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Discrimination reported by older adults living with mental health conditions: types, contexts and association with healthcare barriers

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Abstract

Objective

Australian policy-making needs better information on the prevalence, context and types of discrimination reported by people living with mental health conditions and the association of exposure to discrimination with experiencing a barrier to accessing healthcare.

Methods

Secondary data analysis using the national representative General Social Survey 2014 to examine discrimination and healthcare barriers. Multivariable logistic regression was used to examine the association between discrimination and barriers to healthcare.

Results

Around 10% of older adults without mental health conditions reported an instance of discrimination in the last 12 months, compared to 22–25% of those with mental health conditions. Approximately 20% with mental health conditions attributed discrimination to their health conditions, along with other characteristics including age. Discrimination was reported in settings important to human capital (e.g., healthcare, workplace), but also in general social and public contexts. Everyday discrimination (OR = 2.11 p < 0.001), discrimination in healthcare (OR = 2.92 p < 0.001), and discrimination attributed to the person’s health condition (OR = 1.99 p < 0.05) increased the odds of experiencing a barrier to care two-to-three-fold. For each type of discrimination reported (e.g., racism, ageism etc.), the odds of experiencing a barrier to care increased 1.3 times (OR = 1.29 p < 0.01).

Conclusion

This new population-level evidence shows older adults with mental health conditions are experiencing discrimination at more than twofold compared to those without mental health conditions. Discrimination was associated with preventing or delaying healthcare access. These findings indicate that future strategies to promote mental healthcare in underserved groups of older people will need to be multidimensional and consideration given to address discrimination.

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Acknowledgements

The Australian Bureau of Statistics (ABS) made data for this study available to the authors. The Australian Research Council’s (ARC) Centre of Excellence in Population Ageing Research (CE1101029) funds author 1. The opinions expressed herein do not reflect those of the ABS or ARC.

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Authors and Affiliations

  1. Demography and Ageing Unit, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia

    Jeromey B. Temple

  2. Social Gerontology, National Ageing Research Institute (NARI), Parkville, Australia

    Bianca Brijnath

  3. Monash Centre for Health Research and Implementation, Monash University, Melbourne, Australia

    Joanne Enticott

  4. Southern Synergy, Department of Psychiatry, Monash University, Melbourne, Australia

    Joanne Enticott

  5. School of Geography, Faculty of Science, University of Melbourne, Melbourne, Australia

    Ariane Utomo

  6. Centre for Health Policy, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia

    Ruth Williams & Margaret Kelaher

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  1. Jeromey B. Temple
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Correspondence to Bianca Brijnath.

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Temple, J.B., Brijnath, B., Enticott, J. et al. Discrimination reported by older adults living with mental health conditions: types, contexts and association with healthcare barriers. Soc Psychiatry Psychiatr Epidemiol 56, 1003–1014 (2021). https://doi.org/10.1007/s00127-020-01914-9

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  • DOI: https://doi.org/10.1007/s00127-020-01914-9

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