Impact of stigma on use of mental health services by elderly Koreans

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Abstract
This study compared the factors associated with the utilization of mental health services across various age cohorts, with a particular focus on the differential influence of the stigma placed on mental illness on the use of these services. The present study used data from a Korean national epidemiological survey of mental disorders among community-dwelling adults aged 18–74 years (n = 3,055). The subjects were categorized into three age groups: young (18–39), middle-aged (40–59), and late adulthood (60–74). The Perceived Devaluation-Discrimination scale was used to assess the stigma placed on mental disorders in each group. The influence of perceived stigma on lifetime utilization of mental health services was examined according to age cohort using multiple logistic regression analyses that were adjusted for various sociodemographic factors (p < 0.006 with a Bonferroni correction). The late-adulthood cohort was more likely to have perceived stigma of mental illness than were the other two groups, and the utilization of mental health services by the elderly cohort was more strongly affected by this perceived stigma than was such utilization by younger cohorts [adjusted odds ratio (AOR) 4.14, 95 % confidence interval (CI) 1.86–9.22]. In the middle-aged cohort, being female or never being married was a significant determinant of use of mental health services (female, AOR 3.80, 95 % CI 2.17–6.65; unmarried, AOR 3.09, 95 % CI 1.43–6.70). It is important to reduce the perceived stigma placed on mental illness to improve access to mental health care among the current population of elderly people in Korea.

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