title: Use of mental health care by community-dwelling older adults.
abstract: OBJECTIVE
  To examine relationships between perceived need for care, illness characteristics, attitudes toward care, and probability that older adults will use mental health care (MHC).
  
  
  METHODS
  Secondary data analysis.
  
  
  METHODS
  The Collaborative Psychiatric Epidemiology Surveys (2001-2003).
  
  
  METHODS
  One thousand six hundred eighty-one community-dwelling adults aged 65 and older.
  
  
  METHODS
  Self-reported MHC use and perceived need for care in the previous 12 months, previous year and history of mental illness, history of physical illness, attitudes toward care, and sociodemographic characteristics.
  
  
  RESULTS
  Of the entire sample, 6.5% had received some type of MHC in the previous year, although 65.9% of those with major depressive disorder (MDD) and 72.5% with anxiety did not receive MHC. In respondents with previous-year depression or anxiety, use was less likely for those with low World Health Organization Disability Assessment Scale (WHO-DAS) self-care ability. Use was more likely for those with more chronic physical conditions and worse WHO-DAS cognitive capacity. Seventeen percent of those with perceived need for MHC did not receive it. In respondents with perceived need, subthreshold generalized anxiety disorder was associated with lower likelihood of use. Use was more likely for older respondents and those with more household members, at least a high school education, and better self-care ability. Forty-one percent of those who perceived a need for care but did not use it met previous-year diagnostic criteria for anxiety, and 17% met criteria for MDD.
  
  
  CONCLUSIONS
  Understanding the perceptions that underlie individuals' health care-seeking behavior is an important step toward reducing underuse of MHC by older adults.
authors.affiliation: Research Enhancement Award Program and Geriatric Research, Education, and Clinical Center, James J Peters Veterans Affairs Medical Center, Bronx, New York, USA. melissa.garrido@mssm.edu
authors.forename: Melissa M
authors.initials: MM
authors.lastname: Garrido
authors.forename: Robert L
authors.initials: RL
authors.lastname: Kane
authors.forename: Merrie
authors.initials: M
authors.lastname: Kaas
authors.forename: Rosalie A
authors.initials: RA
authors.lastname: Kane
mesh_terms: D000368:Aged / Q000523:psychology*; D001008:Anxiety Disorders / Q000453:epidemiology / Q000534:rehabilitation; D002908:Chronic Disease / Q000453:epidemiology; D015897:Comorbidity; D003866:Depressive Disorder / Q000453:epidemiology / Q000534:rehabilitation; D005260:Female; D006306:Health Surveys; D006801:Humans; D016015:Logistic Models; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology / Q000534:rehabilitation*; D008605:Mental Health Services / Q000706:statistics & numerical data*; D015999:Multivariate Analysis; D010342:Patient Acceptance of Health Care; D012959:Socioeconomic Factors; D019966:Substance-Related Disorders / Q000453:epidemiology / Q000534:rehabilitation; D014481:United States / Q000453:epidemiology