Use of mental health services by the rural aged: longitudinal study

Recent longitudinal research investigating historic shifts in attitudes toward mental health services reveal a positive cohort shift. Most likely, this shift equates to greater use of mental health services. The purpose of this study was to examine historic shifts in the use of mental health services in a rural population. In 1987, we administered a survey to 358 randomly selected rural individuals investigating their willingness to use mental health services. In 1994, we resurveyed 110 individuals from our original sample. As predicted, we found that there was a shift in our participants' willingness to use mental health services, increasing from 5% to 18%. This increased use, although improved, still fell somewhat below the actual need for mental health services, which had remained constant (about 25%). Interestingly, there was no greater reliance on psychotropic medication in lieu of psychotherapy (about 10%). In 1987, we found that those rural elderly who had the greatest need for mental health services were the least likely to use them. This trend may be shifting as well, although it requires further investigation and confirmation. The salient implications for the design and implementation of rural mental health services for baby boomers are noted.