Perceived Need for Mental Health Care Among Community-Dwelling Older Adults

Disadvantaged neighborhood environments may have low access to healthcare, perpetuating health disparities. Previous research has reported on associations between neighborhood disadvantage (ND) and depressive symptomology but not depression diagnoses, which may indicate access to healthcare. This study tested how ND relates to depressive symptomology and diagnosis to assess for neighborhood disparities in mental health care cross-sectionally. Data from 998 community-dwelling, Black and White individuals aged 65+ included in the University of Alabama at Birmingham Study of Aging were analyzed. We obtained participants’ depressive symptomology from the Geriatric Depression Scale (n = 100) and a verified depression diagnosis from self-report and review of medication, physician-report, and/or hospital discharge summaries (n = 84). We assessed ND from US Census data, divided the sample into tertiles of ND and fit models with Generalized Estimating Equations covarying for various other variables (e.g., sex, race, physical performance, socioeconomic status, etc.). We found living in the high and mid-ND tertiles to be associated with depressive symptomology, yet ND had no significant relation to depression diagnosis. Therefore, older adults living in high and mid-disadvantaged neighborhoods may be more likely to experience depressive symptomology but not receive a diagnosis, indicating a possible disparity in mental health care.

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Participation in life-review playback theater enhances mental health of community-dwelling older adults: A randomized controlled trial.

Psychology of Aesthetics Creativity and the Arts ◽

10.1037/aca0000354 ◽

2020 ◽

Author(s):

Shoshi Keisari ◽

Yuval Palgi ◽

Dani Yaniv ◽

Anat Gesser-Edelsburg

Keyword(s):

Mental Health ◽

Older Adults ◽

Randomized Controlled Trial ◽

Controlled Trial ◽

Life Review ◽

Community Dwelling ◽

Randomized Controlled ◽

Community Dwelling Older Adults

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Roles of Psychological Distress and Social Support in the Relationship Between Childhood Maltreatment and Perceived Needs for Mental Health Care

Journal of Interpersonal Violence ◽

10.1177/08862605211006368 ◽

2021 ◽

pp. 088626052110063

Author(s):

Tingting Gao ◽

Songli Mei ◽

Muzi Li ◽

Carl D’ Arcy ◽

Xiangfei Meng

Keyword(s):

Mental Health ◽

Social Support ◽

Health Care ◽

Psychological Distress ◽

Mental Health Care ◽

Childhood Maltreatment ◽

Perceived Needs ◽

Perceived Need ◽

History Of ◽

The Relationship

Childhood maltreatment is a major public health issue worldwide. It increases a range of health-risk behaviors, psychological and physical problems, which are associated with an increased need for mental health services in adulthood. Identification of mediating factors in the relationship between maltreatment and seeking mental health care may help attenuate the negative consequences of childhood maltreatment and promote more appropriate treatment. This study aims to examine whether the relationship between childhood maltreatment and perceived need for mental health care is mediated by psychological distress and/or moderated by social support. Data from the Canadian Community Health Survey-Mental Health 2012 are analyzed. A total of 8,993 participants, who had complete information on childhood maltreatment and diagnoses of mental disorders or psychological distress, are included in this study. Structural equation modeling and the PROCESS macro were used to identify relationships among childhood maltreatment, perceived needs for mental health care, and psychological distress. Hierarchical linear regression was then used to verify the moderated mediation model. We found that psychological distress partially mediated the effect of childhood maltreatment on perceived needs for mental health care in adulthood. Social support played an important role in terms of moderating the relationship between maltreatment and perceived needs for care. For those with a history of childhood maltreatment, those who perceived a low level of social support were more likely to have higher levels of psychological distress and perceived need for mental health care. This is the first study to identify the separate and combined roles of psychological distress and social support in the relationship between childhood maltreatment and perceived need for mental health care. Selective prevention strategies should focus on social support to improve mental health services among people with a history of childhood maltreatment.

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Improving Mental Health Treatment Initiation among Depressed Community Dwelling Older Adults

American Journal of Geriatric Psychiatry ◽

10.1016/j.jagp.2015.11.005 ◽

2016 ◽

Vol 24 (4) ◽

pp. 310-319 ◽

Cited By ~ 8

Author(s):

Jo Anne Sirey ◽

Samprit Banerjee ◽

Patricia Marino ◽

Ashley Halkett ◽

Elmira Raeifar ◽

...

Keyword(s):

Mental Health ◽

Older Adults ◽

Mental Health Treatment ◽

Treatment Initiation ◽

Community Dwelling ◽

Health Treatment ◽

Community Dwelling Older Adults

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Perceived need for mental health care: influences of diagnosis, demography and disability

Psychological Medicine ◽

10.1017/s0033291701004913 ◽

2002 ◽

Vol 32 (2) ◽

pp. 299-309 ◽

Cited By ~ 53

Author(s):

G. MEADOWS ◽

P. BURGESS ◽

I. BOBEVSKI ◽

E. FOSSEY ◽

C. HARVEY ◽

...

