Use of Mental Health Care by Community-Dwelling Older Adults

Authors

  • Melissa M. Garrido PhD,

    1. From the *Research Enhancement Award Program and Geriatric Research, Education, and Clinical Center, James J Peters Veterans Affairs Medical Center, Bronx, New York; Brookdale Department of Geriatrics and Palliative Medicine, Mount Sinai School of Medicine, New York, New York; Institute for Health, Health Care Policy and Aging Research, Rutgers University, New Brunswick, New Jersey; and §Division of Health Policy and Management and School of Nursing, University of Minnesota–Twin Cities, Minneapolis, Minnesota.
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  • Robert L. Kane MD,

    1. From the *Research Enhancement Award Program and Geriatric Research, Education, and Clinical Center, James J Peters Veterans Affairs Medical Center, Bronx, New York; Brookdale Department of Geriatrics and Palliative Medicine, Mount Sinai School of Medicine, New York, New York; Institute for Health, Health Care Policy and Aging Research, Rutgers University, New Brunswick, New Jersey; and §Division of Health Policy and Management and School of Nursing, University of Minnesota–Twin Cities, Minneapolis, Minnesota.
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  • Merrie Kaas DNSc, RN,

    1. From the *Research Enhancement Award Program and Geriatric Research, Education, and Clinical Center, James J Peters Veterans Affairs Medical Center, Bronx, New York; Brookdale Department of Geriatrics and Palliative Medicine, Mount Sinai School of Medicine, New York, New York; Institute for Health, Health Care Policy and Aging Research, Rutgers University, New Brunswick, New Jersey; and §Division of Health Policy and Management and School of Nursing, University of Minnesota–Twin Cities, Minneapolis, Minnesota.
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  • Rosalie A. Kane PhD

    1. From the *Research Enhancement Award Program and Geriatric Research, Education, and Clinical Center, James J Peters Veterans Affairs Medical Center, Bronx, New York; Brookdale Department of Geriatrics and Palliative Medicine, Mount Sinai School of Medicine, New York, New York; Institute for Health, Health Care Policy and Aging Research, Rutgers University, New Brunswick, New Jersey; and §Division of Health Policy and Management and School of Nursing, University of Minnesota–Twin Cities, Minneapolis, Minnesota.
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  • Portions of this work were presented at the 2009 Annual Meeting of Academy Health.

Address correspondence to Melissa M. Garrido, PhD, GRECC, James J Peters VA Medical Center, 130 West Kingsbridge Road, Bronx, NY 10468. E-mail: melissa.garrido@mssm.edu

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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