Perceived Need, Mental Health Literacy, Neuroticism and Self- Stigma Predict Mental Health Service Use Among Older Adults

Abstract

ABSTRACT Objectives Older adults are the least likely age group to seek mental health services. However, few studies have explored a comprehensive range of sociodemographic, psychological, and social barriers and facilitators to seeking treatment in later life. Methods A cross-sectional, national sample of Canadian older adults (55+, N = 2,745) completed an online survey including reliable and valid measures of predisposing, enabling, and need characteristics, based on Andersen’s behavioral model of health, as well as self-reported use of mental health services. Univariate and hierarchical logistic regressions predicted past 5-year mental health service use. Results Mental health service use was most strongly and consistently associated with greater perceived need (OR = 11.48) and mental health literacy (OR = 2.16). Less self-stigma of seeking help (OR = .65) and greater neuroticism (OR = 1.57) also predicted help-seeking in our final model, although their effects were not as strong or consistent across gender, marital status, and age subgroups. Conclusions The need category was crucial to seeking help, but predisposing psychological factors were also significant barriers to treatment. Clinical Implications Interventions that target older adults high in neuroticism by improving perceptions of need for treatment, mental health literacy, and self-stigma of seeking help may be particularly effective ways of improving access to mental health services.