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Predisposing, enabling, and need factors of service utilization in the elderly with mental health problems

Published online by Cambridge University Press:  04 December 2017

Jana Volkert ,
Sylke Andreas ,
Martin Härter ,
Maria Christina Dehoust ,
Susanne Sehner ,
Anna Suling ,
Berta Ausín ,
Alessandra Canuto ,
Mike J. Crawford  and
Chiara Da Ronch
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Jana Volkert*
Affiliation:
Department of Medical Psychology, University Medical Centre Hamburg-Eppendorf, Martinistrasse 52, Building W 26, 20246, Hamburg, Germany Department of Psychosocial Prevention, University of Heidelberg, Bergheimer Str. 54, 69115, Heidelberg, Germany
Sylke Andreas
Affiliation:
Department of Medical Psychology, University Medical Centre Hamburg-Eppendorf, Martinistrasse 52, Building W 26, 20246, Hamburg, Germany Institute of Psychology, Alpen-Adria University Klagenfurt, 9020, Klagenfurt, Austria Department of Psychology, University Witten/Herdecke, Alfred-Herrhausen-Str. 50, 58448, Witten, Germany
Martin Härter
Affiliation:
Department of Medical Psychology, University Medical Centre Hamburg-Eppendorf, Martinistrasse 52, Building W 26, 20246, Hamburg, Germany
Maria Christina Dehoust
Affiliation:
Department of Medical Psychology, University Medical Centre Hamburg-Eppendorf, Martinistrasse 52, Building W 26, 20246, Hamburg, Germany
Susanne Sehner
Affiliation:
Institute of Medical Biometry and Epidemiology, University Medical Centre Hamburg–Eppendorf, Martinistrasse 52, Building W 34, 20246, Hamburg, Germany
Anna Suling
Affiliation:
Institute of Medical Biometry and Epidemiology, University Medical Centre Hamburg–Eppendorf, Martinistrasse 52, Building W 34, 20246, Hamburg, Germany
Berta Ausín
Affiliation:
School of Psychology, University Complutense of Madrid, Campus de Somosaguas s/n, 28223, Madrid, Spain
Alessandra Canuto
Affiliation:
Nant Foundation, East Vaud Psychiatric Institute, Route de Nant, 1804, Corsier-sur-Vevey, Switzerland
Mike J. Crawford
Affiliation:
Royal College of Psychiatrists, Mansell Street 21, E18AA, London, UK
Chiara Da Ronch
Affiliation:
Department of Biomedical and Specialty Surgical Sciences, Institute of Psychiatry, University of Ferrara, Corso Giovecca 203, Ferrara, 44121, Italy
Luigi Grassi
Affiliation:
Department of Biomedical and Specialty Surgical Sciences, Institute of Psychiatry, University of Ferrara, Corso Giovecca 203, Ferrara, 44121, Italy
Yael Hershkovitz
Affiliation:
Hadassah University Medical Centre, P.O.B 12000, 91120, Jerusalem, Israel
Manuel Muñoz
Affiliation:
School of Psychology, University Complutense of Madrid, Campus de Somosaguas s/n, 28223, Madrid, Spain
Alan Quirk
Affiliation:
Royal College of Psychiatrists, Mansell Street 21, E18AA, London, UK
Ora Rotenstein
Affiliation:
Hadassah University Medical Centre, P.O.B 12000, 91120, Jerusalem, Israel
Ana Belén Santos-Olmo
Affiliation:
School of Psychology, University Complutense of Madrid, Campus de Somosaguas s/n, 28223, Madrid, Spain
Arieh Y. Shalev
Affiliation:
Department of Psychiatry, NY Langone Medical Center, New York, USA
Jens Strehle
Affiliation:
Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Chemnitzer Strasse 46, 01187, Dresden, Germany
Kerstin Weber
Affiliation:
Medical Direction, University Hospitals of Geneva, Chemin de Champ-Dollon 20, 1241, Puplinge, Switzerland
Karl Wegscheider
Affiliation:
Institute of Medical Biometry and Epidemiology, University Medical Centre Hamburg–Eppendorf, Martinistrasse 52, Building W 34, 20246, Hamburg, Germany
Hans-Ulrich Wittchen
Affiliation:
Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Chemnitzer Strasse 46, 01187, Dresden, Germany Department of Psychiatry and Psychotherapy, Ludwigs-Maximilians-Universität München, Nußbaumstr. 7, 80336, München, Germany
Holger Schulz
Affiliation:
Department of Medical Psychology, University Medical Centre Hamburg-Eppendorf, Martinistrasse 52, Building W 26, 20246, Hamburg, Germany
*
Correspondence should be addressed to: Dr Jana Volkert, Department of Psychosocial Prevention, University of Heidelberg, Bergheimer Str. 54, 69115 Heidelberg, Germany. Phone: +49 (0)6221-56-4710; Fax: +49 (0)6221-56-4702. Email: jana.volkert@med.uni-heidelberg.de.
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Abstract

Background:

Empirical data on the use of services due to mental health problems in older adults in Europe is lacking. The objective of this study is to identify factors associated with service utilization in the elderly.

Methods:

As part of the MentDis_ICF65+ study, N = 3,142 people aged 65–84 living in the community in six European and associated countries were interviewed. Based on Andersen's behavioral model predisposing, enabling, and need factors were analyzed with logistic regression analyses.

Results:

Overall, 7% of elderly and 11% of those with a mental disorder had used a service due to mental health problems in the last 12 months. Factors significantly associated with underuse were male sex, lower education, living in the London catchment area, higher functional impairment and more comorbid mental disorders. The most frequently reported barrier to service use was personal beliefs, e.g. “I can deal with my problem on my own” (90%).

Conclusion:

Underutilization of mental health services among older people in the European community is common and interventions are needed to achieve an adequate use of services.

Keywords

agingservicesepidemiology
Type
Original Research Article
Information
International Psychogeriatrics , Volume 30 , Issue 7: Issue Theme: Benzodiazepines and Hypnotics , July 2018 , pp. 1027 - 1037
Copyright
Copyright © International Psychogeriatric Association 2017 

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