Mental Health Screening of Older Adults in Primary Care

In an effort to document mental health outreach in our primary care clinic, 316 veterans (mean age 72) not currently in psychiatric treatment were screened for multiple mental health symptoms. Depressed mood was reported by 18% of the sample, insomnia by 26%, and morbid/suicidal ideation by 6.9% for at least several days during the past 2 weeks. Of those who experienced a loss over the past year (43%), 36% remained affected by the loss. Also reported were anxiety symptoms (29%) and PTSD symptoms (14%). Two-fifths (39%) of patients reported drinking alcohol in the past week, 18% more than 5 days, and 13% more than 3 drinks per sitting. Twenty-six percent of the patients reported symptoms warranting intervention; of these, only 39% accepted a treatment referral. While screening for depressed mood and alcohol use is now common in primary care, we found it useful to screen for specific symptoms of depression (including insomnia and suicidal ideation), persisting grief reactions, anxiety, and PTSD in this setting. Further research is necessary to determine factors that underlie some patients' refusal to accept mental health treatment.