Daniel E Jimenez1, Benjamin Lê Cook1, Giyeon Kim1, Charles F Reynolds1, Margarita Alegría1, Sarah Coe-Odess1, Stephen J Bartels1. 1. Dr. Jimenez is with the Department of Psychiatry, University of Miami Center on Aging, Miami, Florida (e-mail: dej18@med.miami.edu ). Dr. Cook is with the Department of Psychiatry, Harvard Medical School, Cambridge, Massachusetts. Dr. Kim is with the Department of Psychology, Center for Mental Health and Aging, University of Alabama, Tuscaloosa. Dr. Reynolds is with the Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh. Dr. Alegría is with the Center for Multicultural Mental Health Research, Cambridge Health Alliance, Somerville, Massachusetts. Ms. Coe-Odess is an undergraduate at Swarthmore College, Swarthmore, Pennsylvania. Dr. Bartels is with the Department of Psychiatry, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire.
Abstract
OBJECTIVES: The association of general medical illness and mental health service use among older adults from racial-ethnic minority groups is an important area of study given the disparities in mental health and general medical services and the low use of mental health services in this population. The purpose of this report is to describe the impact of comorbid general medical illness on mental health service use and expenditures among older adults and to evaluate disparities in mental health service use and expenditures in a racially-ethnically diverse sample of older adults with and without comorbid general medical illness. METHODS: Data were obtained from the Medical Expenditure Panel Survey (years 2004-2011). The sample included 1,563 whites, 519 African Americans, and 642 Latinos (N=2,724) age ≥65 with probable mental illness. Two-part generalized linear models were used to estimate and compare mental health service use among adults with and without a comorbid general medical illness. RESULTS: Mental health service use was more likely for older adults with comorbid general medical illness than for those without it. Once mental health services were accessed, no differences in mental health expenditures were found. Comorbid general medical illness increased the likelihood of mental health service use by older whites and Latinos. However, the presence of comorbidity did not affect racial-ethnic disparities in mental health service use. CONCLUSIONS: This study highlighted the important role of comorbid general medical illness as a potential contributor to using mental health services and suggests intervention strategies to enhance engagement in mental health services by older adults from racial-ethnic minority groups.
OBJECTIVES: The association of general medical illness and mental health service use among older adults from racial-ethnic minority groups is an important area of study given the disparities in mental health and general medical services and the low use of mental health services in this population. The purpose of this report is to describe the impact of comorbid general medical illness on mental health service use and expenditures among older adults and to evaluate disparities in mental health service use and expenditures in a racially-ethnically diverse sample of older adults with and without comorbid general medical illness. METHODS: Data were obtained from the Medical Expenditure Panel Survey (years 2004-2011). The sample included 1,563 whites, 519 African Americans, and 642 Latinos (N=2,724) age ≥65 with probable mental illness. Two-part generalized linear models were used to estimate and compare mental health service use among adults with and without a comorbid general medical illness. RESULTS: Mental health service use was more likely for older adults with comorbid general medical illness than for those without it. Once mental health services were accessed, no differences in mental health expenditures were found. Comorbid general medical illness increased the likelihood of mental health service use by older whites and Latinos. However, the presence of comorbidity did not affect racial-ethnic disparities in mental health service use. CONCLUSIONS: This study highlighted the important role of comorbid general medical illness as a potential contributor to using mental health services and suggests intervention strategies to enhance engagement in mental health services by older adults from racial-ethnic minority groups.
Authors: Majd AlGhatrif; Majd Al Ghatrif; Yong-Fang Kuo; Soham Al Snih; Mukaila A Raji; Laura A Ray; Kyriakos S Markides Journal: Ann Epidemiol Date: 2010-08-21 Impact factor: 3.797
Authors: Emily K Porensky; Mary Amanda Dew; Jordan F Karp; Elizabeth Skidmore; Bruce L Rollman; M Katherine Shear; Eric J Lenze Journal: Am J Geriatr Psychiatry Date: 2009-06 Impact factor: 4.105