Objective: This study explored predisposing, illness-related, and enabling factors as predictors ofmental health service use among disaster survivors with perceived need for services. Methods: Participants (N5658) were part of a three-wave, population-based study of Hurricane Ike survivors. At each wave, participants were asked whether they perceived having a need for mental health services, for example, information about stress reactions andmedication for emotional problems. Those with perceived need were asked about use of eight services, such as a psychiatrist or physician, to address needs. Generalized estimating equations examined predisposing, illness-related, and enabling factors as predictors of service use among participants with perceived need (N5304). Results: More general stressors (predisposing factor) and insurance coverage (enabling factor) predicted service use among participants with perceived need. Conclusions: The results suggest that expanded access to services that do not require insurance coverage could better address survivors' mental health needs after a disaster.