scholarly journals Perceived need for treatment and non-utilization of outpatient psychotherapy in old age: two cohorts of a nationwide survey

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Paul Gellert ◽  
Sonia Lech ◽  
Eva-Marie Kessler ◽  
Wolfram Herrmann ◽  
Susanne Döpfmer ◽  
...  
Keyword(s):  
Mental Health ◽  
Older Adults ◽  
Mental Health Problems ◽  
Health Problems ◽  
General Health Status ◽  
Outpatient Psychotherapy ◽  
Need For Treatment ◽  
Perceived Need ◽  
Rural Residency ◽  
Perceived Need For Treatment

Abstract Beackground Older adults with mental health problems may benefit from psychotherapy; however, their perceived need for treatment in relation to rates of non-utilization of outpatient psychotherapy as well as the predisposing, enabling, and need factors proposed by Andersen’s Model of Health Care Utilization that account for these differences warrant further investigation. Methods We used two separate cohorts (2014 and 2019) of a weighted nationwide telephone survey in Germany of German-speaking adults with N = 12,197 participants. Across the two cohorts, 12.9% (weighted) reported a perceived need for treatment for mental health problems and were selected for further analyses. Logistic Generalized Estimation Equations (GEE) was applied to model the associations between disposing (age, gender, single habiting, rural residency, general health status), enabling (education, general practitioner visit) non-utilization of psychotherapy (outcome) across cohorts in those with a need for treatment (need factor). Results In 2014, 11.8% of 6087 participants reported a perceived need for treatment due to mental health problems. In 2016, the prevalence increased significantly to 14.0% of 6110 participants. Of those who reported a perceived need for treatment, 36.4% in 2014 and 36.9%in 2019 did not see a psychotherapist – where rates of non-utilization of psychotherapy were vastly higher in the oldest age category (59.3/52.5%; 75+) than in the youngest (29.1/10.7%; aged 18–25). Concerning factors associated with non-utilization, multivariate findings indicated participation in the cohort of 2014 (OR 0.94), older age (55–64 OR 1.02, 65–74 OR 1.47, 75+ OR 4.76), male gender (OR 0.83), lower educational status (OR 0.84), rural residency (OR 1.38), single habiting (OR 1.37), and seeing a GP (OR 1.39) to be related with non-utilization of psychotherapy; general health status was not significantly associated with non-utilization when GP contact was included in the model. Conclusion There is a strong age effect in terms of non-utilization of outpatient psychotherapy. Individual characteristics of both healthcare professionals and patients and structural barriers may add to this picture. Effective strategies to increase psychotherapy rates in those older adults with unmet treatment needs are required.

scholarly journals Perceived Need for Treatment and Non-utilization of Outpatient Psychotherapy in Old Age: Two Cohorts of a Nationwide Survey

2021 ◽  
Author(s):  
Paul Gellert ◽  
Sonia Lech ◽  
Eva-Marie Kessler ◽  
Wolfram Herrmann ◽  
Susanne Döpfmer ◽  
...  
Keyword(s):  
Mental Health ◽  
Older Adults ◽  
Mental Health Problems ◽  
Health Problems ◽  
General Health Status ◽  
Outpatient Psychotherapy ◽  
Need For Treatment ◽  
Perceived Need ◽  
Rural Residency ◽  
Perceived Need For Treatment

