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Predisposing, enabling, and need factors of service utilization in the elderly with mental health problems

Published online by Cambridge University Press:  04 December 2017

Jana Volkert*
Affiliation:
Department of Medical Psychology, University Medical Centre Hamburg-Eppendorf, Martinistrasse 52, Building W 26, 20246, Hamburg, Germany Department of Psychosocial Prevention, University of Heidelberg, Bergheimer Str. 54, 69115, Heidelberg, Germany
Sylke Andreas
Affiliation:
Department of Medical Psychology, University Medical Centre Hamburg-Eppendorf, Martinistrasse 52, Building W 26, 20246, Hamburg, Germany Institute of Psychology, Alpen-Adria University Klagenfurt, 9020, Klagenfurt, Austria Department of Psychology, University Witten/Herdecke, Alfred-Herrhausen-Str. 50, 58448, Witten, Germany
Martin Härter
Affiliation:
Department of Medical Psychology, University Medical Centre Hamburg-Eppendorf, Martinistrasse 52, Building W 26, 20246, Hamburg, Germany
Maria Christina Dehoust
Affiliation:
Department of Medical Psychology, University Medical Centre Hamburg-Eppendorf, Martinistrasse 52, Building W 26, 20246, Hamburg, Germany
Susanne Sehner
Affiliation:
Institute of Medical Biometry and Epidemiology, University Medical Centre Hamburg–Eppendorf, Martinistrasse 52, Building W 34, 20246, Hamburg, Germany
Anna Suling
Affiliation:
Institute of Medical Biometry and Epidemiology, University Medical Centre Hamburg–Eppendorf, Martinistrasse 52, Building W 34, 20246, Hamburg, Germany
Berta Ausín
Affiliation:
School of Psychology, University Complutense of Madrid, Campus de Somosaguas s/n, 28223, Madrid, Spain
Alessandra Canuto
Affiliation:
Nant Foundation, East Vaud Psychiatric Institute, Route de Nant, 1804, Corsier-sur-Vevey, Switzerland
Mike J. Crawford
Affiliation:
Royal College of Psychiatrists, Mansell Street 21, E18AA, London, UK
Chiara Da Ronch
Affiliation:
Department of Biomedical and Specialty Surgical Sciences, Institute of Psychiatry, University of Ferrara, Corso Giovecca 203, Ferrara, 44121, Italy
Luigi Grassi
Affiliation:
Department of Biomedical and Specialty Surgical Sciences, Institute of Psychiatry, University of Ferrara, Corso Giovecca 203, Ferrara, 44121, Italy
Yael Hershkovitz
Affiliation:
Hadassah University Medical Centre, P.O.B 12000, 91120, Jerusalem, Israel
Manuel Muñoz
Affiliation:
School of Psychology, University Complutense of Madrid, Campus de Somosaguas s/n, 28223, Madrid, Spain
Alan Quirk
Affiliation:
Royal College of Psychiatrists, Mansell Street 21, E18AA, London, UK
Ora Rotenstein
Affiliation:
Hadassah University Medical Centre, P.O.B 12000, 91120, Jerusalem, Israel
Ana Belén Santos-Olmo
Affiliation:
School of Psychology, University Complutense of Madrid, Campus de Somosaguas s/n, 28223, Madrid, Spain
Arieh Y. Shalev
Affiliation:
Department of Psychiatry, NY Langone Medical Center, New York, USA
Jens Strehle
Affiliation:
Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Chemnitzer Strasse 46, 01187, Dresden, Germany
Kerstin Weber
Affiliation:
Medical Direction, University Hospitals of Geneva, Chemin de Champ-Dollon 20, 1241, Puplinge, Switzerland
Karl Wegscheider
Affiliation:
Institute of Medical Biometry and Epidemiology, University Medical Centre Hamburg–Eppendorf, Martinistrasse 52, Building W 34, 20246, Hamburg, Germany
Hans-Ulrich Wittchen
Affiliation:
Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Chemnitzer Strasse 46, 01187, Dresden, Germany Department of Psychiatry and Psychotherapy, Ludwigs-Maximilians-Universität München, Nußbaumstr. 7, 80336, München, Germany
Holger Schulz
Affiliation:
Department of Medical Psychology, University Medical Centre Hamburg-Eppendorf, Martinistrasse 52, Building W 26, 20246, Hamburg, Germany
*
Correspondence should be addressed to: Dr Jana Volkert, Department of Psychosocial Prevention, University of Heidelberg, Bergheimer Str. 54, 69115 Heidelberg, Germany. Phone: +49 (0)6221-56-4710; Fax: +49 (0)6221-56-4702. Email: [email protected].

