The American Journal of Geriatric Psychiatry
Regular Research ArticleCaring for Mental Illness in the United States: A Focus on Older Adults
Section snippets
METHODS
We analyzed data from the Healthcare for Communities (HCC) household survey, fielded between September 1997 and March 1998. This survey, funded by the Robert Wood Johnson Foundation, was designed to provide information about treatment for alcohol, drug, and mental health conditions. The HCC survey respondents were selected from participants in the Community Tracking Study (CTS), a nationally representative study of 60,446 individuals run in 1996 and 1997 (65% response rate). The HCC sample was
RESULTS
Sample characteristics, broken down into three age categories (young adults from 18 to 29, middle-aged adults from 30 to 64, and older adults age 65 and older) can be found in Table 1, which contains weighted percentages and unweighted Ns. HCC data are weighted to be nationally representative and to track the census numbers based on the Current Population Survey (CPS) well, suggesting that HCC findings are generalizable.16
Largely because of Medicare coverage, the oldest age-group was the least
DISCUSSION
Only about half of all respondents who met research diagnostic criteria for mental disorders reported any treatment for such disorders in primary care or specialty mental health care settings during a 1-year period, confirming a high level of unmet need for mental health care that has been documented in previous studies.1, 5, 17 Our findings suggest that middle-aged adults with probable mental disorders have higher rates of mental health care than younger or older adults in almost every
References (31)
Mental Health: A Report of the Surgeon General
(1999)- et al.
Depressive symptoms and the cost of health services in HMO patients age 65 years and older: a 4-year prospective study
JAMA
(1997) - et al.
Healthcare costs of primary care patients with recognized depression
Arch Gen Psychiatry
(1995) - et al.
Awareness, diagnosis, and treatment of depression
J Gen Intern Med
(1999) - et al.
The quality of care for depressive and anxiety disorders in the United States
Arch Gen Psychiatry
(2001) - et al.
Predictors of types of help provided to people using services for mental health problems: an analysis of the Australian National Survey of Mental Health and Well-Being
Aust N Z J Psychiatry
(2001) - et al.
Factors affecting the utilization of specialty and general medical mental health services
Med Care
(1988) - et al.
Characteristics of patients with major depression who received care in general medical and specialty mental health settings
Med Care
(1994) - et al.
A 12-item short-form health survey: construction of scales and preliminary tests of reliability and validity
Med Care
(1996) - Zhang L, Tang L, Liao D, et al: Healthcare for Communities Household Survey Public Use Files: Codebook; August...
The World Health Organization Composite International Diagnostic Interview Short-Form (CIDI-SF)
Diagnostic and Statistical Manual of Mental Disorders, 3rd Edition, Revised
SUDAAN User's Manual, Release 7.5
Selection without replacement from within strata with probability proportional to size
Journal of the Royal Statistical Society
Cited by (247)
Psychological distress, multimorbidity and health services among older adults in rural South Australia
2022, Journal of Affective DisordersValidation study of microRNAs previously associated with antidepressant response in older adults treated for late-life depression with venlafaxine
2020, Progress in Neuro-Psychopharmacology and Biological PsychiatryEpidemiology of selected mental disorders in later life
2020, Handbook of Mental Health and AgingCommunity and home care for mentally ill older adults
2020, Handbook of Mental Health and AgingPsychological Issues in Medically Underserved Patients
2019, Physician Assistant Clinics
We thank Dr. Kenneth B. Wells for his support and review of an earlier version of this manuscript and Lily Zhang, M.S., for outstanding programming support.
This work was funded by The Robert Wood Johnson Foundation Healthcare for Communities (Grant #031280; Kenneth B. Wells, M.D., M.P.H., P.I.), The John A. Hartford Foundation/AFAR Medical Student Geriatric Scholars Program (Kathleen Tschantz), The John A. Hartford Foundation (Jürgen Unützer, M.D., M.P.H.), and The Research Center on Managed Care for Psychiatric Disorders (National Institute of Mental Health: #2 P50MH54623; Kenneth B. Wells, M.D., M.P.H., P.I.).