Mental health distress in homebound older adults: Importance of the aging network

Abstract

Homebound older adults may be at risk of suicide due to elevated loneliness, social isolation, and depression. The Interpersonal Theory of Suicide posits that thwarted belongingness, perceived burdensomeness, and reduced fear of death are key components of suicide risk. To better understand suicide risk among culturally diverse, homebound older adults, we collected baseline data on the prevalence of psychological distress, thwarted belongingness, perceived burdensomeness, and past/present suicidality. Standardized measures were completed by 493 adults (ages 60-103) during in-home interviews, and results were compared to existing cutoffs to assess current risk. In total, 15.62% scored above the suicide risk cutoff, 23.73% of homebound older adults reported a history of suicidal ideation or behavior, 65 adults in this sample (13.18%) indicated the possibility of attempting suicide in the future, and 2.43% described a future attempt as “likely” or “very likely.” There were no differences in suicide risk, thwarted belongingness, or perceived burdensomeness based on sex and race. However, there was a significant difference in psychological distress (F(3,428) = 2.624, p = .05), with White females (M = 7.90, SD = 5.63; N = 78) scoring higher than Black males (M = 5.43, SD = 5.04; N = 81). Using Aging Network services such as nutrition services (e.g.home-delivered meal programs) to intervene with at-risk older adults represents a strategy to prevent suicide. Implications for suicide intervention, including the potential to deliver services by linking them to nutrition services programs, are discussed.