Barriers to mental health care utilization in Parkinson's disease

J Geriatr Psychiatry Neurol. 2013 Jun;26(2):105-16. doi: 10.1177/0891988713481269. Epub 2013 Apr 15.

Abstract

Background: Parkinson's disease (PD) is frequently complicated by co-occurring psychiatric problems such as depression and anxiety that negatively affect the course and management of the illness. Yet, in most cases, these psychiatric comorbidities are neither recognized nor treated to remission. The primary purpose of this study was to identify and describe barriers to mental health care utilization for people with PD. Secondary objectives included the assessment of attitudes and preferences regarding the need for mental health services in the PD community and the acceptability of telehealth interventions as a method for improving access and quality of care.

Methods: A total of 769 people with PD completed an anonymous cross-sectional questionnaire assessing barriers to mental health care utilization in this medical population. Respondents were drawn from a national sample.

Results: Commonly endorsed barriers to mental health care utilization in PD reflect the patients' incomplete understanding of mental health problems, access issues, and illness-specific concerns, as well as the inadequate screening and detection of psychiatric complications by medical providers and the need for more effective treatments in this medical population. Several demographic, medical, and psychiatric variables also influenced the likelihood of accessing mental health care. Interest in telehealth approaches to mental health treatment was high and, in several instances, correlated with perceived barriers to mental health care utilization.

Conclusions: People with PD may encounter a multitude of barriers that impede their pursuit of mental health care. Clinical implications are discussed and further research is needed to replicate and extend these findings.

Trial registration: ClinicalTrials.gov NCT01167608.

Keywords: Parkinson’s disease; anxiety; barriers; depression; mental health care utilization.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Cross-Sectional Studies
  • Female
  • Health Services Accessibility*
  • Humans
  • Male
  • Mental Disorders / etiology
  • Mental Disorders / therapy
  • Mental Health Services / statistics & numerical data*
  • Middle Aged
  • Needs Assessment
  • Parkinson Disease / complications
  • Parkinson Disease / psychology*
  • Parkinson Disease / therapy
  • Surveys and Questionnaires
  • Telemedicine

Associated data

  • ClinicalTrials.gov/NCT01167608