title: Mental health service use among older African Americans: the National Survey of American Life.
abstract: OBJECTIVE
  The objective of this study was to examine mental health services utilization of older African Americans using data from the National Survey of American Life.
  
  
  METHODS
  A subsample of African American respondents aged 55 years or older (N = 837) was used for this study. Thirteen mental disorders, including mood, anxiety, and substance disorders, were assessed using the Diagnostic Statistical Manual-IV World Mental Health Composite International Diagnostic Interview. Seventy-four respondents (9.6%) met criteria for a disorder. Self-reported service use included psychiatric and nonpsychiatric mental health services, general medical care, and nonhealth care (e.g., human services and complementary-alternative medicine).
  
  
  RESULTS
  Overall, 46.5% (N = 30) of older African Americans with any one 12-month disorder used some form of services in the last year; 47.2% (N = 12) with two or more disorders used any services. Those reporting any mood disorder had higher service use in every sector compared with those with any anxiety or any substance disorder. Age was significantly related with each service sector except for nonhealth care. There were no significant gender or work status differences, and marital status was only significant in nonhealth care use. Those aged 55-64, married, and not residing in the south were more likely to report any service use than their respective counterparts.
  
  
  CONCLUSIONS
  These findings reveal that a significant proportion of African American older adults with mental health disorders do not receive professional help. Future research on system, provider, and patient factors is needed to clarify and explain underutilization of mental health services.
authors.affiliation: Institute for Social Research, Center for Research on Ethnicity, University of Michigan, Ann Arbor, MI, USA. woodyn@umich.edu
authors.forename: Harold W
authors.initials: HW
authors.lastname: Neighbors
authors.forename: Amanda Toler
authors.initials: AT
authors.lastname: Woodward
authors.forename: Kai McKeever
authors.initials: KM
authors.lastname: Bullard
authors.forename: Briggett C
authors.initials: BC
authors.lastname: Ford
authors.forename: Robert Joseph
authors.initials: RJ
authors.lastname: Taylor
authors.forename: James S
authors.initials: JS
authors.lastname: Jackson
mesh_terms: D000328:Adult; D001741:Black or African American / Q000523:psychology* / Q000706:statistics & numerical data; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000208:ethnology*; D008605:Mental Health Services / Q000706:statistics & numerical data*; D008875:Middle Aged; D015999:Multivariate Analysis; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D012044:Regression Analysis; D014481:United States / Q000453:epidemiology