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Prim Care Companion CNS Disord. 2017 Feb 2;19(1). doi: 10.4088/PCC.16m02059.

Predictors and Barriers to Mental Health Treatment Utilization Among Older Veterans Living With HIV.

Author information

1
Department of Psychiatry, University of California, San Diego, 220 Dickinson Drive, St B (8231), San Diego, CA 92103-8231. r6moore@ucsd.edu.
2
VA San Diego Healthcare System, San Diego, California, USA.
3
Department of Psychiatry, University of California San Diego, La Jolla, California, USA.
4
The Sam and Rose Stein Institute for Research on Aging, University of California San Diego, La Jolla, California, USA.
5
California School of Professional Psychology, Alliant International University, San Diego, California, USA.

Abstract

Objective:

To identify key mood, social, and functional correlates of current participation in mental health treatment and barriers to participation in mental health treatment among older HIV infected (HIV+) veterans.

Methods:

HIV+ veterans (N = 150) aged ≥ 50 years receiving HIV-related medical care at the VA San Diego Healthcare System, San Diego, California, anonymously completed a survey assessing current self-reported mood, social support, daily functioning problems, mental health service utilization, and barriers to participating in mental health services. Veterans also completed the 2-item Patient Health Questionnaire (PHQ-2), a validated depression screening instrument frequently used in primary care settings. Data were collected from February 2014 to May 2014.

Results:

Overall, 44% of participants screened positive for depressive symptomatology on the PHQ-2; 55% of those who screened positive were participating in mental health treatment. Of the 45% of veterans who screened positive on the PHQ-2 and were not in treatment, two-thirds (66%) stated they had been offered services; however, they were not engaging in or accepting the services. Regardless of PHQ-2 status, current self-reported depressive symptoms emerged as an independent, significant positive predictor of participation in mental health treatment (odds ratio = 5.98; 95% CI, 1.16-30.72; P = .03), whereas anxiety, HIV-related stigma, sufficiency of social support, and daily functioning problems were not associated with mental health treatment utilization. Primary reported barriers to mental health treatment included scheduling/availability, travel time and transportation, and discomfort with group settings.

Conclusions:

Results of this study suggest there may be a need to better engage older HIV+ veterans in depression-related treatment. The use of telehealth technology, such as teletherapy, electronic devices, and cell phone-based programs, may be beneficial in helping older HIV+ veterans overcome many barriers that restrict their participation in mental health treatment.

PMID:
28157277
PMCID:
PMC6057469
DOI:
10.4088/PCC.16m02059
[Indexed for MEDLINE]
Free PMC Article

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