Determining the Prevalence of Depression and Assessing Health-seeking Behavior among the Geriatric Population in Urban Slums of Sea Coast City of Saurashtra Region of Gujarat in India: A Community-based Cross-sectional Study.

Abstract

Background: The elderly are disproportionately affected by depression, a devastating mental health illness that is common and causes significant impairment and a poor quality of life. In a community setting in India, this study sought to evaluate the prevalence of depression, degrees of associated disability, healthcare use patterns, health-seeking behavior, and awareness of government initiatives of mental health and care for the elderly.

Objectives: This study was aimed to determine the prevalence of depression and to assess the health-seeking behavior among the geriatric population aged ≥60 years in the study area during the study period.

Methodology: A cross-sectional community study including 450 senior citizens aged ≥60 years living in urban slums was carried out. Data were collected through structured interviews, utilizing the Geriatric Depression Scale using 30 items for assessing depression, the Sheehan Disability Scale for evaluating disability levels, and questionnaires on healthcare utilization, health-seeking behavior, and knowledge of government programs.

Results: The prevalence of depression was high, with 129 (28.67%) participants suffering from mild depression and 33 (7.33%) from severe depression. Moderate to marked disruptions in their work (17, 51.52%), social life/leisure pursuits (24, 72.73%), and social responsibilities (family life) (27, 51.52%) were reported in a significant proportion of those with severe depression. Additionally, a substantial percentage reported feeling impaired and unproductive for most days of the week (P < 0.001). While the majority (358, 79.56%) visited healthcare providers, with 333 (93.02%) visiting government providers and 330 (92.18%) visiting community-level providers, the utilization of mental health services (10, 2.79%) and treatment for depression with antidepressants (7, 4.32%) was minimal. In addition, just 26 people (5.78%) and 3 people (0.67%) knew about the National Programme for Health Care of the Elderly and the Mental Healthcare Act of 2017, respectively, indicating a lack of knowledge regarding government initiatives pertaining to mental health and geriatric care.

Conclusion: The study highlights the significant burden of depression, associated disabilities, and inadequate health-seeking behavior among the elderly population in the study setting. Efforts should focus on strengthening community-based mental health services, improving awareness and access to existing health services and government programs and addressing the various risk factors responsible for the emergence and persistence of depression, and poor health-seeking behavior in the aforementioned vulnerable group.