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The Gerontologist 46:193-199 (2006)
© 2006 The Gerontological Society of America

Behavioral Health Services Utilization Among Older Adults Identified Within a State Abuse Hotline Database

Lawrence Schonfeld, PhD1, Rebecca G. Larsen, MSPH2 and Paul G. Stiles, JD, PhD2

Correspondence: Address correspondence to Lawrence Schonfeld, PhD, Department of Aging & Mental Health, Louis de la Parte Florida Mental Health Institute, University of South Florida, 13301 Bruce B. Downs Blvd., Tampa, FL 33612. E-mail: schonfel{at}

Purpose: This study examined the extent to which older adults identified in a statewide abuse hotline registry utilized behavioral health services. This is important as mental health issues have been identified as a high priority for filling gaps in services for victims of mistreatment. Design and Methods: We compared Medicaid and Medicare claims data for two groups of older adults: those using health services and identified within a statewide abuse hotline information system and those claimants not identified within the hotline database. Results: Behavioral health service use was greater among those identified in the abuse hotline database. The penetration rate (percentage of service users out of all enrollees) for Medicaid behavioral health service claims was more than twice that of other service users, with costs of services about 30% greater. Analyses of Medicare data revealed that the penetration rate for those in the hotline data was almost 6 times greater at approximately twice the cost compared to other service users. Implications: The results provide evidence for previous assumptions that mistreated individuals experience a higher rate of behavioral health disorders. As mental health screening by adult protective services is rarely conducted, the results suggest the need to train investigators and other service providers to screen older adults for behavioral health and substance-abuse issues as well as physical signs of abuse. Further research on the relationship of abuse to behavioral health might focus on collection of additional data involving more specific victim-related characteristics and comparisons of cases of mistreatment versus self-neglect.

Key Words: Elder abuse • Mental health • Substance abuse • Medicaid • Medicare

This article has been cited by other articles:

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S. M. Strasser and T. Fulmer
The Clinical Presentation of Elder Neglect: What We Know and What We Can Do
Journal of the American Psychiatric Nurses Association, January 1, 2007; 12(6): 340 - 349.
[Abstract] [PDF]

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Copyright © 2006 by The Gerontological Society of America.