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Mental distress and service utilization among help-seeking, community-dwelling older adults

  • Adam Simning (a1), Thomas M. Richardson (a1) (a2), Bruce Friedman (a1) (a2), Lisa L. Boyle (a2), Carol Podgorski (a2) and Yeates Conwell (a2)...


Background: This study aimed to characterize healthcare and human services utilization among mentally distressed and non-distressed clients receiving in-home care management assessment by aging services provider network (ASPN) agencies in the U.S.A.

Methods: A two-hour research interview was administered to 378 English-speaking ASPN clients aged 60+ years in Monroe County, NY. A modified Cornell Services Index measured service utilization for the 90 days prior to the ASPN assessment. Clients with clinically significant anxiety or depressive symptoms were considered distressed.

Results: ASPN clients utilized a mean of 2.93 healthcare and 1.54 human services. The 42% of subjects who were distressed accessed more healthcare services (e.g. mental health, intensive medical services) and had more outpatient visits and days hospitalized than the non-distressed group. Contrary to expectations, distressed clients did not receive more human services. Among those who were distressed, over half had discussed their mental health with a medical professional in the past year, and half were currently taking a medication for their emotional state. A far smaller proportion had seen a mental health professional.

Conclusions: In the U.S.A., aging services providers serve a population with high medical illness burden and medical service utilization. Many clients also suffer from anxiety and depression, which they often have discussed with a medical professional and for which they are receiving medications. Few, however, have seen a mental health specialist preceding intake by the ASPN agency. Optimal care for this vulnerable, service intensive group would integrate primary medical and mental healthcare with delivery of community-based social services for older adults.


Corresponding author

Correspondence should be addressed to: Yeates Conwell, MD, University of Rochester School of Medicine and Dentistry, 300 Crittenden Blvd., Rochester, NY 14642, U.S.A. Phone: +1 (585) 275-6739; Fax: +1 (585) 273-1066. Email:


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