Why may older people with depression not present to primary care? Messages from secondary analysis of qualitative data: Depression in older people
Open accessAbstract
Depression in older people is common, under-recognised and often undertreated. This study aimed to explore the reasons why older people with depression may not present to primary care. Secondary analysis was carried out, of qualitative data collected in two previous studies in North-West England. Older people are reluctant to recognise and name 'depression' as a set of symptoms that legitimises attending their general practitioner (GP). They do not consider themselves candidates for help for their distress. This is partly due to perceptions of the role of the GP but also to previous negative experiences of help seeking. In addition, treatments offered, which are predominantly biomedical, may not be acceptable to older people. Interventions offered to older people need to encourage social engagement, such as befriending, and enhancement of creative, physical and social activity.
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Deep rooted communication issues such as differential mental health models, perceived candidacy for treatment and recursivity in cultural expectations of treatment exist in both groups.
“A marked difference between groups included meeting the language needs of some minority patients, however deep rooted communication issues such as differential mental health models [21], perceived candidacy for treatment [22] and recursivity in cultural expectations of treatment [23] exist in both groups [8].”
From Development and evaluation of culturally sensitive psychosocial interventions for under-served people in primary care (2014) · cites this paper as [21]
The Conclusions (page unavailable) discuss older patients’ perceived candidacy for help, how prior encounters affect future help-seeking, and mismatches between anticipated care and what patients think would help. The Use of secondary analysis section (page unavailable) reports similar concerns about the legitimacy of seeking care and service receptivity across the older-person data and the larger hard-to-reach-groups study. It does not establish that all three specified communication issues, particularly differential mental-health models and cultural expectations of treatment, exist in both groups. (LLM, conf=0.82)
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- Authors
- Chew-Graham, C., Kovandžić, M., Gask, L., Burroughs, H., Clarke, P., Sanderson, H., & Dowrick, C.
- Affiliations
- University of Manchester (GB)
- University of Liverpool (GB)
- Manchester Mental Health and Social Care Trust (GB)
- Venue
- Health & Social Care in the Community
- Publisher
- Wiley
- Published
- 2011-07-12
- Volume
- 20
- Issue
- 1
- Pages
- 52-60
- ISSN
- 0966-0410 (ISSN-L)
- OpenAlex
- W1946983294
- Cited by
- 88
- References
- 28
- Citations by year
- 2026: 5 · 2025: 6 · 2024: 1 · 2023: 5 · 2022: 2 · 2021: 3 · 2020: 8 · 2019: 13 · 2018: 11 · 2017: 5 · 2016: 9 · 2015: 7 · 2014: 7 · 2013: 2 · 2012: 4
- FWCI
- 5.66
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Health & Social Care in the Community (publishedVersion)
- PubMed (publishedVersion)
- Research Explorer (The University of Manchester) (submittedVersion)
- Funders
- National Institute for Health and Care Research (RP-PG-0606-1071)
- Age UK
- Topics
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Aging, Health, and Disability
- Social Sciences › Psychology › Clinical Psychology › Health and Well-being Studies
- Keywords
- geriatric depression, help-seeking, primary care, general practitioners, treatment acceptability, biomedical treatment, social engagement, befriending
- MeSH terms
- Aged, Aged, 80 and over, Depression, England, Female, Humans, Male, Middle Aged, Patient Acceptance of Health Care, Primary Health Care, Social Support, Qualitative Research
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