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Mental health service use among Canadian older adults with anxiety disorders and clinically significant anxiety symptoms
- Authors:
- SCOTT Tiffany, et al
- Journal article citation:
- Aging and Mental Health, 14(7), September 2010, pp.790-800.
- Publisher:
- Taylor and Francis
Using data from the Canadian Community Health Survey-Mental Health and Well-Being, a nationally representative survey of community-dwelling Canadians, the use of mental health services by older adults with anxiety disorders were investigated. This study examined past-year use of mental health services in both the specialty mental health and general medical sectors by the 12,792 adults aged 55 and over. Logistic regression analyses were used to examine predictors of service use among the 279 individuals with anxiety disorders and 880 individuals with clinically significant anxiety symptoms. The results showed that only 20.8% of older adults with an anxiety disorder and no mood disorder used services in the past year, compared to 43.1% of those with a mood disorder, and 72.7% of those with comorbid disorders. The findings indicate that anxious older adults are less likely to use mental health services than those who are depressed. While predisposing and enabling factors do not appear to impede service use, the need for help does. Anxious older adults and those they interact with may not be interpreting their anxiety symptoms as warranting services.
Mental health help-seeking attitudes, utilization, and intentions among older Chinese immigrants in Canada
- Authors:
- TIEU Yvonne, KONNERT Candace A.
- Journal article citation:
- Aging and Mental Health, 18(2), 2014, pp.140-147.
- Publisher:
- Taylor and Francis
This study aimed to determine the extent to which demographic factors, perceived social support, and Chinese cultural beliefs predict attitudes toward mental health help seeking; second, to assess mental health utilization; and third, to assess intentions to utilize mental health services among older Chinese immigrants in Canada aged 55 and above. A total of 149 older Chinese adults (M = 73.92 years, SD = 9.99, range = 55–95 years) completed a semi-structured interview protocol in Cantonese or Mandarin. Demographic and health information were collected, and questionnaires assessing perceived social support, mental health help-seeking attitudes, and belief in Chinese culture and values were administered. Demographic and health information, perceived social support, Chinese cultural beliefs and values accounted for 21.8% of the variance in help-seeking attitudes. Descriptive data related to mental health utilization and intentions are provided. Older Chinese participants exhibited less positive attitudes that were significantly associated with Chinese cultural beliefs and values. Implications for practice with older Chinese adults are also discussed. (Edited publisher abstract)
Religion, health beliefs and the use of mental health services by the elderly
- Authors:
- NG Tze Pin, et al
- Journal article citation:
- Aging and Mental Health, 15(2), March 2011, pp.143-149.
- Publisher:
- Taylor and Francis
Health beliefs that people have about their mental health and services influence their perception of need and use of health services. This study investigated whether elderly people of particular religious affiliations are more or less likely to seek treatment for mental illness, and whether this is related to their health beliefs. The study used data from the National Mental Survey of Elderly Singaporeans in 2004, a population-based survey with a total of 1092 participants aged 60 and above. Data were collected on reported religious affiliations, and 1-year prevalence of mental disorders from diagnostic interviews using the Geriatric Mental State schedule, self-report of treatment for mental health problems, and health beliefs about the curability of mental illness, embarrassment and stigma, ease in discussing mental problems, effectiveness and safety of treatment, and trust in professionals. The results showed that, compared to those with no religious affiliation, elderly people of all religious affiliations showed higher prevalence of mental health problems, yet reported less frequent treatment by healthcare professionals. In multivariate analyses, the adjusted odds ratio of association with seeking treatment were for Christianity, 0.12; Islam, 0.12; Buddhism/Taoism, 0.59; and Hinduism, 0.21 versus no affiliation. Various religious affiliations differ from each other and from non-religious affiliation on some negative health beliefs, but they did not adequately explain why religious affiliates were less likely to seek treatment.
Attitudes toward mental health services: age-group differences in Korean American adults
- Authors:
- JANG Yuri, CHIRIBOGA David A., OKAZAKI Sumie
- Journal article citation:
- Aging and Mental Health, 13(1), January 2009, pp.127-134.
- Publisher:
- Taylor and Francis
The present study examined the attitudes toward mental health services held by younger (aged 20-45, n = 209) and older (aged 60 and older, n = 462) groups of Korean Americans. Predisposing (age, gender, marital status and education), need (anxiety and depressive symptoms) and enabling (acculturation, health insurance coverage and personal experience and beliefs) variables were considered. In the mean-level assessment, younger and older adults were found to hold a similar level of positive attitudes toward mental health services. In the multivariate analysis, culture-influenced beliefs were shown to have a substantial contribution to the model of attitudes toward mental health services in both age groups. The belief that depression is a medical condition was found to be a common predictor of positive attitudes across the groups. In the older adult sample, more negative attitudes were observed among those who believed that depression is a sign of personal weakness and that having a mentally ill family member brings shame to the whole family. The findings show that older adults are not only more subject to cultural misconceptions and stigma related to mental disorders, but also their attitudes toward service use are negatively influenced by the cultural stigma. The findings provide important implications for interventions targeted to improve access to mental health care among minority populations. Based on the similarities and differences found between young and old, both general and age-specific strategies need to be developed in order to increase effectiveness of these programs.
Clergy as mental health service providers to older adults
- Authors:
- PICKARD Joseph G., GUO Baorong
- Journal article citation:
- Aging and Mental Health, 12(5), September 2008, pp.615-624.
