Need and Unmet Need for Mental Health Care among Elderly in New York City

Background: One in four old adults has a clinically significant mental disorder, but they are less likely to receive adequate and appropriate care, resulting in adverse outcomes such as functional disabilities, diminished productivity and increased medical expenses.

Objectives: To examine the patterns and correlates of professional mental health service use among old adults in New York City (NYC).

Methods:  This study use data from the Health Indicators Project by NYC Brookdale Center for Healthy Aging & Longevity, which includes 1,870 old adults attending 56 randomly selected senior centers across the five boroughs. The met and unmet need was respectively defined as being in need of care (moderate to severe depression as measured by the PHQ-9) and having or not having used professional mental health services during the previous 12 months. Correlates of mental health service utilization include predisposing factors, enabling factors, and need factors.

Results: 28% of old adults were moderately or severely depressed; however, over 80% of them did not receive professional service in the previous 12 months. Seniors who are female, had physical disability and/or experienced discrimination were more likely to be depressed. Mental health service use was inversely associated with being older age and married, but positively with physical disability.

Conclusion:  Mental health needs of the old adults attending senior centers in NYC are not adequately addressed. Helping professionals in gerontology need to assess mental health status and service needs among older adults, especially those who appear physically better, but may be mentally impaired.