Shying Away from Mental Health Services

As part of the course I am teaching this semester, Rural Public Health Policy Analysis, my graduate students must complete a facilitated reading assignment. In this assignment, I assign pairs of students a rural health policy topic and they pick a recent and relevant article in the peer-reviewed literature and lead the class discussion on that article.

For this week, the students picked “Low use of mental health services among older Americans with mood and anxiety disorders” by Byers, Arean and Yaffe, published in the January 2012 issue of Psychiatric Services. While the article does not give rural and urban splits, it does provide insight into the factors for nonuse of mental health services.

Using data from face-to-face interviews of 348 individuals in their homes, the authors looked at the issues facing this unmet need and barriers to care. All of the respondents to this survey were at least 55 years old and had at least one mood or anxiety disorder.

Overall, more than 7 out of 10 (71.3%) of the respondents did not use mental health services. Using a multivariate logistic regression model, the authors identified factors associated with NOT using mental health services. The authors identified several predisposing, enabling and need factors. The authors end with three main recommendations: (1) improved screening and monitoring programs in community-dwelling older adults, (2) more outreach services to help motivate older adults to seek care, and (3) expand coverage of mental health services for older Americans.

If you are interested in learning more about behavioral health issues in rural Arizona, I would encourage you to read the CRH report on this topic here.