title: Mental health utilization among older Veterans with coexisting depression and dementia.
abstract: OBJECTIVE
  We compared mental health service utilization among older, depressed Veterans (60 years or older) with and without coexisting dementia.
  
  
  METHODS
  This retrospective study examined data from the 2010 Veterans Health Administration National Patient Care Database outpatient treatment files of Veterans with a newly recognized diagnosis of depression (N = 177,710).
  
  
  RESULTS
  Approximately 48.84% with coexisting depression and dementia and 32.00% with depression only received mental health services within 12 months of diagnosis (p < .0001). Veterans with coexisting depression and dementia were more likely to receive medication-management appointments (33.40% vs 20.62%), individual therapy (13.39% vs 10.91%), and family therapy (3.77% vs 1.19%) than depressed Veterans without dementia.
  
  
  CONCLUSIONS
  In general, Veterans with recently diagnosed depression are significantly underusing Veterans Affairs mental health treatment services. Those Veterans who have comorbid dementia are more likely than those with just depression to be enrolled in mental health treatments. Systemic improvements are needed to increase use of mental health services for older, depressed Veterans.
authors.affiliation: VA HSR&D Houston Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center, Houston, TX, USA; Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA.
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: DiNapoli
authors.affiliation: VA HSR&D Houston Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center, Houston, TX, USA; VA South Central Mental Illness Research, Education and Clinical Center, USA.
authors.forename: Jeffrey A
authors.initials: JA
authors.lastname: Cully
authors.affiliation: VA HSR&D Houston Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center, Houston, TX, USA; Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, White River Junction, VT, USA.
authors.forename: Juliette M
authors.initials: JM
authors.lastname: Mott
authors.affiliation: VA HSR&D Houston Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center, Houston, TX, USA; VA South Central Mental Illness Research, Education and Clinical Center, USA.
authors.forename: Natalie E
authors.initials: NE
authors.lastname: Hundt
authors.affiliation: VA HSR&D Houston Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center, Houston, TX, USA; VA South Central Mental Illness Research, Education and Clinical Center, USA.
authors.forename: Joseph
authors.initials: J
authors.lastname: Mignogna
authors.affiliation: VA HSR&D Houston Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center, Houston, TX, USA; VA South Central Mental Illness Research, Education and Clinical Center, USA; Department of Medicine, Baylor College of Medicine, Houston, TX, USA.
authors.forename: Shubhada
authors.initials: S
authors.lastname: Sansgiry
authors.affiliation: VA HSR&D Houston Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center, Houston, TX, USA; VA South Central Mental Illness Research, Education and Clinical Center, USA.
authors.forename: Hong Jen
authors.initials: HJ
authors.lastname: Yu
authors.affiliation: VA HSR&D Houston Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center, Houston, TX, USA; Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA.
authors.forename: Lisa H
authors.initials: LH
authors.lastname: Trahan
authors.affiliation: VA HSR&D Houston Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center, Houston, TX, USA; VA South Central Mental Illness Research, Education and Clinical Center, USA.
authors.forename: Mark E
authors.initials: ME
authors.lastname: Kunik
keywords: Mental health service utilization; Veterans; dementia; depression