ABSTRACT

Despite increasing numbers of older-adult mental health service users, few studies have examined their use of public mental health services. Using the 2018 and 2019 Mental Health-Client Level data for clients age 18+ (N = 4,291,737 in 2018 and N = 4,513,946 in 2019), we examined whether those age 50+ who received outpatient-only, both outpatient and inpatient, or inpatient-only services had greater odds of certain types of mental disorders, especially schizophrenia, than younger adults. Of all users, 25.3% were age 50–64 and 6.7% were age 65 + . Multivariable logistic regression results, controlling for gender, race/ethnicity, census region, and alcohol/substance use disorder, showed that compared to the 30–49 age group, the 50–64 and 65+ age groups had higher odds of having depressive disorder in outpatient-only settings; however, they had consistently higher odds of a diagnosis of schizophrenia or other psychotic disorder in all three service settings. Along with advocating for increased funding for publicly-financed mental health services, social workers in public mental health service systems should ensure that they utilize effective intervention skills for older adults with serious mental illness.

摘要

尽管老年人心理健康服务使用者的数量不断增加，但很少有研究检查他们对公共心理健康服务的使用情况。使用 2018 年和 2019 年 18 岁以上客户的心理健康客户水平数据（2018 年 N = 4,291,737 人，2019 年 N = 4,513,946 人），我们检查了 50 岁以上仅接受门诊、门诊和住院还是住院治疗的患者与年轻人相比，只接受服务的人患某些类型精神障碍的几率更大，尤其是精神分裂症。在所有用户中，25.3% 的年龄在 50-64 岁之间，6.7% 的年龄在 65 岁以上。控制性别、种族/族裔、人口普查地区和酒精/物质使用障碍的多变量逻辑回归结果表明，与 30-49 岁年龄组相比，50-64 岁和 65 岁以上年龄组患抑郁症的几率更高在仅限门诊的环境中；然而，在所有三种服务环境中，他们被诊断为精神分裂症或其他精神病的几率始终较高。除了提倡为公共资助的精神卫生服务增加资金外，公共精神卫生服务系统中的社会工作者还应确保他们对患有严重精神疾病的老年人使用有效的干预技巧。