Barriers to Mental Health Care Utilization in Parkinson’s Disease

Abstract

Background Parkinson’s disease (PD) is frequently complicated by co-occurring psychiatric problems, such as depression and anxiety, that negatively affect the course and management of the illness. Yet, in the majority of cases, these psychiatric comorbidities are neither recognized nor treated to remission. The primary purpose of this study was to identify and describe barriers to mental health care utilization for people with PD. Secondary objectives included the assessment of attitudes and preferences regarding the need for mental health services in the PD community and the acceptability of tele-health interventions as a method for improving access and quality of care. Methods Seven hundred sixty-nine people with PD completed an anonymous cross-sectional questionnaire assessing barriers to mental health care utilization in this medical population. Respondents were drawn from a national sample. Results Commonly endorsed barriers to mental health care utilization in PD reflect the patients’ incomplete understanding of mental health problems, access issues, and illness-specific concerns, as well as the inadequate screening and detection of psychiatric complications by medical providers, and the need for more effective treatments in this medical population. Several demographic, medical, and psychiatric variables also influenced the likelihood of accessing mental health care. Interest in tele-health approaches to mental health treatment was high and, in several instances, correlated with perceived barriers to mental health care utilization. Conclusions People with PD may encounter a multitude of barriers that impede their pursuit of mental health care. Clinical implications are discussed and further research is needed to replicate and extend these findings.

Internet-based cognitive behavioral therapy for depression and anxiety in Parkinson's disease — A pilot study

“…In a survey, 31% of PD patients reported transportation as a barrier to mental health care utilization and 52% said that mental health services were not available locally (Dobkin et al, 2013). The same survey reported that a majority had access to phone, cell phone and internet, and felt comfortable using both phone and computer.…”

Depression and Parkinson’s Disease: Current Knowledge

“…Although it is not always possible to eliminate every symptom of depression, a recovery-oriented approach emphasizes individual strengths and resilience, improved function, the pursuit of meaningful goals for that individual, and a sense of hope and optimism. Despite that, patients with PD depression face barriers to mental health care use, including low health literacy, ability to access care, availability of clinicians who are knowledgeable about PD, and a desire for psychotherapy versus medications [10]. Multidisciplinary PD specialist team care is one model that helps overcome some of these barriers and improve outcomes [80•].…”

“…Untreated the impact of depression extends far beyond mood symptoms: earlier initiation of dopaminergic therapy, greater functional disability, faster physical and cognitive deterioration, increased mortality, poorer quality of life, and increased caregiver distress [3–6]. Unfortunately, in clinical settings, depressive disturbances are underrecognized and, even when identified, frequently undertreated [6–10]. To close that gap, this review focuses on current knowledge of the epidemiology, pathophysiology, clinical features, and treatment of depressive disturbances in PD.…”

Getting to More Effective Weight Management in Antipsychotic-Treated Youth: A Survey of Barriers and Preferences

“…Questions were generated based on a review of existing research regarding adult or parent/caregiver preferences and barriers to participation in weight loss programs 15,16,28 and in mental health treatment, 29 the research team's previous experience working with obesity and metabolic disorders in mentally ill populations, and consultation with experts in community behavioral obesity treatment and in dissemination-implementation research methodology.…”