Abstract

Background:

Empirical data on the use of services due to mental health problems in older adults in Europe is lacking. The objective of this study is to identify factors associated with service utilization in the elderly.

Methods:

As part of the MentDis_ICF65+ study, N = 3,142 people aged 65–84 living in the community in six European and associated countries were interviewed. Based on Andersen's behavioral model predisposing, enabling, and need factors were analyzed with logistic regression analyses.

Results:

Overall, 7% of elderly and 11% of those with a mental disorder had used a service due to mental health problems in the last 12 months. Factors significantly associated with underuse were male sex, lower education, living in the London catchment area, higher functional impairment and more comorbid mental disorders. The most frequently reported barrier to service use was personal beliefs, e.g. “I can deal with my problem on my own” (90%).

Conclusion:

Underutilization of mental health services among older people in the European community is common and interventions are needed to achieve an adequate use of services.

Type
Original Research Article
Copyright
Copyright © International Psychogeriatric Association 2017 

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References

Alonso, J. et al. (2004). Use of mental health services in Europe: results from the European study of the epidemiology of mental disorders (ESEMeD) project. Acta Psychiatrica Scandinavica, 109, 4754.Google Scholar
American Psychiatric Association (2000). Diagnostic and Statistical Manual of Mental Disorders, 4th edn, text rev. Washington, DC: APA.Google Scholar
Andersen, R. M. (2008). National health surveys and the behavioral model of health services use. Medical Care, 46, 647653.Google Scholar
Andreas, S. et al. (2013). The MentDis_ICF65+ study protocol: prevalence, 1-year incidence and symptom severity of mental disorders in the elderly and their relationship to impairment, functioning (ICF) and service utilisation. BMC Psychiatry, 13, 62.Google Scholar
Andreas, S. et al. (2016). Prevalence of mental disorders in the elderly: the European MentDis_ICF65+ Study. British Journal of Psychiatry, 210, 125131.Google Scholar
Barry, L., Abou, J., Simen, A. and Gill, T. (2012). Under-treatment of depression in older persons. Journal of Affective Disorders, 136, 789796.Google Scholar
Belvederri Murri, M. et al. (2015). Second-generation antipsychotics and neuroleptic malignant syndrome: systematic review and case report analysis. Drugs, 15, 4562.Google Scholar
Brenes, G. A., Danhauer, S. C., Lyles, M. F., Hogan, P. E. and Miller, M. E. (2015). Barriers to mental health treatment in rural older adults. American Journal of Geriatric Psychiatry, 23, 11721178.Google Scholar
Byers, A., Arean, P. and Yaffe, K. (2012). Low use of mental health services among older Americans with mood and anxiety disorders. Psychiatric Services, 63, 6672.Google Scholar
Colenda, C. C. et al. (2010). Psychiatric disorders and cognitive dysfunction among older, postmenopausal women: results from the Women's Health Initiative Memory Study. American Journal of Geriatric Psychiatry, 18, 177186.Google Scholar
Cooper, C. et al. (2010). The treatment of common mental disorders across age groups: results from the 2007 adult psychiatric morbidity survey. Journal of Affective Disorders, 127, 96101.Google Scholar
Crabb, R. and Hunsley, J. (2006). Utilization of mental health care services among older adults with depression. Journal of Clinical Psychology, 62, 299312.Google Scholar
Dines, P., Hu, W. and Sajatovic, M. (2014). Depression in later-life: an overview of assessment and management. Psychiatria Danubina, 26 (Suppl. 1), 7884.Google Scholar
Garido, M. M., Kane, R. L., Kaas, M. and Kane, R. A. (2011). Use of mental health care by community-dwelling older adults. Journal of the American Geriatric Society, 59, 5056.Google Scholar
Gonçalves, D. C., Coelho, C. M. and Byrne, G. J. (2014). The use of healthcare services for mental health problems by middle-aged and older adults. Archives of Gerontology and Geriatrics, 59, 393397.Google Scholar
Griffiths, K. M., Crisp, D. A., Jorm, A. F. and Christensen, H. (2011). Does stigma predict a belief in dealing with depression alone? Journal of Affective Disorders, 132, 413417.Google Scholar
