Patterns and predictors of mental health service use and serious mental illness among community-dwelling elderly

Abstract

Older adults have historically utilized mental health services at substantially low rates. Unfortunately, though professional, policy, and other recent developments portend an increase in service use, there has been scant empirical attention devoted to the current or recent utilization of mental health treatment by the elderly, and almost nothing is known about the correlates of mental health need and service use among older adults. Accordingly, the present study examined patterns of serious mental illness (SMI), specific mental health syndromes, and service use among older (65+) and younger (18- 64) adults throughout the United States, and the extent to which various factors predict mental health need and the use and magnitude of mental health treatment. In addition, the study examined factors related to unmet need, as well as age group differences in perceived benefit from treatment. The findings reveal that older adults were three times less likely than their younger counterparts to receive any outpatient mental health treatment. Only 2.5% of older individuals utilized any outpatient mental health service in the past year, versus 7.0% of younger adults. The results indicate that the low rate of utilization by older adults may be partly a function of limited subjective mental health need. Prevalence estimates for SMI and all specific mental health syndromes, with the exception of agoraphobia, were markedly lower in the older than the younger cohort. Importantly, though mental health problems appear to be significantly undertreated in older and younger age groups, the study also reveals that those older and younger adults that make it into services typically benefit considerably from treatment. It is hoped that the knowledge yielded by the current study will promote efforts to enhance mental health care access and reduce the long neglected mental health needs of the nation’s elderly population. Several factors related to mental health need and service use were identified in the study that may assist policy, planning, and outreach efforts aimed at increasing service access.