Barriers and facilitators of older adults for professional mental health help-seeking: a systematic review

The Effects of Commercial Conversational Agents on Older Adults' Mental Health: A Scoping Review

OBJECTIVES

With increasing life expectancy, more older adults are experiencing poor mental health because of the significant life transitions they face. Commercial conversational agents (CAs) are emerging devices that can potentially support older adults' mental well-being. However, limited literature has evaluated the influence of commercial CAs on older adults' mental health. This study aims to examine what is known about the effects of commercial CAs on older adults' mental health and the associated features.

DESIGN

This scoping review was conducted in accordance with Arksey and O'Malley's framework.

SETTING AND PARTICIPANTS

The review primarily focused on community-dwelling older adults aged 60 and above who used any commercial CAs.

METHODS

Quantitative, qualitative, mixed-method peer-reviewed studies and dissertations were included. Eleven databases were searched for relevant articles published from January 1, 2010, until April 9, 2024. Data extracted included the author(s), year, country, objective, population details, eligibility criteria, study design, commercial CA type, and findings related to research questions. Inductive basic content analysis was used for data synthesis.

RESULTS

Twenty-nine articles from 28 studies (n = 1017 older adults) were included. Five categories were synthesized: social wellness, emotional reactions, cognitive stimulation, autonomy, and depression. Common features impacting older adults' mental health were the CAs' conversational capacity and anthropomorphism, voice-activated functions, music, calling and other functions, and technological limitations. There were more positive than adverse effects on older adults' mental health categories.

CONCLUSION AND IMPLICATIONS

Commercial CAs can potentially mitigate mental health in older adults, but the evidence is still very preliminary. Their effects must be verified in randomized controlled trials using objective and validated tools and through mixed-method studies.

"We have a behaviour support plan, let's have a mental health support plan": Perspectives of staff, residents and family carers on understanding, responding to and promoting the mental health of residents within long-term care

Up to two thirds of people living in long-term care homes experience mental health conditions such as anxiety and depression. In addition, over half of residents have cognitive impairment or dementia. However, the quality of mental health care provided in residential care homes is often poor, and the use of mental health quality indictors is lacking. As the first step in a larger project to develop mental health quality indicators for long-term care (MHICare project), this study aimed to explore factors considered important for understanding and responding to mental health conditions and promoting mental well-being of residents. Individual interviews and small group discussions were conducted with twelve residents (both with and without dementia), eight family carers of residents with dementia, and six care home staff members, from across Australia. Qualitative data were analysed using an inductive thematic analysis approach to generate themes and a deductive approach to generate factors and map these to a Balanced Score Card quality indicator framework. Four main factors with several inter-related themes were identified: (1) Resident-related (Transitional impacts, Social connections and active engagement, and Pre-existing and co-morbid conditions); (2) Care and Communication Practices (Assessment and care strategies, Person-centred mental health care, Cultural and generational communication differences, and Staff handover and knowledge sharing); (3) Staff-related (Staff mental health awareness, Staff knowledge, practical skills and training needs, and Staff values and attitudes); and (4) Organisational (Internal staffing levels, Access to external mental health professionals, and Provision of volunteer programs). Findings will inform the key areas and initial content for mental health indicators for use in residential care homes. Once developed, these have the potential to highlight both strengths and gaps in current mental health care practices, and drive quality improvement initiatives.

Examining unmet needs in older adults with lung cancer: A systematic review and narrative synthesis

INTRODUCTION

Unmet needs in the older population with cancer are complex due to aging-related health conditions. A review of unmet needs in older people with cancer showed that needs varied among different cancer types. In lung cancer, a higher incidence of geriatric syndromes and comorbidities exist compared to other cancer cohorts, impacting treatment tolerance and completion. Consequently, it is crucial to identify and understand unmet needs to address supportive care needs beyond cancer diagnosis and treatment. This systematic review aims to synthesise the available literature to analyse the number and nature of unmet needs experienced by older patients with lung cancer.

MATERIALS AND METHODS

We performed a systematic search following Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines, which was registered in PROSPERO(CRD42022311105). We searched CINAHL, Medline, Embase, and Scopus electronic databases for published literature (January 2002 to November 2023) on unmet needs of patients ≥65 years diagnosed with lung cancer. We used a narrative synthesis approach to summarise the results and identify themes.