Abstract Objectives: Older adults with mental health problems may benefit from psychotherapy; however, their perceived need for treatment in relation with rates of non-utilization of outpatient psychotherapy as well as predisposing, enabling, and need factors proposed by Andersen’s Model of Health Care Utilization that account for these differences warrants further investigation.Method: We used two separate cohorts (2014 and 2019) of a German weighted nationwide telephone survey of German-speaking adults with N=12,197 participants. Across the two cohorts, 12.9% (weighted) reported perceived need for treatment for mental health problems and were selected for further analyses. Logistic Generalized Estimation Equations (GEE) was applied to model the associations between disposing (age, gender, single habiting, rural residency), enabling (education, general practitioner visit, general health status) non-utilization of psychotherapy (outcome) across cohorts in those with need for treatment (need factor).Results: In 2014/2019, out of 6,087/6,110 participants, 11.8%/14.0% reported perceived need for treatment due to mental health problems, which reflects a significant increase in prevalence from 2014 to 2019. Of those who reported perceived need for treatment, 36.4%/36.9% did not see a psychotherapist – where rates of non-utilization of psychotherapy were vastly higher in the oldest age (59.3/52.5%; 75+) category, than in the youngest (29.1/10.7%; 18-25 years). Concerning factors associated with non-utilization, multivariate findings indicated participation in the cohort of 2014 (OR 0.94), older age (Age 55-64 OR 1.02, Age 65-74 OR 1.47, Age 75+ OR 4.76), male gender (OR 0.83), lower educational status (OR 0.84), rural residency (OR 1.38), single habiting (OR 1.37), and seeing a GP (OR 1.39) to be related with non-utilization of psychotherapy; general health status was not significantly associated with non-utilization when GP contact was included in the model.Conclusion: There is a strong age effect in terms of non-utilization of outpatient psychotherapy. Individual characteristics of both healthcare professionals and patients and structural barriers may add to this picture. Effective strategies to increase psychotherapy rates in those older adults with unmet needs for treatment are required.

Pemberdayaan Siswa SMAN 1 Sumberpucung Dalam Dukungan Kesehatan Jiwa Dan Psikososial Covid-19 Untuk Kelompok Rentan Khususnya Lansia

2021 ◽  
Vol 4 (4) ◽  
pp. 853-866
Author(s):  
Berliany Venny Sipollo ◽  
Mochamad Ali Sodikin
Keyword(s):  
Mental Health ◽  
Older Adults ◽  
Mental Health Problems ◽  
Psychosocial Support ◽  
Psychosocial Health ◽  
Health Impact ◽  
Health Problems ◽  
The Body ◽  
Vulnerable Groups ◽  
Young Generation

ABSTRAK Pandemi COVID-19 merupakan bencana non alam yang berdampak tidak hanya pada kesehatan fisik saja tetapi berdampak pula terhadap kesehatan jiwa dan psikososial masyarakat. Dampak kesehatan jiwa dan psikososial ini dapat menurunkan sistem imunitas tubuh manusia khususnya kelompok rentan yaitu kelompok lansia. Semakin seseorang merasa cemas yang berlebihan, maka tubuh mengalami kegagalan dalam menghasilkan antibodi untuk melawan virus.. Klien yang terdiagnosis positif COVID-19 merasa sangat takut dengan bayangan kematian, dan secara sosial diisolasi yang akan menimbulkan stigma sehingga mungkin terjadi ansietas dan depresi yang bila berlanjut dapat menyebabkan keputusasaan yang akan memperburuk kondisi fisik. Pemberdayaan generasi muda dalam hal ini adalah siswa SMAN 1 Sumberpucung dalam mendukung kesehatan jiwa dan psikosial lansia, yaitu lansia yang berada dalam keluarga siswa. Metode yang digunakan di masa pandemic COVID-19 dengan kegiatan atau pelatihan DKJPS (Dukungan Kesehatan Jiwa dan Psikososial) dievaluasi selama 1,5 bulan berupa melakukan upaya promosi kesehatan (peningkatan imunitas fisik dan imunitas jiwa) dan pencegahan masalah kesehatan (pencegahan penularan dan pencegahan masalah kesehatan jiwa) yang pada akhirnya disebut sebagai Adaptasi Kebiasaan Baru (AKBmelalui virtual menggunakan zoom dan platform Whatsapp Group Chat dengan metode ceramah, Tanya jawab, diskusi dan demonstrasi. Hasil Jumlah audience: 50 siswa dan jumlah lansia dan pra lansia: 11 orang Kata Kunci : Kesehatan Jiwa, Psikososial, Generasi Muda, Lansia  ABSTRACT The COVID-19 pandemic is a non-natural disaster that has an impact not only on physical health but also on the mental and psychosocial health of the community. This mental and psychosocial health impact can reduce the immune system of the human body, especially vulnerable groups, namely the older adults. The more a person feels excessively anxious; the body fails to produce antibodies to fight the virus. Clients who are diagnosed positive for COVID-19 feel very afraid of the image of death and are socially isolated which will lead to stigma so that anxiety and depression may occur if it continues. Can cause despair that will worsen the physical condition. The empowerment of the younger generation in this case is the students of SMAN 1 Sumberpucung in supporting the mental and psychosocial health of the older adults, which was the older adults who are in the student's family. The method used during the COVID-19 pandemic with DKJPS (Mental Health and Psychosocial Support) activities or training was evaluated for 4 weeks in the form of health promotion efforts (increasing physical immunity and mental immunity) and prevention of health problems (prevention of transmission and prevention of mental health problems. ) which is finally referred to as New Habit Adaptation (AKB through virtual using zoom and the Whatsapp Group Chat platform with the methods of lecturing, question and answer, discussion and demonstration Results Number of audiences: 50 students and the number of older adults and pre-elderly: 11 people Keywords: Mental Health, Psychosocial, Young Generation, Older Adults

