Hostname: page-component-586b7cd67f-2plfb Total loading time: 0 Render date: 2024-11-25T20:25:43.692Z Has data issue: false hasContentIssue false
  • English
  • Français

Health services use for mental health problems by community-living seniors with depression

Published online by Cambridge University Press:  01 October 2007

Martin G. Cole ,
Jane McCusker ,
Maida Sewitch ,
Antonio Ciampi  and
Alina Dyachenko
Martin G. Cole*
Affiliation:
Department of Psychiatry, St. Mary's Hospital Center and McGill University, Montreal, Canada
Jane McCusker
Affiliation:
Department of Clinical Epidemiology and Community Studies, St. Mary's Hospital Center and McGill University, Montreal, Canada
Maida Sewitch
Affiliation:
Department of Clinical Epidemiology and Community Studies, St. Mary's Hospital Center and McGill University, Montreal, Canada
Antonio Ciampi
Affiliation:
Department of Clinical Epidemiology and Community Studies, St. Mary's Hospital Center and McGill University, Montreal, Canada
Alina Dyachenko
Affiliation:
Department of Clinical Epidemiology and Community Studies, St. Mary's Hospital Center, Montreal, Canada
*
Correspondence should be addressed to: Dr. Martin G. Cole, Department of Psychiatry, St. Mary's Hospital Center, 3830 Lacombe Avenue, Montreal, Quebec, H3T 1M5, Canada. Phone +1 514 345-3511 × 5060; Fax +1 514 734-2652. Email: [email protected].
Get access Rights & Permissions [Opens in a new window]

Abstract

Background: The literature on health services (HS) use for mental health problems by community-living seniors with depression is sparse. This study aimed to characterize patterns of HS use for mental health problems by seniors with depressive disorders and symptoms during the previous 12 months.

Method: The study used data from the Canadian Community Health Survey Cycle 1.2: Mental Health and Well-Being (N = 7736). Information was collected on demographic, social, mental, physical and functional variables and HS use for mental health problems. We obtained simple univariate and bivariate descriptions of the data and developed multivariate predictive models for each of the HS utilization variables.

Results: Rates of any HS use for mental health problems ranged from 1.8% for those with no depressive symptoms to 31.1% for those with major depression. Variables predicting increased HS use were: depressive disorder or symptoms, clinically significant distress or impairment, age 65–84, single, post-secondary education, religiousness, disability, co-morbid mental disorder and fewer friends and positive social interactions. Variables predicting HS use among depressed seniors were physical health, psychiatric co-morbidity and activity limitation.

Conclusion: Community-living seniors with major depression, co-morbid major depression and depressive symptoms were more likely to use psychiatrist, family physician, other professional and self-help services for mental health problems but less than a third actually did so.

Keywords

depressionagedhealth services use
Type
Research Article
Information
International Psychogeriatrics , Volume 20 , Issue 3 , June 2008 , pp. 554 - 570
Copyright
Copyright © International Psychogeriatric Association 2007

