90. WHERE HAVE WE LOST THEM? THE UNHEARD NARRATIVES OF GERIATRIC MENTAL HEALTH

Abstract

Introduction

The general course of mental illness is one of worsening with age, with geriatric patients often experiencing more severe illness, with higher comorbidity. Despite a general increase in mental health care (MHC) utilization among US adults, older adults were less likely to access mental health services compared to younger groups, with over half of those with diagnosable conditions not seeking professional help. Moreover, the continued MHC needs of aging individuals remain poorly defined. Identifying barriers to accessing MHC, while considering resource constraints is crucial for delivering high-quality geriatric MHC.

Methods

A retrospective review was conducted of the electronic health records of new adult patients receiving MH services at a large community-based hospital between February 1, 2022, and July 31, 2022. The primary outcome was the number of MH follow-up visits (psychotherapy visits, psychotropic medication management visits, or both) in the subsequent three months following their initial encounter. Poisson regression was used to model the relationship between the outcome and variables.

Results

Across the sample (N = 403), 49 (12.16%) cases were aged 65 years or older (geriatric). Being in the geriatric patient group was negatively associated with the number of FU visits over the subsequent three months (IRR = 0.672, 95% CI [0.486, 0.930], p = 0.017). Also, geriatric patients were more likely to receive both psychotherapy and pharmacotherapy concurrently (p = 0.04, z = 1.6) than adults ages 18 to 64 years, and were noted to experience a more severe median comorbidity burden (p < .001).

Conclusions

Regardless of having a higher burden of comorbid MH illnesses typically requiring more frequent MH services, geriatric patients in this study had fewer FU appointments. Further investigation is needed to identify the roadblocks that impede MHC utilization among the aging population, with the ultimate goal of informing policy development to increase access to MH services by this population.