and Environmental Health, School of Public Health"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4299-9233","authenticated-orcid":true,"given":"Bikram","family":"Adhikari","sequence":"additional","affiliation":[{"name":"The University of Memphis","place":["Memphis, Tennessee, United States of America"],"department":["Division of Epidemiology, Biostatistics, and Environmental Health, School of Public Health"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6683-249X","authenticated-orcid":true,"given":"Kwadwo Owusu","family":"Akuffo","sequence":"additional","affiliation":[{"name":"College of Science, Kwame Nkrumah University of Science and Technology","place":["Kumasi, Ghana"],"department":["Department of Optometry and Visual Science"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-8153-0956","authenticated-orcid":true,"given":"Rhodalene Asantewaa","family":"Buabeng","sequence":"additional","affiliation":[{"name":"Sinclair School of Nursing, University of Missouri","place":["Columbia, Missouri, United States of America"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-0563-9775","authenticated-orcid":true,"given":"Engmann Yorgen Carl Nii","family":"Lomotey","sequence":"additional","affiliation":[{"name":"The University of Memphis","place":["Memphis, Tennessee, United States of America"],"department":["Division of Epidemiology, Biostatistics, and Environmental Health, School of Public Health"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2392-3740","authenticated-orcid":true,"given":"Xinhua","family":"Yu","sequence":"additional","affiliation":[{"name":"The University of Memphis","place":["Memphis, Tennessee, United States of America"],"department":["Division of Epidemiology, Biostatistics, and Environmental Health, School of Public Health"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2026,10,9]]},"reference":[{"issue":"1","key":"pmen.0000744.ref001","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1002\/wps.20193","article-title":"Prevalence of psychiatric disorders in U.S. older adults: Findings from a nationally representative survey","volume":"14","author":"K Reynolds","year":"2015","journal-title":"World Psychiatry"},{"key":"pmen.0000744.ref002","unstructured":"Reinert M, Fritze D, Nguyen T. 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