title: Mental healthcare need and service utilization in older adults living in public housing.
abstract: OBJECTIVE
  Anxiety and depression in socioeconomically disadvantaged older adults frequently go unrecognized and untreated. This study aims to characterize mental illness and its treatment in older adult public housing residents who have many risk factors for anxiety and depression.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  Public housing high-rises in Rochester, New York.
  
  
  METHODS
  One hundred ninety residents aged 60 years and older.
  
  
  METHODS
  Anxiety and depression were assessed using the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, GAD-7, and Patient Health Questionnaire. We obtained information on mental healthcare from medication review and self-report.
  
  
  RESULTS
  Participants had a median age of 66 years, 58% were women, 80% were black, and 92% lived alone. Many participants (31%) were in need of mental healthcare: 21% had syndromal and 11% had subsyndromal anxiety or depression. Mental healthcare need was associated with younger age; intact cognitive functioning; impairments in instrumental activities of daily living (IADL); more medical illness; decreased mobility; smaller social network size; more severe life events; and increased utilization of medical, human, and informal services. Of those with mental healthcare need, most were not receiving it. Compared with residents receiving mental healthcare, residents with untreated need were more likely to be men and have less IADL impairment, medical illness, severe life events, onsite social worker use, and human services utilization.
  
  
  CONCLUSIONS
  Mental illness was common and largely untreated in public housing residents. Increasing collaboration between medical, mental, and human services is needed to improve identification, treatment, and ultimately prevention of late-life mental illness in this community setting.
authors.affiliation: Department of Community and Preventive Medicine, University of Rochester School of Medicine and Dentistry, New York 14642, USA. adam_simning@urmc.rochester.edu
authors.forename: Adam
authors.initials: A
authors.lastname: Simning
authors.forename: Edwin
authors.initials: E
authors.lastname: van Wijngaarden
authors.forename: Susan G
authors.initials: SG
authors.lastname: Fisher
authors.forename: Thomas M
authors.initials: TM
authors.lastname: Richardson
authors.forename: Yeates
authors.initials: Y
authors.lastname: Conwell
mesh_terms: D001741:Black or African American / Q000523:psychology / Q000706:statistics & numerical data; D000368:Aged; D001007:Anxiety / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology*; D005260:Female; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data*; D054625:Healthcare Disparities / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008605:Mental Health Services / Q000706:statistics & numerical data*; D008875:Middle Aged; D020380:Needs Assessment / Q000706:statistics & numerical data; D009518:New York / Q000453:epidemiology; D011638:Public Housing; D012959:Socioeconomic Factors