Behavioral Health Service Utilization and Preferences of Older Adults Receiving Home-Based Aging Services

doi:10.1097/JGP.0b013e3181c29495

The American Journal of Geriatric Psychiatry

Volume 18, Issue 6, June 2010, Pages 491-501

https://doi.org/10.1097/JGP.0b013e3181c29495 Get rights and content

Objective:

To examine use of behavioral health services, treatment preferences, and facilitators and barriers to service use in older adults receiving home-based services within the aging network.

Design:

Cross-sectional survey.

Setting:

Interviews were conducted in participants’ homes.

Participants:

One hundred forty-two clients receiving home-based aging services.

Measurements:

Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition; Brief Symptom Inventory-18; Discrimination-Devaluation Scale; utilization of behavioral health services; and preferences, facilitators, and barriers for behavioral health services.

Results:

Use of psychotropic medication was high (54.2%), primarily received in primary care settings (58.8%), with a few visits a year (54.0%). Participants were more likely to be taking psychotropic medication if they were younger and white. Approximately one-third of participants on antidepressant or antianxiety medication still met criteria for an Axis I disorder. Twenty-one participants (14.8%) reported receiving counseling within the past year, with a few visits or less a year for most (57.1%). Almost all were willing to see at least one professional (97.2%) and try prescribed medications or counseling (90.1%). The most common barriers to service use were practical: affordability (71.8%), difficulty traveling (62.7%), and lack of transportation (45.8%).

Conclusions:

Aging network clients receiving home-based services have ready access to psychotropic medications but receive very few specialty behavioral health services and medication monitoring visits. They are willing to use a variety of behavioral health services and perceive mainly practical barriers to using services. The aging network has significant potential to enhance access to service utilization; strategies for integrating behavioral health services in the aging network are discussed.

Section snippets

Overview

Details of the study methods are reported elsewhere.⁴ The design was cross-sectional, and data were derived from interviews with clients conducted by trained research interviewers and standardized assessments conducted by clients’ case managers. All study procedures were approved by the University of South Florida Institutional Review Board, and all participants provided written informed consent.

Participants

Participants (N = 142) were recruited from aging network agencies in four counties in Florida.

Current Use of Behavioral Health Services

Table 1 displays details regarding the use of psychotropic medications and counseling. More than half of the sample was using at least one prescribed psychotropic medication (N = 77; 54.2%). Of the 77 participants who had psychotropic medications recorded by the interviewer, only 51 reported taking a psychotropic medication. Therefore, prescribing professional, location, and frequency of visits are missing for 26 individuals. Among those 51 reporting taking psychotropic medications, most

DISCUSSION

Broadly, the study findings indicate that aging network clients receiving home-based services have ready access to psychotropic medications but receive very few specialty behavioral health services and medication monitoring visits. They are willing to use a variety of behavioral health services and perceive mainly practical barriers to using services. The use of prescribed medications was quite high (54.2%); >70% of participants diagnosed with an Axis I depressive or anxiety disorder in the

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The authors thank the older adults who participated in this study and the aging service agencies that collaborated with us to complete this study: Community Aging and Retirement Services, Inc., Gulf Coast Jewish Family Services, Hillsborough County Aging Services, and Polk County Elderly Services.

This work was supported by a grant from University of South Florida New Researcher (to AMG).

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Regular Research ArticlesBehavioral Health Service Utilization and Preferences of Older Adults Receiving Home-Based Aging Services

Objective:

Design:

Setting:

Participants:

Measurements:

Results:

Conclusions:

Section snippets

Overview

Participants

Current Use of Behavioral Health Services

DISCUSSION

Am J Prev Med

Am J Geriatr Psychiatry

Am J Geriatr Psychiatry

Am J Geriatr Psychiatry

Am J Geriatr Psychiatry

Am J Geriatr Psychiatry

J Psychiatr Res

Gen Hosp Psychiatry

Am J Geriatr Psychiatry

Biol Psychiatry

Am J Geriatr Psychiatry

Gen Hosp Psychiatry

Modernizing Older Americans Act Programs

Depression in public community long-term care: implications for intervention development

J Behav Health Serv Res

Behavioral health needs and problem recognition by older adults receiving home-based aging services

Int J Geriatr Psychiatry

Depression in late life: review and commentary

J Gerontol A Biol Sci Med Sci

Major depression in elderly home health care patients

Am J Psychiatry

Twelve-month use of mental health services in the United States: results from the National Comorbidity Survey Replication

Arch Gen Psychiatry

Revisiting the behavioral model and access to medical care: does it matter?

J Health Soc Behav

Diagnosis and treatment of depression in the elderly medicare population: predictors, disparities, and trends

J Am Geriatr Soc

Regular Research Articles
Behavioral Health Service Utilization and Preferences of Older Adults Receiving Home-Based Aging Services