Use of Mental Health Care by Community-Dwelling Older Adults

被引:60
作者
Garrido, Melissa M. [1 ,2 ,3 ,4 ]
Kane, Robert L. [5 ]
Kaas, Merrie [6 ]
Kane, Rosalie A. [5 ]
机构
[1] James J Peters VA Med Ctr, GRECC, Bronx, NY 10468 USA
[2] James J Peters VA Med Ctr, Res Enhancement Award Program, Bronx, NY 10468 USA
[3] Mt Sinai Sch Med, Brookdale Dept Geriatr & Palliat Med, New York, NY USA
[4] Rutgers State Univ, Inst Hlth Hlth Care Policy & Aging Res, New Brunswick, NJ 08903 USA
[5] Univ Minnesota Twin Cities, Div Hlth Policy & Management, Minneapolis, MN USA
[6] Univ Minnesota Twin Cities, Sch Nursing, Minneapolis, MN USA
关键词
perceived need; mental health care; attitudes; depression; anxiety; PERCEIVED NEED; UNITED-STATES; ANXIETY DISORDER; HELP-SEEKING; LATE-LIFE; DEPRESSION; DETERMINANTS; COMORBIDITY; PREVALENCE; PSYCHIATRY;
D O I
10.1111/j.1532-5415.2010.03220.x
中图分类号
R592 [老年病学]; C [社会科学总论];
学科分类号
03 ; 0303 ; 100203 ;
摘要
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.
引用
收藏
页码:50 / 56
页数:7
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