Making sense of mental health in later life: social network dynamics and service access

Using a qualitative approach, this study explores how older people have experienced barriers and facilitators in access to mental health services (MHS). It uses the life-course perspective and the Network Episode Model (NEM) as theoretical frameworks. It addresses three research questions: 1) How have older people experienced access to MHS as older adults and at other times during their life-course? 2) How and why do older people decide to access MHS? and 3) What barriers and facilitators have older people experienced when wanting to use MHS?

Four in-depth semi-structured interviews were conducted with older people (65 +) using mental health services, which were recruited using purposive sampling. The results were analysed using reflexive thematic analysis, considering the subjectivity and reflexivity of the researchers.

Three themes were identified as the main processes where barriers and facilitators are experienced: 1) Recognising that there is a mental health problem and you can get help, 2) Destigmatisation of mental health, and 3) Need for integral support.

Participants' past experiences and knowledge of mental health seem to contribute to help-seeking. Health and mental health professionals, especially GPs, can facilitate access to MHS by recognising, validating and integrating older people's needs. Conversations about mental health with personal and community organisations can lessen stigma and increase social support. Policies should continue promoting mental health literacy and awareness, and adopt a holistic delivery model from a gerontological perspective that includes older people and their social networks.