Identification of and beliefs about depressive symptoms and preferred treatment approaches among community-living older African Americans.
OBJECTIVE
To examine older African American's recognition of and beliefs about depressive symptoms, preferred symptom management strategies, and factors associated with willingness to use mental health treatments. Differences between the depressed and nondepressed and men and women were examined.


METHODS
Cross-sectional survey.


METHODS
Home, senior center.


METHODS
A total of 153 senior center members (56 male, 97 female) 55 years and older.


METHODS
Using a depression vignette, participants indicated if the person was depressed and their endorsement of items reflecting beliefs, stigma, symptom management, and willingness to use treatments (yes/no). A 9-item Patient Health Questionnaire assessed current symptomatology.


RESULTS
Overall, 24.2% reported depressive symptoms (≥5); 88.2% correctly identified the person in the vignette as depressed. Most (≥75%) endorsed active symptom management strategies, preference for treatment in physician and therapist offices, and willingness to take medications, seek therapy, see doctor, and attend support groups; less than 33% viewed depression as stigmatizing, whereas 48% viewed depression as normal aging. Logistic regressions revealed lower education, higher physical function, and feeling okay if community knew of depression diagnosis were associated with willingness to see physician if feeling depressed; being married and believing antidepressant medications are beneficial were related to willingness to use medications. Different associations emerged for depressed/nondepressed and men and women.


CONCLUSIONS
Overall, this older African American sample had positive attitudes and beliefs and endorsed traditional treatment modalities suggesting that beliefs alone are unlikely barriers to underutilization of mental health services. Because different factors were associated with willingness to seek physician help and use medications and factors differed for depressed/nondepressed and by sex, interventions should be tailored.
Department of Health Systems and Outcomes (LNG), School of Nursing, and Center for Innovative Care in Aging, Johns Hopkins University, Baltimore, MD 21205, USA. lgitlin1@jhu.edu
Laura N
LN
Gitlin
Nancy L
NL
Chernett
Marie P
MP
Dennis
Walter W
WW
Hauck
D000223:Adaptation, Psychological; D001741:Black or African American / Q000523:psychology*; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D003469:Culture; D003866:Depressive Disorder / Q000453:epidemiology / Q000208:ethnology* / Q000523:psychology / Q000628:therapy*; D005260:Female; D006306:Health Surveys; D006801:Humans; D057187:Independent Living / Q000523:psychology*; D008297:Male; D008605:Mental Health Services; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D014481:United States