Low use of mental health services among older Americans with mood and anxiety disorders
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OBJECTIVE: It is unclear why late-life mood and anxiety disorders are highly undertreated, despite being common among older adults. Thus this study examined prevalence of and key factors associated with nonuse of mental health services among older community-dwelling adults with these disorders. METHODS: The sample included 348 participants aged 55 years or older who met 12-month criteria for DSM-IV mood and anxiety disorders and responded to the National Comorbidity Survey Replication (NCS-R), a population-based probability sample. Analyses included frequency measures and logistic regression with weights and complex design-corrected statistical tests. Key factors associated with not using mental health services were determined in a final multivariable model based on a systematic approach that accounted for a comprehensive list of potential predictors. RESULTS: Approximately 70% of older adults with mood and anxiety disorders did not use services. Those who were from racial-ethnic minority groups, were not comfortable with discussing personal problems, were married or cohabitating, and had middle- versus high-income status had increased odds of not using mental health services. In addition, respondents with mild versus serious disorders, no chronic pain complaints, and low versus high perceived cognitive impairment had greater odds of nonuse. CONCLUSIONS: Results indicate that improvements are needed in the following areas to combat the very high number of mood and anxiety disorders that go untreated in older Americans: awareness of need, comfort in discussing personal problems with a health care professional, and screening and other prevention efforts.
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Approximately 70% of older adults with prevalent anxiety and mood disorders do not use any services.
“with approximately 70% with prevalent anxiety and mood disorders not using any services (23).”
From Telephone-based group mental health support for older adults in central Canada: pilot acceptability and effectiveness findings of The CONNECT Program (2025) · cites this paper as [23]
The Results section reports that 71.3% of respondents did not use mental health services, supporting the approximate 70% figure for older adults with prevalent mood and anxiety disorders. It does not establish that they used no services of any kind. (LLM, conf=0.88)
Experimental — accuracy not yet measuredOnly a small proportion of older individuals have been found to seek or receive appropriate treatment for mental health conditions.
“only a small proportion of older individuals have been found to seek or receive appropriate treatment (Byers et al., 2012).”
From Feasibility, acceptability, and preliminary efficacy of an internet-based CBT intervention for loneliness in older adults: A pilot RCT (2024) · cites this paper as Byers et al., 2012
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- Authors
- Byers, A. L., Arean, P. A., & Yaffe, K.
- Affiliations
- San Francisco VA Medical Center (US)
- The authors are affiliated with the Department of Psychiatry, University of California, San Francisco (UCSF), 4150 Clement St. (116H), San Francisco, CA 94121 (e-mail: ).
- Venue
- Psychiatric Services
- Published
- 2012-01
- Volume
- 63
- Issue
- 1
- Pages
- 66-72
- ISSN
- 0022-1597 (ISSN-L)
- 1075-2730
- 1557-9700
- PMC
- PMC3726310
- OpenAlex
- W2166725413
- Cited by
- 192
- References
- 49
- Citations by year
- 2026: 10 · 2025: 11 · 2024: 14 · 2023: 17 · 2022: 20 · 2021: 24 · 2020: 19 · 2019: 13 · 2018: 15 · 2017: 11 · 2016: 1 · 2015: 18 · 2014: 3 · 2013: 12 · 2012: 4
- FWCI
- 17.85
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Psychiatric Services (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- Robert Wood Johnson Foundation
- Pfizer
- National Institutes of Health
- Substance Abuse and Mental Health Services Administration
- National Institute on Aging (AG031155, K24AG031155)
- National Institute of Mental Health (MH079093, MH074717, U01-MH-60220, K01MH079093, U01MH060220, K24MH074717)
- National Institute on Drug Abuse
- Topics
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Aging, Health, and Disability
- Keywords
- mental health service utilization, mood disorders, anxiety disorders, older adults, geriatric mental health, undertreatment, help-seeking, racial and ethnic minorities, marital status, income, perceived cognitive impairment, chronic pain, mental health screening
- MeSH terms
- Age Factors, Aged, Anxiety Disorders, Epidemiologic Methods, Female, Medicare, Health Services Needs and Demand, Humans, Male, Mental Health Services, Middle Aged, Patient Acceptance of Health Care, Socioeconomic Factors, United States, Insurance Coverage, Mood Disorders, Diagnostic and Statistical Manual of Mental Disorders
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