Predictors and Barriers to Mental Health Treatment Utilization Among Older Veterans Living With HIV.
OBJECTIVE
To identify key mood, social, and functional correlates of current participation in mental health treatment and barriers to participation in mental health treatment among older HIV infected (HIV+) veterans.


METHODS
HIV+ veterans (N = 150) aged ≥ 50 years receiving HIV-related medical care at the VA San Diego Healthcare System, San Diego, California, anonymously completed a survey assessing current self-reported mood, social support, daily functioning problems, mental health service utilization, and barriers to participating in mental health services. Veterans also completed the 2-item Patient Health Questionnaire (PHQ-2), a validated depression screening instrument frequently used in primary care settings. Data were collected from February 2014 to May 2014.


RESULTS
Overall, 44% of participants screened positive for depressive symptomatology on the PHQ-2; 55% of those who screened positive were participating in mental health treatment. Of the 45% of veterans who screened positive on the PHQ-2 and were not in treatment, two-thirds (66%) stated they had been offered services; however, they were not engaging in or accepting the services. Regardless of PHQ-2 status, current self-reported depressive symptoms emerged as an independent, significant positive predictor of participation in mental health treatment (odds ratio = 5.98; 95% CI, 1.16-30.72; P = .03), whereas anxiety, HIV-related stigma, sufficiency of social support, and daily functioning problems were not associated with mental health treatment utilization. Primary reported barriers to mental health treatment included scheduling/availability, travel time and transportation, and discomfort with group settings.


CONCLUSIONS
Results of this study suggest there may be a need to better engage older HIV+ veterans in depression-related treatment. The use of telehealth technology, such as teletherapy, electronic devices, and cell phone-based programs, may be beneficial in helping older HIV+ veterans overcome many barriers that restrict their participation in mental health treatment.
Department of Psychiatry, University of California, San Diego, 220 Dickinson Drive, St B (8231), San Diego, CA 92103-8231. r6moore@ucsd.edu.|VA San Diego Healthcare System, San Diego, California, USA.|Department of Psychiatry, University of California San Diego, La Jolla, California, USA.|The Sam and Rose Stein Institute for Research on Aging, University of California San Diego, La Jolla, California, USA.
Raeanne C
RC
Moore
Department of Psychiatry, University of California San Diego, La Jolla, California, USA.|The Sam and Rose Stein Institute for Research on Aging, University of California San Diego, La Jolla, California, USA.
María J
MJ
Marquine
California School of Professional Psychology, Alliant International University, San Diego, California, USA.
Elizabeth
E
Straus
VA San Diego Healthcare System, San Diego, California, USA.|Department of Psychiatry, University of California San Diego, La Jolla, California, USA.|The Sam and Rose Stein Institute for Research on Aging, University of California San Diego, La Jolla, California, USA.
Colin A
CA
Depp
Department of Psychiatry, University of California San Diego, La Jolla, California, USA.
David J
DJ
Moore
VA San Diego Healthcare System, San Diego, California, USA.|Department of Psychiatry, University of California San Diego, La Jolla, California, USA.
Dawn M
DM
Schiehser
VA San Diego Healthcare System, San Diego, California, USA.|Department of Psychiatry, University of California San Diego, La Jolla, California, USA.
Neil M
NM
Richtand
Department of Psychiatry, University of California San Diego, La Jolla, California, USA.|The Sam and Rose Stein Institute for Research on Aging, University of California San Diego, La Jolla, California, USA.
Dilip V
DV
Jeste
VA San Diego Healthcare System, San Diego, California, USA.|Department of Psychiatry, University of California San Diego, La Jolla, California, USA.|The Sam and Rose Stein Institute for Research on Aging, University of California San Diego, La Jolla, California, USA.
Lisa T
LT
Eyler
D000339:Affect; D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000453:epidemiology; D002140:California; D003866:Depressive Disorder / Q000150:complications* / Q000453:epidemiology / Q000628:therapy*; D015658:HIV Infections / Q000150:complications* / Q000453:epidemiology / Q000523:psychology / Q000628:therapy; D006787:Hospitals, Veterans; D006801:Humans; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000523:psychology; D015995:Prevalence; D057566:Self Report; D057545:Social Stigma; D014481:United States; D014493:United States Department of Veterans Affairs; D014728:Veterans / Q000523:psychology