Barriers and enablers to help-seeking behaviour for mental health reasons among community dwelling older adults with anxiety: Mixed-methods systematic review

Background: Despite their high prevalence and negative consequences, anxiety disorders in older adults remain underdiagnosed and undertreated, creating an ‘anxiety treatment gap’. To address this treatment gap, it is essential to identify barriers and enablers to help-seeking behavior among this pop...

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Main Authors: Rasha Alkholy, Karina Lovell, Penny Bee, Rebecca Pedley
Format: Article
Language:English
Published: Elsevier 2022-12-01
Series:Journal of Affective Disorders Reports
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S2666915322001329
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author Rasha Alkholy
Karina Lovell
Penny Bee
Rebecca Pedley
author_facet Rasha Alkholy
Karina Lovell
Penny Bee
Rebecca Pedley
author_sort Rasha Alkholy
collection DOAJ
description Background: Despite their high prevalence and negative consequences, anxiety disorders in older adults remain underdiagnosed and undertreated, creating an ‘anxiety treatment gap’. To address this treatment gap, it is essential to identify barriers and enablers to help-seeking behavior among this population. Methods: This mixed-methods systematic review used Andersen's Model and Leventhal's’ Common Sense Model (CSM) in a “best-fit” framework synthesis to explore barriers and enablers to help-seeking behavior for mental health reasons among older adults with anxiety. Results: A comprehensive search of six databases, last updated on 6 April 2022, led to the inclusion of thirteen records published 2011–2022. Quantitative data were synthesised using Andersen's Model, summarised using vote counting based on direction of effect, and focused mainly on factors at the individual level. Qualitative synthesis generated an extended conceptual model which includes a priori themes derived from Andersen's Model and Leventhal's CSM and new themes identified via inductive analysis. The role of individual need factors on help-seeking behavior was corroborated by both quantitative and qualitative evidence. The overarching theme is ‘coherence’ as a multilevel concept. Limitations: It was not possible to aggregate effect estimates extracted from quantitative records. The internal validity of the review is affected by scant evidence, quality of the qualitative records and lack of triangulation of evidence. Conclusions: There is no one model that can depict the complexity of help-seeking behavior among older adults with anxiety. A better understanding of the role of need factors and the multi-level concept of ‘coherence’ on help-seeking behavior is required.
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spelling doaj.art-1801cfe60c15426f9d4cc22c9333b79a2022-12-22T04:17:25ZengElsevierJournal of Affective Disorders Reports2666-91532022-12-0110100440Barriers and enablers to help-seeking behaviour for mental health reasons among community dwelling older adults with anxiety: Mixed-methods systematic reviewRasha Alkholy0Karina Lovell1Penny Bee2Rebecca Pedley3Division of Nursing, Midwifery and Social Work, University of Manchester, England; Lecturer of Family Medicine, Faculty of Medicine, Cairo University, Egypt; Corresponding author at: Division of Nursing, Midwifery and Social Work, University of Manchester, England.Professor of Mental Health, Division of Nursing, Midwifery and Social Work, University of Manchester, EnglandProfessor of Applied Mental Health Research, Division of Nursing, Midwifery and Social Work, University of Manchester, EnglandResearch Fellow, Division of Nursing, Midwifery and Social Work, University of Manchester, EnglandBackground: Despite their high prevalence and negative consequences, anxiety disorders in older adults remain underdiagnosed and undertreated, creating an ‘anxiety treatment gap’. To address this treatment gap, it is essential to identify barriers and enablers to help-seeking behavior among this population. Methods: This mixed-methods systematic review used Andersen's Model and Leventhal's’ Common Sense Model (CSM) in a “best-fit” framework synthesis to explore barriers and enablers to help-seeking behavior for mental health reasons among older adults with anxiety. Results: A comprehensive search of six databases, last updated on 6 April 2022, led to the inclusion of thirteen records published 2011–2022. Quantitative data were synthesised using Andersen's Model, summarised using vote counting based on direction of effect, and focused mainly on factors at the individual level. Qualitative synthesis generated an extended conceptual model which includes a priori themes derived from Andersen's Model and Leventhal's CSM and new themes identified via inductive analysis. The role of individual need factors on help-seeking behavior was corroborated by both quantitative and qualitative evidence. The overarching theme is ‘coherence’ as a multilevel concept. Limitations: It was not possible to aggregate effect estimates extracted from quantitative records. The internal validity of the review is affected by scant evidence, quality of the qualitative records and lack of triangulation of evidence. Conclusions: There is no one model that can depict the complexity of help-seeking behavior among older adults with anxiety. A better understanding of the role of need factors and the multi-level concept of ‘coherence’ on help-seeking behavior is required.http://www.sciencedirect.com/science/article/pii/S2666915322001329AnxietyOlder adultsHelp-seeking behaviorMental health service use
spellingShingle Rasha Alkholy
Karina Lovell
Penny Bee
Rebecca Pedley
Barriers and enablers to help-seeking behaviour for mental health reasons among community dwelling older adults with anxiety: Mixed-methods systematic review
Journal of Affective Disorders Reports
Anxiety
Older adults
Help-seeking behavior
Mental health service use
title Barriers and enablers to help-seeking behaviour for mental health reasons among community dwelling older adults with anxiety: Mixed-methods systematic review
title_full Barriers and enablers to help-seeking behaviour for mental health reasons among community dwelling older adults with anxiety: Mixed-methods systematic review
title_fullStr Barriers and enablers to help-seeking behaviour for mental health reasons among community dwelling older adults with anxiety: Mixed-methods systematic review
title_full_unstemmed Barriers and enablers to help-seeking behaviour for mental health reasons among community dwelling older adults with anxiety: Mixed-methods systematic review
title_short Barriers and enablers to help-seeking behaviour for mental health reasons among community dwelling older adults with anxiety: Mixed-methods systematic review
title_sort barriers and enablers to help seeking behaviour for mental health reasons among community dwelling older adults with anxiety mixed methods systematic review
topic Anxiety
Older adults
Help-seeking behavior
Mental health service use
url http://www.sciencedirect.com/science/article/pii/S2666915322001329
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