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

American Psychiatric Association (1994). Diagnostic and Statistical Manual of Mental Disorders. Washington, DC: American Psychiatric Association.Google Scholar
Arve, S., Lauri, S. and Lehtonen, A. (2000). Clinical pathway of elderly persons with lowered mood in the health care services. Scandinavian Journal of Caring Sciences, 14, 191–198.CrossRefGoogle ScholarPubMed
Beck, C. A. et al. (2005). Antidepressant utilization in Canada. Social Psychiatry and Psychiatric Epidemiology, 40, 799–807.CrossRefGoogle ScholarPubMed
Bodenheimer, T., Wagner, E. H. and Grumbach, K. (2002). Improving primary care for patients with chronic illness. JAMA, 288, 1775–1779.CrossRefGoogle ScholarPubMed
Bruce, M. L. et al. (2004). Reducing suicidal ideation and depressive symptoms in depressed older primary care patients. JAMA, 291, 1081–1091.CrossRefGoogle ScholarPubMed
Callahan, C. M., Hui, S. L., Nienaber, N. A., Musick, B. S. and Tierney, W. M. (1994). Longitudinal study of depression and health services use among elderly primary care patients. Journal of the American Geriatrics Society, 42, 833–838.CrossRefGoogle ScholarPubMed
Ciechanowski, P. et al. (2004). Community-integrated home-based depression treatment in older adults: a randomized controlled trial. JAMA, 291, 1569–1577.CrossRefGoogle ScholarPubMed
Cole, M. G. (2002). Public health models of mental health care for elderly populations. International Psychogeriatrics, 14, 3–6.CrossRefGoogle ScholarPubMed
Cole, M. G. and Yaffe, M. J. (1996). Pathway to psychiatric care of the elderly with depression. International Journal of Geriatric Psychiatry, 11, 157–161.3.0.CO;2-S>CrossRefGoogle Scholar
Cole, M. G., Bellavance, F. and Mansour, A. (1999). Prognosis of depression in elderly community and primary care populations: a systematic review and meta-analysis. American Journal of Psychiatry, 156, 1182–1189.CrossRefGoogle ScholarPubMed
Crabb, R. and Hunsley, J. (2006). Utilization of mental health care services among older adults with depression. Journal of Clinical Psychology, 62, 299–312.CrossRefGoogle ScholarPubMed
Ernst, C. and Angst, J. (1995). Depression in old age: is there a real decrease in prevalence? A review. European Archives of Psychiatry and Clinical Neuroscience, 245, 272–287.CrossRefGoogle Scholar
Gallo, J. J. and Lebowitz, B. D. (1999). The epidemiology of common late-life mental disorders in the community: themes for the new century. Psychiatric Services, 50, 1158–1166.CrossRefGoogle ScholarPubMed
Gravel, R. and Béland, Y. (2005). The Canadian Community Health Survey: mental health and well-being. Canadian Journal of Psychiatry, 50, 573–579.CrossRefGoogle ScholarPubMed
Katon, W. J., Lin, E., Russo, J. and Unützer, J. (2003). Increased medical costs of a population-based sample of depressed elderly patients. Archives of General Psychiatry, 60, 897–903.CrossRefGoogle ScholarPubMed
Kessler, R. C. and Üstün, T. B. (2004). The World Mental Health (WMH) Survey Initiative version of the World Health Organization (WHO) Composite International Diagnostic Interview (CIDI). International Journal of Methods in Psychiatric Research, 13, 93–121.CrossRefGoogle ScholarPubMed
Klap, R., Tschantz Unroe, K. and Unützer, J. (2003). Caring for mental illness in the United States: a focus on older adults. American Journal of Geriatric Psychiatry, 11, 517–524.CrossRefGoogle ScholarPubMed
Luber, M. P. et al. (2001). Depression and service utilization in elderly primary care patients. American Journal of Geriatric Psychiatry, 9, 169–176.CrossRefGoogle ScholarPubMed
McKeen, N. A., Chipperfield, J. G. and Campbell, D. W. (2004). A longitudinal analysis of discrete negative emotions and health-services use in elderly individuals. Journal of Aging and Health, 16, 204–227.CrossRefGoogle ScholarPubMed
NIH Consensus Development Conference (1992). Diagnosis and treatment of depression in late life. JAMA, 268, 1018–1024.CrossRefGoogle Scholar
SAS Institute Inc. (2002)–2003. SAS Online Doc, Version 9–1. Cary. NC: SAS Institute Inc. Available online at www.sas.com.Google Scholar
Unützer, J. et al. (1997). Depressive symptoms and the cost of health services in HMO patients aged 65 years and older: a 4-year prospective study. JAMA, 277, 1618–1623.CrossRefGoogle Scholar
Unützer, J. et al. (1999). Patterns of care for depressed older adults in a large-staff model HMO. American Journal of Geriatric Psychiatry, 7, 235–243.CrossRefGoogle Scholar
Unützer, J. et al. (2002). Collaborative care management of late-life depression in the primary care setting: a randomized controlled trial. JAMA, 288, 2836–2845.CrossRefGoogle ScholarPubMed
Van Korff, M., Ormel, J., Katon, W. and Lin, E. (1992). Disability and depression among high utilizers of health care: a longitudinal analysis. Archives of General Psychiatry, 49, 91–100.CrossRefGoogle Scholar
Wells, K. B. and Burman, A. M. (1991). Caring for depression in America: lessons learned from early findings of the Medical Outcomes Study. Psychiatric Medicine, 9, 503–519.Google ScholarPubMed