RESULTS

The search yielded 1356 articles, of which 35 met the inclusion criteria. A significant portion of older patients with lung cancer reported experiencing unmet needs, ranging from 78 % to100 %. Compared to other cancer streams, older patients with lung cancer experienced a higher burden of unmet needs, with a mean of seven unmet needs per person. Most studies identified psychological and physical/daily living domains as having the greatest prevalence and highest burden of unmet need.

DISCUSSION

Increased psychological distress and poorer quality of life correlated with increased unmet needs. Identifying and addressing unmet needs is critical for patient wellbeing and should be prioritised when developing models of care and tailored interventions for older people with lung cancer.

A qualitative study on elderly patients' preferences for inpatient psychiatric services

INTRODUCTION

Mental illnesses have a high prevalence among elderly patients. It is estimated that half of the elderly do not utilize the psychiatric care that they need. Paying attention to patient preferences can improve treatment adherence and patient outcomes. This study aims to qualitatively identify the preferences of elderly patients hospitalized in the psychiatric wards of hospitals regarding their inpatient psychiatric treatments.

METHOD

This qualitative study was conducted at Khorshid Hospital in Isfahan, Iran. The study sample included patients in the age range of 60 years or above who had already been hospitalized due to diagnosed psychiatric diseases. Twenty-one semistructured interviews were conducted from March to September 2023. A thematic analysis method was used to analyze the data.

RESULTS

The study extracted three overarching themes, including patients' preferences regarding hospital features, patients' preferences regarding hospital staff, and patients' preferences regarding service delivery.

CONCLUSION

The findings of this study showed that elderly patients consider different preferences when choosing inpatient psychiatric services. The findings provide new insights for decision-makers and health providers in designing and implementing psychiatric treatments by considering elderly patients' preferences, which in turn might help improve treatment outcomes and increase patient satisfaction.

Factors Associated with the Usage of Psychological Support Services for Employees in the Romanian Technology Industry

Background/Objectives: Mental health challenges significantly impact employee productivity, especially in high-stress industries like technology. This study aims to investigate the factors influencing the intention to use psychological support services among Romanian tech employees, focusing on barriers and motivators related to availability, accessibility, affordability, and acceptability. Methods: A cross-sectional survey was conducted among 372 Romanian tech employees using a structured online questionnaire. The survey assessed socio-demographic data, prior experience with mental health services, perceived distress levels, and barriers categorized into four dimensions. Data were analyzed using descriptive statistics and inferential analysis to identify key predictors of the intention to use these services. Results: Key factors influencing the use of psychological support services included prior experience with mental health services, the need to take time off work, and the absence of a companion. Barriers such as cost, transportation, awareness of services, and stigma were not significant. The regression model explained 8.4% of the variance in the likelihood of using these services, suggesting that additional factors may need further exploration. Conclusions: Addressing practical barriers, such as time constraints and the absence of support during access, is essential to improving accessibility of these services. Leveraging positive past experiences with mental health services can enhance engagement. These findings can guide the development of targeted interventions to promote the uptake of psychological support services in the tech sector, contributing to a healthier and more productive workforce.

Clusters of Patient Empowerment and Mental Health Literacy Differentiate Professional Help-Seeking Attitudes in Online Mental Health Communities Users

OBJECTIVES

Grounded in the Health Empowerment Model, which posits that health literacy and patient empowerment are intertwined yet distinct constructs, this study investigates how the interplay of these factors influences attitudes toward seeking professional psychological help in members of online communities for mental health (OCMHs). This while acknowledging the multidimensionality of patient empowerment, encompassing meaningfulness, competence, self-determination, and impact.

DESIGN AND METHODS

A cluster analysis of data gathered from 269 members of Italian-speaking OCMHs on Facebook has been performed.

RESULTS

Four profiles have been identified: dangerous self-managers (11.2%), effective self-managers (21.2%), disempowered (40.5%) and ambivalent empowered (27.1%). Clusters provided meaningful variations in help-seeking attitudes, also when controlling for depression and anxiety severity, F3, 265 = 11.910, p < 0.001.

CONCLUSIONS

The findings provided further evidence of the multidimensionality of patient empowerment. Considering the results, we discussed potential interventions aimed at enhancing the quality of OCMHs, tailoring to the unique characteristics of each cluster.

PATIENT OR PUBLIC CONTRIBUTION

Administrators and moderators of mental health Facebook communities-whether expert-led by mental health professionals or peers-played a key role in this study. They provided valuable insights during the questionnaire design process to ensure the questions were both relevant and appropriate for community members. These administrators and moderators also actively facilitated participant recruitment by creating and sharing posts, either video- or text-based, on community homepages. Furthermore, after completing the questionnaire, participants were encouraged to comment on the Facebook posts where the survey link was shared, mentioning that they participated and inviting other members to take part. This approach aimed to foster a sense of involvement and further promoted the survey within the community.

