Mental health of the elderly: use of health and mental health services.

The utilization of services by older patients with mental morbidity is examined in this paper. The population is drawn from a large, multi-site study, the Epidemiological Catchment Area studies, and reports on the findings from the Baltimore, Maryland, site, The Eastern Baltimore Mental Health Survey. The fact that older individuals with mental disorders are less likely to be seen and treated for these disorders than are younger individuals was substantiated by data from this study. Of those under age 65, 8.7 per cent have made a visit to a specialty or primary care provider for mental health care; for those age 65 to 74, the rate is 4.2 per cent, and of those 75 and over, only 1.4 per cent have had such care. In this last group, 75 and over, not a single person saw a specialty mental health provider. The likeliest source of care for older individuals for emotional or psychiatric problems is their primary care providers within the context of a visit made for physical medical problems. Past work and these data suggest that the factors that influence this low level of care can be found in the characteristics of the population as well as in the characteristics of the health care system. The implications of these findings are discussed.