Help-Seeking for Mental Health Problems among Older Adults with Chronic Diseases: An Evaluation and Intervention

You are here:

Help-Seeking for Mental Health Problems among Older Adults with Chronic Diseases: An Evaluation and Intervention

Older adults have high rates of chronic diseases, leaving them more vulnerable to associated mental health declines. Nevertheless, the intentions of older adults with chronic diseases to seek help from mental health support systems are low. Couched in the Theory of Planned Behaviour (TPB), this thesis aimed to 1) identify antecedents to help-seeking for mental health problems in older adults with chronic diseases, and 2) to design, develop and test a behaviour change intervention, promoting mental health help-seeking among older adults with chronic diseases in Australia.

A scoping review was conducted, which mapped 49 articles that applied the TPB to mental health help-seeking in adults aged >18 years. A survey instrument, to measure mental health help-seeking intentions among older adults (MHHS-OA), was developed and piloted with a sample of 54 adults aged 65 to 94 years living in metropolitan Perth, Western Australia. The MHHS-OA was then utilised in a cross-sectional study with 108 adults aged 65 to 93 years, living in metropolitan Perth, diagnosed with cardiovascular diseases, respiratory diseases, and/or type 2 diabetes.

Using multiple linear regressions, the TPB was found to be a suitable model for understanding mental health help-seeking intentions in older adults with chronic diseases, accounting for 69.7% of the variance in intentions. Attitudes and perceived behavioural control had the strongest association with help-seeking intentions, followed by subjective norms. Two common barriers to help-seeking were identified: ‘wondering whether the mental health problem is significant enough to warrant treatment’ (endorsed by 51.9% of participants), and ‘not having a regular primary health care provider to speak with’ (endorsed by 39.6% of participants).

An intervention aimed at promoting mental health help-seeking was developed and tested in a pilot randomised controlled trial. Nine stakeholders were interviewed to inform the design and development of the intervention and 241 adults aged 66 to 90 years were randomised to receive the intervention or control materials. The intervention consisted of a TPB-based brochure, aimed at promoting mental health help-seeking. Results indicated the intervention is an acceptable and feasible method for improving mental health help-seeking in older adults with and without chronic diseases.

Funding agency

School of Arts and Humanities: PhD Research Support

Project duration

2015 – 2021

Publications

Adams, C., Gringart, E., Strobel, N., Masterman, P. (2021). Help-seeking for mental health problems among older adults with chronic disease: an application of the theory of planned behaviour. Australian Journal of Psychology, 73:4, 426-437. DOI: 10.1080/00049530.2021.1952850
Adams, C., Gringart, E., & Strobel, N. A. (2022). Explaining adults’ mental health help-seeking through the lens of the theory of planned behaviour: A scoping review. Systematic Reviews. https://doi.org/10.1186/s13643-022-02034-y
Adams, C., Gringart, E., & Strobel, N. A. (2023). Barriers to mental health help-seeking among older adults with chronic diseases. Australian Psychologist. https://doi.org/10.1080/00050067.2023.2282540
Adams, C., Gringart, E., & Strobel, N. A. (2023). Theory-Based Behaviour Change Intervention to Promote Mental Health Help-Seeking among Older Adults in Australia: Initial Dissemination and Acceptability. Australasian Journal on Ageing. http://doi.org/10.1111/ajag.13185
Adams, C., Gringart, E., & Strobel, N. A. Barriers to seeking professional mental health support among older adults with chronic diseases, 28 September 2022, PREPRINT (Version 1) available at Research Square https://doi.org/10.21203/rs.3.rs-2109770/v1

Presentations

Adams, C., Gringart, E., & Strobel, N. (2021, July 19-23). Intentions to seek mental health support among older adults with chronic disease [Oral presentation]. International Congress of Psychology 2020+, Prague, Czech Republic (virtual conference).
Adams, C., Gringart, E., & Strobel, N. (2021, November). Development and Preliminary Testing of a Theory-Based Intervention to Promote Mental Health Help-Seeking in Primary Healthcare among Older Adults with Chronic Illnesses. Australian Psychological Society (APS) College of Health Psychologists Conference, virtual conference.
Adams, C., Gringart, E., & Strobel, N. (2022, May). Promoting help-seeking for mental health problems among older adults: co-design and feasibility testing of a theory-based, behaviour-change intervention. 5th Annual Integrative Psychiatry Conference, Montreal, Canada (virtual).
Adams, C., Gringart, E., Strobel, N. (2022). Promoting help-seeking for mental health problems among older adults: Co-design and feasibility testing of a theory-based, behaviour-change intervention. 5th Annual Integrative Psychiatry Conference, McGill Journal of Medicine, 20(2), 2022. https://doi.org/10.26443/mjm.v20i2.1000

Migration, Diversity and Care