Patient-Provider Communication for Lonely, Socially Isolated Adults in Medicare

INTRODUCTION

Older adults experiencing loneliness or social isolation may experience poor patient-provider communication, potentially contributing to suboptimal healthcare utilization, particularly in mental healthcare. However, empirical evidence is limited. Thus, this study examined whether there were differences in patient-provider communication and healthcare utilization between Medicare beneficiaries with and without loneliness and social isolation.

METHODS

This study conducted a cross-sectional study using data from the 2021 Medical Expenditure Panel Survey. Outcomes were patient-provider communication and healthcare utilization. The primary independent variables were loneliness and social isolation. Regression analysis was conducted to estimate adjusted differences in outcomes between Medicare beneficiaries with and without loneliness and social isolation. The analysis was conducted in September 2024.

RESULTS

The sample included 4,433 Medicare beneficiaries. Medicare beneficiaries experiencing loneliness were 4.0 percentage points (95% CI=1.0, 7.1) more likely to report poor patient-provider communication compared to those without loneliness. Similarly, those with social isolation were 2.0 percentage points (1.1, 2.9) more likely to report poor communication than those without social isolation. The rates of mental healthcare utilization were higher among those with loneliness (1.8 [1.0, 2.6], 1.5 [0.8, 2.2], and 3.1 [1.1, 5.1] for social workers, psychologists, and psychiatrists) or social isolation (2.3 [0.6, 4.0] for psychiatrists), but the overall level of mental healthcare utilization remained relatively low.

CONCLUSIONS

These findings highlight significant disparities in patient-provider communication among Medicare beneficiaries experiencing loneliness and social isolation. These disparities may partly result from limited engagement with mental health services, which could help address their specific healthcare needs.

Psychotropic medications: a descriptive study of prescription trends in Tabriz, Iran, 2021-2022

INTRODUCTION

Mental disorders, such as anxiety and depression, significantly impacted global populations in 2019 and 2020, with COVID-19 causing a surge in prevalence. They affect 13.4% of the people worldwide, and 21% of Iranians have experienced them. Prescription analysis is critical for evaluating and improving medical care in a cost-effective manner. This study examined prescription patterns for psychotropic drugs in outpatient settings to improve the understanding of medication utilization in a variety of patients. It aimed to assist healthcare professionals in making well-informed decisions about drug prescriptions, a topic not much addressed in Iran.

METHOD

A descriptive study was conducted using data extracted from the Social Security Organization in Iran. We analyzed prescriptions in Tabriz from March 2021 to March 2022. Prescription data were categorized by medication category, physician specialty, age group, and sex. Then statistical analysis was performed using SPSS 2022.

RESULTS

We analyzed the number of psychotropic medication prescriptions issued by 7246 doctors to a group of 413,466 individuals over a year representing 44.9% of our target population. The average age of individuals receiving psychotropic drugs was 45.57 years. Gabapentin had the highest prescription rate, followed by sertraline. Antidepressants accounted for 38.1% of all prescriptions, with anxiolytics accounting for 18.6%. Other psychotropic drugs included alprazolam, chlordiazepoxide, and valproate. Adults in all age groups had the highest frequency of prescriptions for psychotropic medications. The majority of patients were female (63.5%). General practitioners had the highest number of instances of prescribing psychotropic drugs, with psychiatrists contributing 54.7% of the total prescriptions.

CONCLUSION

Approximately 45% of the target population received psychotropic medication, which highlights the significant prevalence of mental health issues in Iran. Antidepressants were the most commonly administered class, highlighting the need for training programs that specifically address their possible negative effects and the correct dosage. The goal is to provide healthcare practitioners with a comprehensive understanding of prescription trends, enabling them to administer the most appropriate treatments.

Psychotherapeutic Interventions for Depressive Symptoms in Community-Dwelling Older Adults: A Systematic Review with Meta-Analysis

The global ageing population faces rising depression rates due to social, economic, and health changes. Depression in older adults, often linked to isolation and health issues, requires comprehensive care. Psychotherapeutic interventions could be effective in reducing symptoms, offering personalized and holistic support. Particularly low-threshold interventions, such as those offered in community-dwelling older adults, which older adults can easily access and which may reduce stigma, promise to close the treatment gap. This review examines community-based psychotherapeutic interventions for older adults with depression.

