Use of Mental Health Care by Community‐Dwelling Older Adults

Melissa M. Garrido · Robert L Kane · Merrie Jean Kaas · Rosalie A. Kane

89 citations0/0 files storedJournal of the American Geriatrics Society

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Mental Health Treatment and Access Psychiatric care and mental health services Aging, Health, and Disability

Abstract

OBJECTIVES: To examine relationships between perceived need for care, illness characteristics, attitudes toward care, and probability that older adults will use mental health care (MHC). DESIGN: Secondary data analysis. SETTING: The Collaborative Psychiatric Epidemiology Surveys (2001-2003). PARTICIPANTS: One thousand six hundred eighty-one community-dwelling adults aged 65 and older. MEASUREMENTS: Self-reported MHC use and perceived need for care in the previous 12 months, previous year and history of mental illness, history of physical illness, attitudes toward care, and sociodemographic characteristics. RESULTS: Of the entire sample, 6.5% had received some type of MHC in the previous year, although 65.9% of those with major depressive disorder (MDD) and 72.5% with anxiety did not receive MHC. In respondents with previous-year depression or anxiety, use was less likely for those with low World Health Organization Disability Assessment Scale (WHO-DAS) self-care ability. Use was more likely for those with more chronic physical conditions and worse WHO-DAS cognitive capacity. Seventeen percent of those with perceived need for MHC did not receive it. In respondents with perceived need, subthreshold generalized anxiety disorder was associated with lower likelihood of use. Use was more likely for older respondents and those with more household members, at least a high school education, and better self-care ability. Forty-one percent of those who perceived a need for care but did not use it met previous-year diagnostic criteria for anxiety, and 17% met criteria for MDD. CONCLUSION: Understanding the perceptions that underlie individuals' health care-seeking behavior is an important step toward reducing underuse of MHC by older adults.

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References

2003Diagnostic and Statistical Manual of Mental Disorders (DSM-IV)2003Screening for Serious Mental Illness in the General Population 2004The World Mental Health (WMH) Survey Initiative version of the World Health Organization (WHO) Composite International Diagnostic Interview (CIDI)2004The US National Comorbidity Survey Replication (NCS‐R): design and field procedures 2004Sample designs and sampling methods for the Collaborative Psychiatric Epidemiology Studies (CPES)2002Perceived Need and Help-Seeking in Adults With Mood, Anxiety, or Substance Use Disorders 2003Increased Medical Costs of a Population-Based Sample of Depressed Elderly Patients 2010Depression Care in the United States

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