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Correlates of Perceived Need for and Use of Mental Health Services by Older Adults in the Collaborative Psychiatric Epidemiology Surveys

https://doi.org/10.1097/JGP.0b013e3181dd1c06Get rights and content

Objectives

Older adults are especially unlikely to seek mental health services, but little is known about whether their perceptions of need for help contribute to this problem. The objectives of this study were to compare perceived need across the lifespan and to examine sociodemographic and mental health correlates of whether older adults sought professional help, perceived the need for help without seeking it, and sought help from specialty mental health professionals.

Methods

The authors examined help-seeking and perceived need with the Collaborative Psychiatric Epidemiology Surveys, focusing on 3,017 adults aged 55 years and older. Logistic regressions predicted help-seeking and perceived need from sociodemographic factors, past-year psychiatric disorders, and past-year suicidal behaviors. Individuals who perceived the need for help without receiving it also reported barriers to help-seeking.

Results

Levels of perceived need were highest among 25–44 year olds and lowest among adults aged 65 years and older. Among older adults with psychiatric disorders, 47.1% did not perceive a need for professional help. Diagnoses and suicidal behaviors were strong predictors of whether individuals perceived need, whereas among those who perceived the need for help, only older age was positively associated with help-seeking. Few factors clearly distinguished those who did and did not seek help from specialty mental health professionals with the exception of having three or more psychiatric diagnoses. Finally, the most common barrier to help-seeking was a desire to handle problems on one's own.

Conclusions

A lack of perceived need for mental health services and self-sufficiency beliefs are significant barriers to older adults' use of mental health services.

Section snippets

Sample

The Collaborative Psychiatric Epidemiologic Surveys (CPES)28 comprised three surveys conducted between 2001 and 2003: the National Comorbidity Survey Replication (NCS-R, N = 9,282), the National Survey of American Life (NSAL, N = 6,082), and the National Latino and Asian American Study (NLAAS, N = 4,649). The three surveys are representative of the U.S. adult population and they empolyed very similar methodologies, including using trained lay interviewers to conduct interviews primarily in

RESULTS

In terms of the weighted demographic makeup of our sample, 41.1% were 55–64 years of age, 32.4% were 65–74 years, and 26.5% were 75 years and older. The majority of individuals were female (56.8%) and non-Hispanic white (80.8%). In addition, 9.7% were black, 5.3% were Hispanic, 2.6% were Asian, and 1.5% reported an “other” race/ethnicity. With respect to education, 26.3% had less than 12 years, 33.2% had 12 years, 21.3% had 13–15 years, and 19.2% had 16 years or more. The majority of

DISCUSSION

This study examined perceived need for mental health services using a large, representative sample of Americans aged 55 years and older. Fortunately, most of the individuals in this study who perceived the need for help sought it; that is, 53% of older adults with past-year mood, anxiety, or substance-related disorders perceived the need for professional help and 41% sought it. On the other hand, these data also demonstrate that approximately half of the older individuals with a clear objective

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    This work was supported by the University of Manitoba University Research grants Program (to CSM), by a Canadian Institutes of Health Research New Investigator Award 152348 (to JS), and by a graduate fellowship from the Social Sciences and Humanities Research Council of Canada (SSHRC) (to JP). The Collaborative Psychiatric Epidemiologic Surveys (CPES) are funded by the National Institute of Mental Health (NIMH).

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