The 130th Annual Meeting of APHA

Abstract #43209

Cynthia M Zubritsky, PhD, Center for Mental Health Policy and Services Research, University of Pennsylvania, 3535 Market St., Philadelphia, PA 19104, 215-662-2886, cdz@mail.med.upenn.edu and David Oslin, MD, Section on Geriatric Psychiatry, University of Pennsylvania, 3535 Market St., Philadelphia, PA 19104.

Older adults do not typically use formal mental health or substance abuse services. Stigma, underdetection, lack of understsanding and cohort differences all play a role in this non-help seeking behavior. This presentation examines the current utilization of formal MH/SA services by adults aged 65 and older receiving primary care services. Participants were part of the national PRISMe study that is designed to increase access to care for older persons with MH/SA problems. Elderly primary care patients were systematically screened for symptoms of depression, anxiety, or at-risk alcohol use and asked about current involvement in formal mental health or substance abuse treatment; preliminary results are available. Of the total sample, 10% screened positive for at-risk drinking and 17% for generalized distress. Among those who screened positive, current use of formal services was remakably low. Only 14% of those with distress were currently seeking help and only 1% of those with at-risk drinking. There were no racial or age differences distinguishing help seekers from those who had not sought treatment. Both greater severity of distress and greater quantity of drinking predicted help seeking in those who screened positive. Older adults that are currently engaged in treatment are those with the greatest distress or drinking, suggesting a clear bias for treating only the most severely impaired patients. These findings raise significant issues related to the acceptability of formal MH/SA treatment by both patients and providers. Improving access to care and understanding patient and provider attitudes about treatment will be discussed.

Learning Objectives: At the end of this session attendees will be able to

1.Discuss mental health and substance abuse service utilization rates for older adults in primary care services. 2.Discuss stigma, underdection and cohort differences in older adults' use of formal mental health and substance abuse services.
• Discuss patient's and primary care provider's attitudes about formal mental health and substance abuse services.

Keywords: Mental Health, Elderly

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.