Abstract:
The underutilization of mental health services (MHS) by older adults – and especially by racial/ethnic minority elders – is a well-recognized problem. Though several national-level mental health policies have been enacted and implemented over the past decade, rates of underutilization remain high. Guided by the Socio-Ecological Theory of public health policy, we aimed to examine individual- and community-level factors that have fostered the most successful implementations of national mental health policies in recent years. This dissertation conducted a multilevel growth curve analysis in order to examine older adults’ MHS use using a large, nationally-representative panel survey (the Medical Expenditure Panel Survey – Household Component, or MEPS-HC). We considered MHS use in the MEPS-HC for the period of 2002-2012, during which members of MEPS Panels 6-17 provided responses. This analysis revealed that rates of older adults’ MHS use did not increase significantly over our examination period, regardless of race/ethnicity or rurality of location. Only insurance status was a significant predictor of change in MHS use rates over the years 2002-2012. Our findings highlighted several important issues for policy implementation and future research of MHS use and mental health policy, and we make suggestions for ensuring greater efficiency and efficacy of efforts to improve older adults’ MHS use in the coming decade.