- Publisher:
- Taylor and Francis
Older adults tend to seek help for emotional problems from clergy at greater rates than they do from other sources. However, their help-seeking from clergy is largely understudied. This study used data from the Naturally Occurring Retirement Community (NORC) Demonstration Project in the US to examine older adults' patterns of help-seeking from clergy. A sample of adults aged 65 or older (n = 317) were studied to determine which factors were related to help-seeking from a religious leader. This study was framed within the Behavioral Model of Health Services Utilization. Results of hierarchical logistic regression analyses indicated that having less social support and greater frequency of attendance at religious services was related to help-seeking from clergy for this sample, while other predisposing, enabling, need and religiosity variables were not found to be related to help-seeking from clergy. Discussion focuses on the need for mental health workers to be aware of the important role that clergy play in service provision and to find ways to leverage knowledge and skills to enhance provider-clergy relationships in order to improve services that older adults receive.
Intentions to seek (preventive) psychological help among older adults: an application of the theory of planned behaviour
- Authors:
- WESTERHOF Gerben J., et al
- Journal article citation:
- Aging and Mental Health, 12(3), May 2008, pp.317-322.
- Publisher:
- Taylor and Francis
The study is carried out from the theory of planned behaviour and distinguishes attitudes (psychological openness), subjective norms (indifference to stigma), and perceived behavioural control (help-seeking propensity) in explaining behavioural intentions with regard to seeking preventive and therapeutic psychological help. One hundred and sixty seven Dutch adults between 65 and 75 years of age filled out a questionnaire measuring these concepts. Results found older adults have low intentions to seek professional help for psychological problems. Their intentions to use preventive help are somewhat higher. Older adults are rather indifferent to stigma and they perceive control, but they are less open to professional help when it comes to their own person. Regression analyses revealed that psychological openness and help-seeking propensity are related to intentions to seek preventive and therapeutic help.
Unmet needs for mental health services for Latino older adults: perspectives from consumers, family members, advocates, and service providers
- Authors:
- BARRIO Concepcion, et al
- Journal article citation:
- Community Mental Health Journal, 44(1), February 2008, pp.57-74.
- Publisher:
- Springer
This study qualitatively assessed the need for mental health services among Latino older adults in San Diego, California. The primary mental health issue was depression. Primary organizational barriers to accessing services were language and cultural barriers secondary to a lack of translators, dearth of information on available services, and scarcity of providers representative of the Latino community. Other challenges included a lack of transportation and housing, and the need for socialization and social support. Latino older adults experienced their unmet needs in ways associated with their cultural background and minority status. Age- and culturally-appropriate services are needed to overcome these barriers.
Pathways to health and mental-health service utilization among older Mexicans
- Authors:
- ROGERS Anissa T., GALLEGOS Joseph S.
- Journal article citation:
- International Social Work, 50(5), September 2007, pp.654-670.
- Publisher:
- Sage
Pathways to service utilization among older Mexicans and Mexican- Americans were investigated through examining participants’ health beliefs and behaviours. Results indicated that definitions of health and illness had an impact on service utilization decisions. Results also suggested that an assumption that Mexican elders utilize social support networks for healthcare assistance is questionable, with implications for practice.
Age, gender, and the underutilization of mental health services: the influence of help-seeking attitudes
- Authors:
- MACKENZIE C. S., GEKOSKI W. L., KNOX V. J.
- Journal article citation:
- Aging and Mental Health, 10(6), November 2006, pp.574-582.
- Publisher:
- Taylor and Francis
The objectives of this study were to explore age and gender differences in attitudes toward seeking professional psychological help, and to examine whether attitudes negatively influence intentions to seek help among older adults and men, whose mental health needs are underserved. To achieve these objectives 206 community-dwelling adults completed questionnaires measuring help-seeking attitudes, psychiatric symptomatology, prior help-seeking, and intentions to seek help. Older age and female gender were associated with more positive help-seeking attitudes in this sample, although age and gender interacted with marital status and education, and had varying influences on different attitude components. Age and gender also influenced intentions to seek professional psychological help. Women exhibited more favourable intentions to seek help from mental health professionals than men, likely due to their positive attitudes concerning psychological openness. Older adults exhibited more favourable intentions to seek help from primary care physicians than younger adults, a finding that was not explained by age differences in attitudes. Results from this study suggest that negative attitudes related to psychological openness might contribute to men's underutilization of mental health services. Help-seeking attitudes do not appear to be a barrier to seeking professional help among older adults, although their intentions to visit primary care physicians might be. These findings suggest the need for education to improve men's help-seeking attitudes and to enhance older adults’ willingness to seek specialty mental health services.
Measurement issues of service use among elders
- Author:
- TAN Jing
- Journal article citation:
- Journal of Human Behavior in the Social Environment, 19(2), March 2009, pp.171-185.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
Published studies on service use among elders were reviewed to analyse how service use is defined and measured. Specific questions focused on how services are defined and classified, how service use is operationalised, and how data on service use are collected. Twenty studies published from 2001 to 2006 were analysed. Fifteen studies measured service use in the medical sector of care, 4 measured service use in the mental health sector, and 9 measured service use in the social services sector. Services were distinguished and classified based on type of service provided in a majority of the studies. The majority of the studies quantified service use dichotomously in terms of use and non-use, whereas more than one third quantified service use in terms of frequency of some unit. Self-report and provider records were the two sources of information about service utilisation among elders. Two studies used data from both these sources. Suggestions of how to improve measurement of service use among elders are discussed.