Barriers to Mental Health Care for an Ethnically and Racially Diverse Sample of Older Adults

Abstract

OBJECTIVES This study examined potential barriers to mental healthcare use of older adults from diverse ethnic and racial backgrounds. DESIGN Data were obtained from the 2007, 2009, 2011–12, and 2013–14 California Health Interview Survey (CHIS), a population-based survey representative of California’s noninstitutionalized population. PARTICIPANTS The total sample consisted of 75,324 non-Hispanic white (NHW), 6,600 black, 7,695 Asian and Pacific Islander (API), and 4,319 Hispanic adults aged 55 and older. RESULTS Results from logistic regression analyses that controlled for multiple demographic and health status characteristics revealed ethnic and racial differences in reasons for not seeking treatment and for terminating treatment. Specifically, API and Hispanic adults had greater odds than NHWs of endorsing feeling uncomfortable talking to a professional as a reason for not seeking treatment. Hispanic respondents had lower odds of endorsing concerns about someone finding out than APIs, and APIs and blacks had significantly greater odds of endorsing this concern as a reason for not seeking treatment than NHWs. When asked about reasons for no longer receiving treatment, all respondents, irrespective of race or ethnicity, endorsed that they no longer needed treatment as the most frequent reason for terminating treatment, although specific ethnic and racial differences emerged with respect to perceptions of not getting better, lack of time or transportation, and lack of insurance coverage as reasons for no longer seeking treatment. CONCLUSION Understanding how barriers to mental health treatment differ for older adults from diverse ethnic and racial backgrounds is an important step toward designing interventions to overcome these obstacles and improve mental health outcomes.

Mental health care treatment seeking among African Americans and Caribbean Blacks: what is the role of religiosity/spirituality?

“…In one study, 65.9% of the older participants with major depressive disorder and 72.5% with anxiety were not receiving mental health care (Garrido, Kane, Kaas, Kane, 2011). The literature on older adults with mental health diagnoses have shown many reasons explaining underutilization of mental health services stemming from a lack of knowledge of the availability of sources, lack of transportation or financial means to afford the services, older adults feeling as though they can take care of the problem on their own, or that the problem will go away with time (Sorkin, Murphy, Nguyen, & Biegler, 2016). The research also indicates that older adults report being worried about the stigma associated with seeking mental health care (Garrido et al, 2011;Jiminez, Bartels, Cardenas, and Alegria, 2013).…”

Effectiveness of a Peer-Based Intervention on Loneliness and Social Isolation of Older Chinese Immigrants in Canada: a Randomized Controlled Trial

“…The use of peer-based interventions could be perceived as less stigmatizing and socially 'natural', thus attracting older people as well as their social support networks to participate in and bene t from interventions. This is particularly important for culturally diverse older adults who might feel uncomfortable using formal professional services [56,57]. Mental illness has long been subject to public stigmatization and discrimination in Chinese culture, which makes some people reluctant to seek professional help [58].…”

Older Adults’ Perceptions of Psychotherapy in Cyprus

“…In particular, attitudes towards mental health services by older adults have been suspected as major barriers to seeking treatment. Reasons why older adults have been thought to reject mental health care include lack of education regarding mental health and generational negative attitudes or stigma surrounding mental illness [15]. It has been proposed that older adults tend to associate mental disorders with personal failure or spiritual deficiency [16].…”