Determinants of receiving mental health care for depression in older adults

BACKGROUND: Major Depressive Disorder (MDD) is common among elderly people. However, it appears that only a minority receives treatment. This study aims to identify and analyse the factors that determine whether elderly people with depressive disorders have contact with health care professionals for mental problems. METHOD: Cross-sectional analysis of cohort data collected in the Netherlands Study of Depression in Older persons (NESDO) and the Netherlands Study of Depression and Anxiety (NESDA) among 167 respondents aged >/=55 with a depressive disorder as indicated by the CIDI. Contacts for mental health problems during the past six months (TiC-P), and indicators of predisposing, enabling, and objective need factors were assessed by interview. RESULTS: Of the total sample, 70{\%} had contact for mental health problems, almost entirely within primary care (62{\%}). The odds of having contact increased with advancing age; for respondents born in the Netherlands; for those who felt less lonely; and for those with a higher household income. LIMITATIONS: Our study is based on base-line interviews and thus has a cross-sectional character. Therefore, causal conclusions cannot be drawn. Furthermore, we studied the respondents' perception whether mental health care was received. CONCLUSIONS: The contact rate for mental health problems is high. Health care professionals should be aware that having contact is not associated with a higher objective need, but rather with increasing age, being Dutch-born, being less lonely and having a higher household income