Barriers and Facilitators to Mental Health Help-seeking among Older Adults: A Systematic Review

Abstract

Background: Older adults are very unlikely to seek mental health help. There are multiple factors that contribute to a person's final decision to seek formal help. The aim of this study is to systematically review and summarize quantitative literature on the barriers and facilitators that influence older adult's mental health help-seeking behaviors. Methods : Four databases including PubMed-Medline, EMBASE, ProQuest central, and Scopus were searched to identify barriers and/or facilitators to mental health help-seeking behaviors. Studies were included if they satisfied the following criteria: Articles that were quantitative studies published during the period between 2015-2021, that address barriers and/or facilitators to mental health help seeking among older adults aged 65 years old or older and examining depression, anxiety, and psychological distress disorders. Help-seeking was defined as receiving a consultation from health professionals such as a general practitioner, clinical psychologist, councilor, or social worker. Study quality and risk of bias was assessed using The Newcastle-Ottawa Scale (NOS). Results: Five cross-sectional studies met the inclusion criteria for this review. These studies were from Australia, United States, and Malaysia, and were carried out during the period 2015-2021. Two studies examined both facilitators and barriers while three studies examined barriers only. Neither of the studies examined facilitators only. The prevalence of seeking mental health help among elderly people ranged between 77% to 82%. Cost, stigma, and beliefs of the effectiveness of mental health counseling, were the most reported key barriers. Main reported facilitators included prior positive experience with mental health services, high level of education, and a high-income level. Conclusion: The findings reported in this systematic review can be used in future research and practical implications to assess the barriers and facilitators among older adults.