Substance Abuse and Mental Health Services Administration, U.S. Department of Health and Human Services, 1 Choke Cherry Rd., Rockville, MD 20854, USA.
Psychiatr Serv. 2011 Mar;62(3):291-8. doi: 10.1176/ps.62.3.pss6203_0291.
This study examined the prevalence and predictors of past-year serious psychological distress and receipt of mental health services among community-dwelling older adults in the United States.
The sample included 9,957 adults aged 65 or older from the 2004-2007 National Survey on Drug Use and Health. Serious psychological distress was defined as having a score of 13 or higher on the K6 scale of nonspecific psychological distress. Descriptive analyses and logistic regression modeling were applied.
Among community-dwelling older adults, 4.7% had serious psychological distress in the past year. Among those with past-year serious psychological distress, 37.7% received mental health services in the past year (4.8% received inpatient services, 15.8% received outpatient services, and 32.1% received prescription medications) (weighted percentages). Logistic regression results suggested that among older adults with serious psychological distress, receipt of mental health services was more likely among women, non-Hispanic whites, those who were married, those who were highly educated, Medicare-Medicaid dual beneficiaries, those with a major depressive episode, and those with more general medical conditions.
These results suggest the need to screen for mental health problems among older adults and to improve the use and the quality of their mental health services. Since 2008 significant changes have revolutionized payment for mental health care and may promote access to mental health care in this population. Further studies are needed to assess trends in mental health service utilization among older adults and in the quality of their mental health care over time.
本研究在美国社区居住的老年人群体中，调查了过去一年中严重心理困扰的发生率和预测因素，以及他们获得心理健康服务的情况。
该样本包括来自 2004-2007 年全国药物使用与健康调查的 9957 名 65 岁或以上的成年人。严重心理困扰的定义是 K6 非特异性心理困扰量表得分为 13 或更高。采用描述性分析和逻辑回归模型进行分析。
在社区居住的老年人群体中，过去一年有 4.7%的人存在严重心理困扰。在过去一年有严重心理困扰的人群中，37.7%的人在过去一年中接受了心理健康服务（4.8%接受住院服务，15.8%接受门诊服务，32.1%接受处方药物）（加权百分比）。逻辑回归结果表明，在有严重心理困扰的老年人群体中，女性、非西班牙裔白人、已婚、受过高等教育、同时参加医疗保险和医疗补助的双重受益人群、有重度抑郁发作的人以及有更多一般医疗条件的人更有可能接受心理健康服务。
这些结果表明，需要对老年人群体进行心理健康问题的筛查，并改善他们对心理健康服务的使用和服务质量。自 2008 年以来，心理健康护理的支付方式发生了重大变化，这可能会促进该人群获得心理健康护理。需要进一步研究，以评估老年人群体中心理健康服务利用的趋势，以及随着时间的推移，他们的心理健康护理质量的变化。