METHODS

This review investigates psychotherapeutic interventions for reducing depressive symptoms in older adults in a community setting. RCTs were assessed using Joanna Briggs Institute tools. The following databases were searched: CINAHL Plus with Full Text, MedicLatina, MEDLINE with Full Text, and the Psychology and Behavioral Sciences Collection.

RESULTS

A meta-analysis of 13 studies with 1528 participants showed a medium, significant pooled effect size at post-intervention (Hedges' g = -0.36, p < 0.001) and substantial heterogeneity. Follow-up analysis of studies indicated a small, non-significant effect (Hedges' g = -0.17, p = 0.27). Group interventions, particularly the "reminiscence protocol", had the largest significant effect.

DISCUSSION

This systematic review and meta-analysis found that in community-dwelling older adults' group psychotherapeutic interventions, particularly the "reminiscence protocol" and "modified behavioral activation treatment" are most effective for reducing depressive symptoms. Individual psychotherapeutic interventions like "prevention of suicide in primary care elderly" and "behavioral activation" also show effectiveness, with group psychotherapeutic interventions being generally more effective than when these treatments are offered in individual psychotherapeutic interventions.

CONCLUSION

Group and individual psychotherapeutic interventions reduce depressive symptoms in community-dwelling older adults, with group psychotherapeutic interventions being more effective.

Association of Caregiving Receipt With Mental Health Utilization in a National Cohort of Older Adults

OBJECTIVE

There exist significant age disparities in mental health (MH) utilization, such that older adults, including older veterans, are much less likely to use MH services. In-home caregivers represent a novel, yet understudied, pathway to increase appropriate utilization. We sought to examine the association between receiving caregiving assistance and MH utilization and test moderation effects of cognitive status and depression severity in a sample of older veterans.

METHODS

Cross-sectional, mixed effects logistic regression with moderation analyses was used with a unique data resource combining survey data from the 2000-2012 U.S. Health and Retirement Study with Veterans Affairs (VA) healthcare administrative records. The analytic sample included N=1,957 Community-dwelling veterans (mean age 68.2 [9.7]), primarily male (96.5%) and non-Hispanic white (77.0%). Measures included MH utilization extracted from VA records or self-report; CESD-8 for depressive symptoms; and the Langa-Weir cognitive status classification using the modified TICS.

RESULTS

After accounting for demographics, spousal caregiver availability, health factors, and socioeconomic status, caregiving receipt was associated with two-fold odds of MH utilization, compared to receiving no assistance (8,839 person-year observations; OR = 2.02; 95% CI 1.54-2.65) and remained similar following VA policy changes to enhance MH access. Exploratory analyses revealed that categories of cognition and depressive symptoms may moderate the association.

CONCLUSION

Receipt of any in-home caregiving is associated with increased likelihood of MH use by older adults. Caregivers may represent an underutilized resource to reduce age-related mental health access disparities.

Interventions for improving health literacy among older people: a systematic review

BACKGROUND

Health literacy(HL) is defined as the degree to which individuals have the capacity to obtain process and understand basic health information and services required for making appropriate health decisions. Effective interventions to improve older people's HL have become increasingly important. The purpose of this study is to conduct a review of interventions aimed at enhancing the HL of older people.

METHODOLOGY

Relevant information was gathered from various databases including PubMed, Scopus, Cochrane Library, Science Direct, and Web of Science. Additionally, a manual search of related journals and Google Scholar, a search of the reference lists of selected articles, and a search of unpublished sources were also conducted up to 30 August 2024. Reporting quality assessment was performed using CONSORT: 2010, JBI Critical Appraisal Checklist for Quasi-Experimental Studies, and "Quality Assessment Criteria for Survey Research Reports".

RESULTS

A total of 21 articles were included in this study. The interventions conducted in high-income countries were found to be more effective compared to those conducted in middle and low-income countries. Furthermore, interventions carried out at the community level were more effective than those performed in nursing homes. Educational interventions were more effective than lifestyle modification interventions, and interventions carried out in a single dimension were more effective than multidimensional interventions. Additionally, interventions that utilized technology were found to be more effective.

CONCLUSION

Based on the findings, community-based interventions that encompass a one-dimensional approach, incorporating the use of technology and considering the duration of the intervention, are more recommended.