Han, B., Gfroerer, J. C., Colpe, L. J., Barker, P. R. and Colliver, J. D. (2011). Serious psychological distress and mental health service use among community-dwelling older US adults. Psychiatric Services, 62, 291298.Google Scholar
Hoeck, S., Francois, G., Van Der Heyden, J., Geerts, J. and Van Hal, G. (2011). Healthcare utilisation among the Belgian elderly in relation to their socio-economic status. Health Policy, 99, 174182.Google Scholar
Keeter, S., Kennedy, C., Dimock, M., Best, J. and Craighill, P. (2006). Gauging the impact of growing nonresponse on estimates from a national RDD telephone survey. Public Opinion Quarterly, 70, 759779.Google Scholar
Luppa, M., Sikorski, C., Motzek, T., Konnopka, A., König, H. H. and Riedel-Heller, S. (2012). Health service utilization and costs of depressive symptoms in late life-a systematic review. Current Pharmaceutical Designs, 18, 59365957.Google Scholar
Mackenzie, C. S., Pagura, J. and Sareen, J. (2010). Correlates of perceived need for and use of mental health services by older adults in the collaborative psychiatric epidemiology surveys. American Journal of Geriatric Psychiatry, 18, 11031115.Google Scholar
National Institute for Health and Care Excellence (2015). Older people: independence and mental wellbeing. NICE Guideline (NG32).Google Scholar
Pepin, R., Segal, D. L. and Coolidge, F. L. (2009). Intrinsic and extrinsic barriers to mental health care among community-dwelling younger and older adults. Aging Mental Health, 13, 769777.Google Scholar
Roy-Byrne, P. P. et al. (2008) Anxiety disorders and comorbid medical illness. General Hospital Psychiatry, 30, 208225.Google Scholar
Sareen, J. et al. (2007). Perceived barriers to mental health service utilization in the United States, Ontario, and the Netherlands. Psychiatric Services, 58, 357364.Google Scholar
Scott, T., Mackenzie, C. S., Chipperfield, J. G. and Sareen, J. (2010). Mental health service use among Canadian older adults with anxiety disorders and clinically significant anxiety symptoms. Aging Mental Health, 14, 790800.Google Scholar
Shah, S. M., Carey, I. M., Harris, T., DeWilde, S. and Cook, D.G. (2011). Antipsychotic prescribing to older people living in care homes and the community in England and Wales. International Journal of Geriatric Psychiatry, 26, 423434.Google Scholar
Statacorp (2011). Stata Statistical Software. College Station, TX: StataCorp LP.Google Scholar
Thompson, A., Hunt, C. and Issakidis, C. (2004). Why wait? Reasons for delay and prompts to seek help for mental health problems in an Australian clinical sample. Social Psychiatry and Psychiatric Epidemiology, 39, 810817.Google Scholar
United Nations/UN (2010). World population prospects: The 2011 Revision. New York, NY: United Nations, Department of Economic and Social Affairs.Google Scholar
Veerbeek, M., Oude Voshaar, R., Depla, M. and Pot, A. M. (2013). Mental health care monitor older adults (MEMO): monitoring patient characteristics and outcome in dutch mental health services for older adults. International Journal of Methods in Psychiatric Research, 22, 100109.Google Scholar
Wang, P., Lane, M., Olfson, M., Pincus, H., Wells, K. and Kessler, R. (2005). Twelve-month use of mental health services in the United States: results from the national comorbidity survey replication. Archives of General Psychiatry, 62, 629640.Google Scholar
Weissman, M. M. (2001). Stigma. JAMA, 285, 261262.Google Scholar
Werner, P., Stein-Shvachman, I. and Heinik, J. (2009). Perceptions of self-stigma and its correlates among older adults with depression: a preliminary study. International Psychogeriatrics, 21, 11801189.Google Scholar
Wittchen, H. U. et al. (2014). Measuring symptoms and diagnosing mental disorders in the elderly community: the test–retest reliability of the CIDI65+. International Journal of Methods Psychiatric Research, 24, 116129.Google Scholar
Wittchen, H.-U. and Pfister, H. (1997). DIA-X-Interviews: Manual für Screening-Verfahren und Interview; Interviewheft Längsschnittuntersuchung (DIA-XLifetime); Ergänzungsheft (DIA-X-Lifetime); Interviewheft Querschnittuntersuchung (DIA-X-12 Monate); Ergänzungsheft (DIA-X-12Monate); PC-Programm zur Durchführung des Interviews (Längs- und Querschnittuntersuchung); Auswertungsprogramm, Frankfurt, Swets & Zeitlinger.Google Scholar
World Health Organization (2016). Fact sheet: Mental Health in Older Adults. Available at: http://www.who.int/mediacentre/factsheets/fs381/en/; last accessed 25 July 2017.Google Scholar