Keyword(s):

Mental Health ◽

Health Care ◽

Mental Health Care ◽

Affective Disorders ◽

Mental Health Problems ◽

Reliability And Validity ◽

Composite International Diagnostic Interview ◽

Detailed Examination ◽

Perceived Need ◽

Co Morbidity

Background. Recent major epidemiological studies have adopted increasingly multidimensional approaches to assessment. Several of these have included some assessment of perceived need for mental health care. The Australian National Survey of Mental Health and Wellbeing, conducted in 1997, included a particularly detailed examination of this construct, with an instrument with demonstrated reliability and validity.Methods. A clustered probability sample of 10641 Australians responded to the field questionnaire for this survey, including questions on perceived need either where there had been service utilization, or where a disorder was detected by administration of sections of the Composite International Diagnostic Interview. The confidentialized unit record file generated from the survey was analysed for determinants of perceived need.Results. Perceived need is increased in females, in people in the middle years of adulthood, and in those who have affective disorders or co-morbidity. Effects of diagnosis and disability can account for most of the differences in gender specific rates. With correction for these effects through regression, there is less perceived need for social interventions and possibly more for counselling in females; disability is confirmed as strongly positively associated with perceived need, as are the presence of affective disorders or co-morbidity.Conclusions. The findings of this study underscore the imperative for mental health services to be attentive and responsive to consumer perceived need. The substantial majority of people who are significantly disabled by mental health problems are among those who see themselves as having such needs.

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Racial/ethnic differences in perceived need for mental health care and disparities in use of care among those with perceived need in 1990–1992 and 2001–2003

Ethnicity and Health ◽

10.1080/13557858.2016.1252834 ◽

2016 ◽

Vol 23 (2) ◽

pp. 142-157 ◽

Cited By ~ 7

Author(s):

Andrea Ault-Brutus ◽

Margarita Alegria

Keyword(s):

Mental Health ◽

Health Care ◽

Mental Health Care ◽

Ethnic Differences ◽

Perceived Need ◽

Racial Ethnic

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Impact of a Wearable Device-Based Walking Programs in Rural Older Adults on Physical Activity and Health Outcomes: Cohort Study (Preprint)

10.2196/preprints.11335 ◽

2018 ◽

Author(s):

Il-Young Jang ◽

Hae Reong Kim ◽

Eunju Lee ◽

Hee-Won Jung ◽

Hyelim Park ◽

...

Keyword(s):

Physical Activity ◽

Older Adults ◽

Health Care ◽

Health Outcomes ◽

Rural Areas ◽

Wearable Devices ◽

Community Dwelling ◽

Wearable Device ◽

Self Management ◽

Community Dwelling Older Adults

BACKGROUND Community-dwelling older adults living in rural areas are in a less favorable environment for health care compared with urban older adults. We believe that intermittent coaching through wearable devices can help optimize health care for older adults in medically limited environments. OBJECTIVE We aimed to evaluate whether a wearable device and mobile-based intermittent coaching or self-management could increase physical activity and health outcomes of small groups of older adults in rural areas. METHODS To address the above evaluation goal, we carried out the “Smart Walk” program, a health care model wherein a wearable device is used to promote self-exercise particularly among community-dwelling older adults managed by a community health center. We randomly selected older adults who had enrolled in a population-based, prospective cohort study of aging, the Aging Study of Pyeongchang Rural Area. The “Smart Walk” program was a 13-month program conducted from March 2017 to March 2018 and included 6 months of coaching, 1 month of rest, and 6 months of self-management. We evaluated differences in physical activity and health outcomes according to frailty status and conducted pre- and postanalyses of the Smart Walk program. We also performed intergroup analysis according to adherence of wearable devices. RESULTS We recruited 22 participants (11 robust and 11 prefrail older adults). The two groups were similar in most of the variables, except for age, frailty index, and Short Physical Performance Battery score associated with frailty criteria. After a 6-month coaching program, the prefrail group showed significant improvement in usual gait speed (mean 0.73 [SD 0.11] vs mean 0.96 [SD 0.27], P=.02), International Physical Activity Questionnaire scores in kcal (mean 2790.36 [SD 2224.62] vs mean 7589.72 [SD 4452.52], P=.01), and European Quality of Life-5 Dimensions score (mean 0.84 [SD 0.07] vs mean 0.90 [SD 0.07], P=.02), although no significant improvement was found in the robust group. The average total step count was significantly different and was approximately four times higher in the coaching period than in the self-management period (5,584,295.83 vs 1,289,084.66, P<.001). We found that participants in the “long-self” group who used the wearable device for the longest time showed increased body weight and body mass index by mean 0.65 (SD 1.317) and mean 0.097 (SD 0.513), respectively, compared with the other groups. CONCLUSIONS Our “Smart Walk” program improved physical fitness, anthropometric measurements, and geriatric assessment categories in a small group of older adults in rural areas with limited resources for monitoring. Further validation through various rural public health centers and in a large number of rural older adults is required.

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