Mental health in senior housing: Racial/ethnic patterns and correlates of major depressive disorder

Abstract

Objectives: Mental health problems are associated with disability, overuse of medical care, higher rates of mortality and suicide as well as personal suffering for older adults. Residents of urban, low-income senior housing may face increased risk of a variety of mental health problems, including depression. This study identified the prevalence of multiple mental health problems in older residents of low-income senior housing and explored correlates of major depressive disorder for the two largest ethnic groups: black and Latino.

Method: In-person diagnostic interviews identified rates of mental illness in a sample of 635 residents of 13 low-income senior housing buildings in a medium-sized northeastern city. Applying George's Social Antecedent Model of Depression, logistic regression analyses identified shared and unique correlates of depression for Latino and black participants.

Results: This population had high rates of major depressive disorder (26%), generalized anxiety disorder (12%) and other mental health problems that varied significantly by ethnic and racial group. Separate multivariate models for Latino and black people showed that younger age, more chronic conditions and social distress were related to major depressive disorder for both ethnic groups. Perceived environmental stress, shorter tenure in the building, poorer perceived health, higher life stress and fewer leisure activities were associated with depression for Latinos only.

Conclusion: Mental health screening and treatment services are needed in senior housing to address these high rates of mental illness. Unique constellations of correlates of depression for different ethnic groups underscore a need for culturally competent approaches to identification and treatment.

Keywords:

• mental illness
• elderly housing
• Latino
• black

Acknowledgements

This research was supported by a three-year grant from The Patrick and Catherine Weldon Donaghue Medical Research Foundation entitled ‘Improving Access to Mental Health Services for Older Hartford Residents’ (DF #01-201) and represented a partnership between the Institute for Community Research (PI: Jean J. Schensul), the Braceland Center for Mental Health and Aging (Site PI: Julie Robison), the North Central Area Agency on Aging (Site PI: Carmen Y. Reyes) and the Hartford Housing Authority. The authors would like to express their appreciation to members of the research team who contributed greatly to this project including Evelyn Baez, Karen Blank, Kenneth Brockman, Nuria Ciofalo, Kelly Desmarais, Leslie Escobales, Eugene Hickey, Gustavo Lopez, Dawn McKinley, and the staff and residents of the 13 buildings involved in this study. We would also like to thank members of the Clinical Advisory Committee that have supported the work of the project, including mental health services at St Francis Hospital Behavioral Health/PATH Outpatient Services, Capital Region Mental Health Center, Charter Oak Rice Heights Health Center Inc., Hartford Behavioral Health, the Institute for the Hispanic Family and the Institute of Living/Hartford Hospital Geriatric Services.