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An investigation of mental health service utilization by older adults

Karyn M Skultety, University of Massachusetts Amherst


Although the current literature documents the lack of sufficient utilization of mental health services by older adults, there has been a lack of clarity regarding which factors are significant utilization predictors. The goal of this study was to examine a wide array of demographic, external, and internal utilization barriers, as well as to explore the new barriers of treatment fearfulness, self-concealment, aging concerns and memory controllability. A sample of community adults (214 females and 129 males) completed a self-report questionnaire on mental health services. The sample ranged in age from 40 to 91 years (M = 58.01, SD = 12.27) and was divided into two cohort groups (Baby Boomers and older adults in the Post-War, WWII and Depression cohorts). Four measures of mental health service utilization were used, including past utilization, future likelihood of utilization and two questions regarding how respondents would respond to depressive symptoms. Multiple logistic and linear regression analyses revealed several variables were unique predictors of utilization even when all other significant individual barriers were controlled for. For the Baby Boomers these variable included: health status, physician visits, knowledge of insurance, depression, therapist responsiveness, self-concealment, and attitudes towards psychotherapy. For the older adult cohort group these variables included: Medicare (having Medicare), the belief in inevitable decline in memory, attitudes towards psychotherapy and knowledge of insurance. Additional variables were significant predictors when tested alone, including gender and the memory controllability subscales for the Baby Boomers, religiosity for the older adult cohort group, and coercion concerns for both cohort groups. Lastly, depressed individuals reported significantly more negative beliefs regarding memory and higher levels of treatment fears than non-depressed individuals. These results suggest that treatment fears and memory controllability are important factors to consider as effecting mental health service utilization. The findings also support the notion that demographic, external, and internal factors have unique impacts on service utilization and vary by cohort group. Research and clinical applications of these findings are discussed in an attempt to help address the needs of the older population in mental health clinical practice, administration and policy.

Subject Area


Recommended Citation

Skultety, Karyn M, "An investigation of mental health service utilization by older adults" (2003). Doctoral Dissertations Available from Proquest. AAI3110555.