Help-seeking for mental health problems among older adults with chronic disease: an application of the theory of planned behaviour

ABSTRACT Objective Despite high risk for mental health problems, older adults with chronic diseases underutilise mental health services. This study applied the Theory of Planned Behaviour (TPB) to understand mental health help-seeking intentions among this population and identified factors which influence help-seeking intentions. Method We conducted a cross-sectional study with a non-clinical sample of 108 older adults aged 65 years or over, living with cardiovascular disease, respiratory disease, and/or type 2 diabetes. TPB variables (attitudes, subjective norms, and perceived behavioural control), intentions to seek help, and additional factors (past help-seeking behaviour, quality of life, and physical health) were assessed using standardised questionnaires. Multiple linear regressions were conducted to identify predictors of help-seeking intentions. Results 41% of the participants did not intend to seek help, and all three TPB variables were associated with help-seeking intentions. The traditional TPB model accounted for 69.7% of the variance in intentions, and the extended TPB model accounted for an additional 1.6% of the variance. Conclusions Attitudes and perceived behavioural control have the strongest association with help-seeking intentions among older adults with chronic disease. Further research is needed to identify predictors of mental health help-seeking behaviour and to develop interventions to promote help-seeking in this population. KEY POINTS What is already known about this topic: Older adults aged 65 years or over living with chronic disease are at an increased risk of mental health decline. Older adults underutilise mental health services, and consequently mental health problems often go undiagnosed and untreated in this population. A growing body of research has demonstrated the utility of the Theory of Planned Behaviour in predicting intentions to seek mental health support services. What this topic adds: Most older adults with chronic disease have some intention to seek professional mental health support when needed. Older adults with chronic disease have a high perceived ability to seek professional help. Promoting favourable attitudes towards mental health help-seeking is likely to facilitate the greatest change in help-seeking intentions in the present population.