The COVID-19 Pandemic and Its Effects on Mental Health-A before, during, and after Comparison Using the U.S. Census Bureau's Household Pulse Survey

BACKGROUND

Although significantly increased mental health concerns were noted globally during the first year of the COVID-19 pandemic, much less is known about the mental health trends during the COVID-19 recovery period. We aimed to compare current anxiety or depression rates to those before and during the first year of the pandemic and to evaluate demographic differences.

METHODS

We analyzed Household Pulse Survey data prospectively collected from a representative U.S. population sample. We compared the anxiety or depression rates from the first pandemic year (04/2020-05/2021) and recovery period (06/2023-03/2024) from the national cohort and demographic subgroups using two-sided paired t-tests and regression analyses and compared these to pre-pandemic (01/2019-12/2019) rates using one-sided t-tests.

RESULTS

The national estimates for anxiety or depression improved during the recent COVID-19 recovery period as compared to the first year (29.5 ± 5.5 vs. 37.6 ± 3.1; p < 0.0001) but did not return to the pre-pandemic benchmark (29.5% vs. 10.8%; p < 0.001). Higher rates were noted in younger individuals aged 18-29 years (p < 0.0001), in individuals with less than a high school diploma (p < 0.0001), or with disabilities (p < 0.0001). Non-Hispanic Asians reported the lowest rates (p < 0.0001), and no significant gender differences were noted.

CONCLUSION

The U.S. population's mental health concerns have improved since the first year of the pandemic but remain above pre-pandemic benchmarks. Certain demographic subgroups are at higher risk, indicating the need for targeted health care and economic policy interventions to address these disparities.

Neurobiology and medico-legal aspects of suicides among older adults: a narrative review

The task of preventing suicide in older adults is an important social burden as older adults aged above 65 are exposed to singular psychological aspects that increase suicide risks. Moreover, when an older adult corpse is found, the medico-legal inspection represents a fundamental tool to identify the exact cause of death, classifying or excluding it as suicide. In this scenario, this review aims to explore the neurobiological factors that could be related to suicidal behavior in older adults. A further goal of this review is the exploration of the medico-legal aspects surrounding older adult suicides, clarifying the importance of forensic investigation. Particularly, this review examines issues such as neurotransmitter imbalances, cognitive impairment, neuroinflammation, psychosocial factors related to geriatric suicide, and neurodegenerative diseases. Additionally, medico-legal aspects such as policy considerations, legal frameworks, mental health assessments, ethical implications and forensic investigation were explored. Considering the importance of this phenomenon, especially in western countries, a need has emerged for focused screening tools on suicidal behavior among older adults, in order to contain it. Therefore, this review makes an exhaustive appraisal of the literature giving insights into the delicate interplay between neurobiology as well as mental health in relation to older adult suicide within a medico-legal context. The comprehension of different aspects about this complex phenomenon is fundamental to propose new and more effective interventions, supporting tailored initiatives such as family support and improving healthcare, specifically towards vulnerable ageing societies to reduce older adult suicide risks.

The Nexus of Aging and Substance Use: A Scoping Review of Therapeutic Modalities for Geriatric Substance Use Disorders

The insidious grip of substance use disorders (SUDs) manifests as a ubiquitous public health crisis, indiscriminately affecting individuals across the spectrum of age, gender, and socioeconomic status. While advancements in treatment offer a glimmer of hope, millions continue to grapple with the debilitating physical, psychological, and social consequences of addiction, particularly those involving alcohol and opioids. This crisis is further exacerbated by the alarming rise of SUDs among older adults. As the global population undergoes a process of demographic senescence, the escalating prevalence of SUDs in this demographic underscores the urgent need for nuanced interventions. This review explores the therapeutic landscape for managing SUDs in older adults, evaluating pharmacological and non-pharmacological treatment modalities. A detailed literature search was conducted using databases like PubMed, Google Scholar, and Scopus, and studies were selected based on their relevance to therapeutic interventions for older adults with SUDs, encompassing pharmacological and non-pharmacological modalities. The synthesized results provide an extensive overview of contemporary therapeutic approaches. The findings indicate that pharmacological interventions demonstrate varied effectiveness in managing opioid and alcohol use disorders, with each drug offering distinct benefits and limitations regarding safety, tolerability, and patient adherence. Non-pharmacological interventions provide critical psychological and social support, often requiring adaptations to meet elderly patients' needs effectively. Integrated care models, which combine pharmacological and non-pharmacological treatments, emerge as the most effective approach, addressing the comprehensive needs of elderly patients by leveraging multidisciplinary teams, centralized service access, and coordinated, patient-centered care. Implementing these models, however, requires overcoming significant resource and coordination challenges. Indeed, the confluence of a burgeoning geriatric population and escalating rates of SUDs necessitates the development and implementation of granular and integrated care protocols specifically designed for older adults. By employing such a targeted approach, optimism can be cultivated and the quality of life enhanced for this vulnerable and often overlooked segment of society. This ensures the fight against addiction extends its reach, leaving no one behind.