scholarly journals 414 - Rise in the number of geriatric patients attending psychiatric emergency services in a tertiary hospital during the COVID-19 lockdown period

2020 ◽  
Vol 32 (S1) ◽  
pp. 130-130
Author(s):  
Migita M. D’cruz ◽  
Thomas G. Issac ◽  
Gargi Mondal ◽  
Naga VSS Gorthi ◽  
Shiva Shankar Reddy Mukku ◽  
...  
Keyword(s):  
Mental Health ◽  
Older Adults ◽  
Geriatric Patients ◽  
Emergency Services ◽  
Mental Health Problems ◽  
Health Problems ◽  
Care Hospital ◽  
Global Response ◽  
Number Of Patients ◽  
Pathway To Care

Introduction: Older adults are at disproportionate risk of serious disease and mortality due to the novel coronavirus (COVID-19) pandemic. Further, the global response to the lockdown has rendered older adults particularly vulnerable to loneliness and social isolation due to the physical distancing and shelter in place mandate. We hypothesized that both these factors would lead to an increase in geriatric mental health problems during the COVID-19 pandemic.Material and Methods: We undertook a clinical audit of all geriatric patients (above 60 years of age) attending the psychiatry emergency services at a tertiary care hospital. This audit was conducted over a period of 52 days dating from the cessation of non-essential services at the hospital as part of the national response to the COVID-19 pandemic (lockdown).We used descriptive statistics to summarize the number, age, sex, presenting complaint and diagnoses of our patients. We further compared the average number of geriatric patients attending the psychiatry emergency services in the hospital during the lockdown to that of geriatric patients attending the same in the year before the lockdown.Results: A total of 112 geriatric patients attended the psychiatry emergency services during the lockdown period. Of these, 62 were male and 50 female. The average number of geriatric patients attending the emergency services daily during this period (μ1 2.15) was significantly higher (z 5.36, p ≤ 0.01) than the average number of patients attending the emergency services in the year preceding the lockdown (μ2 1.34).The most common presenting complaint was agitation in the preceding weeks. The most common diagnoses were late onset schizophrenia spectrum disorders followed by affective disorders and major neurocognitive disorders.Discussion: The COVID-19 pandemic and the global response to the same constitute life events for older adults. They may contribute to biological, psychological and social risk factors for mental health problems in older adults during this period. The increase in geriatric patients attending our emergency services, despite an increase in restrictions on mobility which act as barriers in the pathway to care, is worrying. Under stimulation in older adults during this period may contribute to an increase in agitation.

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