We examined sociodemographic and illness/need associations with mental health care use and service use intensity (i.e., number of visits) among domestic violence survivors. Data from 252 women recruited from 5 Midwestern domestic violence shelters were analyzed. Univariate analyses indicated a more positive treatment attitude was related to increased mental health service use and service use intensity. Second, being Caucasian and greater PTSD severity were associated with increased service use intensity. A sociodemographic and attitudinal multivariate predictor model explained 14% of variance in treatment use intensity, and a need/illness model significantly contributed an additional 10% variance. In contrast, the interaction of PTSD Symptom Severity × Perceived Need was significant. Results demonstrate illness has a significant effect above and beyond sociodemographic variables in accounting for mental health care use, and that PTSD severity moderated the relationship between perceived need and service use.