title: The Barriers to Mental Health Services Scale Revised: Psychometric Analysis Among Older Adults.
abstract: OBJECTIVE
  Older adults underutilize mental health services suggesting that significant barriers are operating. This study presents reliability and validity data for a revised version of the self-report Barriers to Mental Health Services Scale (BMHSS) designed to quantify 10 barriers to mental health service use, so that barriers can be examined collectively.
  
  
  METHODS
  The Barriers to Mental Health Services Scale Revised (BMHSS-R) was revised to improve its reliability and validity, including adding items, eliminating poor items, and balancing the number of items across subscales. A sample of 100 older adults (Mage = 72.1 years,SD= 17.8 years) completed the BMHSS-R, the Beliefs Toward Mental Illness Scale, and the Willingness to Seek Help Questionnaire.
  
  
  RESULTS
  Internal consistency for the 10 subscales of the BMHSS-R ranged between .63 and .87, with 8 of the 10 values greater than .70. Correlational analyses indicated that many of the subscales overlap considerably but are still distinct. Convergent validity of the BMHSS-R subscales of help-seeking and stigma was partially supported, although correlations were modest.
  
  
  CONCLUSIONS
  Revisions to the BMHSS resulted in improved reliability estimates for use as a measure of perceived barriers to mental health services. We recommend when using the BMHSS-R to combine results with other information (e.g., service utilization data) to characterize a profile of barriers. We discuss directions for future research and further refinement of the BMHSS-R.
authors.affiliation: Geisel School of Medicine at Dartmouth, Lebanon, NH, USA.
authors.forename: Renee
authors.initials: R
authors.lastname: Pepin
authors.affiliation: University of Colorado at Colorado Springs, Colorado Springs, CO, USA.
authors.forename: Daniel L
authors.initials: DL
authors.lastname: Segal
authors.affiliation: University of Colorado at Colorado Springs, Colorado Springs, CO, USA.
authors.forename: Kelli J
authors.initials: KJ
authors.lastname: Klebe
authors.affiliation: University of Colorado at Colorado Springs, Colorado Springs, CO, USA.
authors.forename: Frederick L
authors.initials: FL
authors.lastname: Coolidge
authors.affiliation: University of Colorado at Colorado Springs, Colorado Springs, CO, USA.
authors.forename: K Maja
authors.initials: KM
authors.lastname: Krakowiak
authors.affiliation: Geisel School of Medicine at Dartmouth, Lebanon, NH, USA.
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Bartels
keywords: aging; barriers; mental health; service use