The prevalence of depression, determinants, and linkage with functional disability amongst postmenopausal women in India: Evidence from the Longitudinal Ageing Study in India

BACKGROUND

The study objective was estimating the prevalence and determinants of depression amongst postmenopausal women in India. Additionally, we used panel mediation analysis to model the extent to which multimorbidity was associated with depression after adjusting for the effects of functional disability in the participants.

METHODS

Data from 28,160 women aged 50 and above from the Longitudinal Aging Study in India (LASI) Wave 1 were analyzed. Depression was assessed using the Composite International Diagnostic Interview-Short Form (CIDI-SF), with multimorbidity and functional disability (ADL and IADL) considered as key predictor variables. Logistic regression and Karlson-Holm-Breen (KHB) mediation analysis were employed.

RESULTS

The weighted prevalence of depression among women aged ≥ 50 years was 21.76% (95% CI: 20.81, 22.73), significantly higher women aged < 50 years (17.60%, 95% CI: 16.33, 18.94). Factors independently associated with increased odds of depression included being unmarried, rural residence, and multimorbidity, while higher educational status was associated with lower odds of depression. The relationship between multimorbidity and depression was partially mediated by ADL and IADL disabilities. Notable regional (state) variations in the magnitude of depression were observed.

CONCLUSIONS

Nearly one in five postmenopausal women in India aged 50 years and older have clinical depression. Community screening for reaching the unreached with primary care mental health strengthening need enhanced policy focus.

Attitudes towards seeking psychological help among community dwelling older adults enrolled in primary care in Chile

BACKGROUND

Depression and anxiety are common mental disorders among older adults, but they are frequently underdiagnosed. Attitudes towards seeking professional mental health care is one of the barriers to access to treatment. This study was aimed at assessing the attitudes towards seeking psychological help among older adults who are enrolled in primary care in Chile, and to determine the associated factors.

METHODS

This cross-sectional study recruited 233 primary care users aged 65 or more years. The Attitudes Towards Seeking Professional Psychological Help was used. Reliability and factor analysis of this scale were carried out. The average scores of the scale and factors were calculated and compared, by selected variables. Multivariate linear regression was estimated to determine factors associated with attitudes towards seeking psychological help.

RESULTS

Three factors were identified in the attitudes towards seeking psychological help: confidence in psychologists, coping alone with emotional problems, and predisposition to seek psychological help. On average, participants had a favorable attitude towards seeking psychological help, compared with previous research. Lower level of education, and risk of social isolation were inversely associated with these attitudes.

CONCLUSION

Strategies to improve mental health literacy and social connection among older adults, could have an impact on factors that mediate the access to mental health care, such as attitudes towards seeking psychological help, among people who have a lower level of education or are at risk of social isolation.

Effect of long-term care insurance policy on depression in non-disabled people: evidence from China

BACKGROUND

Policy effect might be multidimensional and spill over to non-recipients. It is unclear how the implementation of Long-Term Care Insurance (LTCI) policy affects depression in non-disabled people and how this effect differs in different non-disabled groups.

METHODS

Using time-varying differences-in-differences method and nationally representative health survey data in wave 2011, wave 2013, wave 2015 and wave 2018 from the China Health and Retirement Longitudinal Study, we assessed the effect of LTCI policy on depression in non-disabled people aged 45 years and older, and discussed the heterogeneity of effect across different population characteristics: retirement, financial support and social participation status.

RESULTS

We found LTCI policy statistically significant reduced depression by 0.76 units in non-disabled people compared to non-pilot cities. Depression in non-disabled people who unretired, with financial support and without social participation was reduced by 0.8267, 0.7079 and 1.2161 units, respectively.

CONCLUSIONS

Depression in non-disabled people was statistically significant reduced because of LTCI policy in China, and non-disabled people who unretired, with financial support and without social participation benefited more from LTCI policy. Our findings highlight the depression-reducing effect of LTCI policy in non-recipients and suggest that non-disabled people who unretired, with financial support and without social participation should be concerned during LTCI policy progress.