Self-Reported Aging Needs of Racially and Ethnically Diverse Older Adults With Serious Mental Illness

The growing population of older adults with serious mental illness (SMI) faces significant unmet needs as they age. Despite the increasing prevalence of SMI among older adults, limited research has focused on their specific needs, particularly within racially and ethnically diverse populations. This study examines the self-reported needs of 746 adults aged 50 years and older using data collected between 2018 and 2022 from the Bridge, a supportive housing agency in New York.

Need was operationalized as reported difficulties older adults encounter with various functional domains, including activities of daily living, instrumental activities of daily living, and mobility tasks. Data were analyzed using the team-based and patient-centered Rapid and Rigorous Qualitative Data Analysis method. Identified themes were categorized according to the social determinants of health framework.

The most frequently reported subcategories of needs included housing (17.4%), access to care (10.7%), and social support systems (7.9%). Many participants emphasized the need for stable, accessible housing. Difficulties in accessing healthcare included challenges in obtaining mental health services, medications, and specialized care such as dental and vision services. Difficulties in social support systems involved a need for stronger family connections, companionship, and community involvement. Additionally, maintaining independence (6.6%) and holistic well-being (6.1%) emerged as key concerns, with participants emphasizing the importance of self-sufficiency and overall mental and physical well-being.

The findings of this study underscore the gap between existing supportive services and the multidimensional needs of racially and ethnically diverse older adults with SMI. Addressing these challenges requires integrated healthcare models, housing stability initiatives, and expanded social support programs to improve quality of life and long-term outcomes for this vulnerable population.