Underutilization of Mental Health Services among American Elders: Two-Dimensional Policy Evaluation Model

Mental illnesses of American elders have posed serious public health challenges to today's U.S. society. Due to prevalent social stigma against both aging and mental illnesses, the mismatch between needs of American elders and provisions of mental health care, and the fragmented mental health service delivery, American elders have still been an underserved population in urgent needs of mental health care. Given that policies pervade every aspect of human life, the authors developed a two-dimensional policy evaluation model and then applied this model to the underutilization of mental health services among American elders. The vertical dimension represents a chronological approach (time). The horizontal dimension represents a SPECI analysis (space and being). Using this model, this article aims to understand which factors contribute to the underutilization of mental health services among American elders. Finally, implications for social work practice with mentally ill American elders are discussed.