Study on the Early Detection of Mental Health Problems in the Elderly and the Utilization of Related Services

노인의 정신건강 문제의 발견과 관련서비스 이용에 관한 연구

  • 박경순 (연세대학교 고령화융복합연구센터) ;
  • 박영란 (강남대학교 실버산업학과) ;
  • 손덕순 (용인송담대학교 사회복지과) ;
  • 염유식 (연세대학교 사회학과)
  • Received : 2019.07.08
  • Accepted : 2019.08.09
  • Published : 2019.09.28


This study aims at investigating the major symptoms that help family carers detect mental illness in elderly patients. Another purpose of this study is to empirically verify the major factors determining the utilization of mental health services with a focus on family carers. The results of this study are as follows. First, the most commonly detected symptoms that caused the family carers to suspect mental illness in the elderly patients were memory decline and other forms of cognitive function decline. Second, the determinants of the elderly's utilization of mental health services included the patient's long-term care insurance level, the age of the family carer, the period of care, the level stress associated with the provision of care felt by the carer, his understanding of geriatric mental illness, and the level of perception about community mental health services. Based on these findings, this study suggests policies and practical implications for the early detection of and response to elderly mental health problems and the utilization of related services from the viewpoint of the family carers of the elderly.

본 연구는 가족돌봄자가 노인의 정신질환을 주로 어떤 증상을 통해 발견하였는지를 알아보는 한편, 가족돌봄자를 중심으로 노인의 정신건강서비스를 이용하게 이끄는 주된 원인이 무엇인지를 실증적으로 검증하고자 하였다. 이를 위해 정신건강문제를 갖고 지역사회에 거주하는 노인을 돌보는 가족돌봄자를 대상으로 설문조사를 실시하였으며 이를 통해 수집된 324명의 자료로 이항 로지스틱 회귀분석을 실시하였다. 연구결과를 보면 첫째, 가족돌봄자가 노인 환자의 정신건강질환을 의심하게 된 주된 증상은 기억력 저하와 다른 인지기능 저하가 가장 많은 것으로 확인되었다. 둘째, 노인이 노인 정신건강서비스를 이용하는데 영향을 미치는 요인으로는 노인의 장기요양등급, 가족돌봄자의 나이, 노인을 돌본 기간, 가족돌봄자가 느끼는 돌봄 스트레스의 수준, 가족 돌봄자의 노년기 정신질환에 대한 이해, 가족돌봄자의 지역사회 정신건강서비스에 대한 인지도가 영향을 미치는 것으로 확인되었다. 이러한 연구결과를 토대로 노인 가족돌봄자의 관점에서 노인 정신건강문제 조기 발견과 대응 및 관련서비스 이용을 위한 정책적 실천적 함의를 제시하였다.



Supported by : 한국연구재단, 보건복지부


  1. Health Insurance Review & Assessment Service, National Health Insurance Service, National Health Insurance Statistical Yearbook, 2016.
  2. Ministry of Health and Welfare, "The Elderly Aged over 70 Suffering Panic Disorders Causing Deadly Fear Increases by 3.4 Times," News release on March 19, 2017.
  3. G. H. Jeong, The 2014 National Survey on Aged Population, Korea Institute for Health and Social Affairs, 2014.
  4. Korea Ranks First Among OECD Countries in Suicide Rate (2017, November 11), Sejong Economy News, Retrieved from
  5. National Institute of Dementia. The 2016 National State of Dementia Patients, National Institute of Dementia, 2016.
  6. J. P. Hong, The Survey of Mental Disorders in Korea, Ministry of Health and Welfare, 2016.
  7. D. U. Lee, S. H. Yu, and S. J. Cho, "The Development of Community-Based Elderly Mental Health Care Mode," Report on Research Entrusted by the National Mental Health Center Research Center, pp.1-148, 2009.
  8. N. C. Kim, J. H. Kim, and Y. M. Lim, "A Study on Community-dwelling Elders with Dementia, their Primary Caregiver, and Living Environments," The Journal of Korea Community Health Nursing Academic Society, Vol.16, No.1, pp.13-29, 2002.
  9. Y. H. Park, "Family Caregivers' Stress of the Old Adults," Stress, Vol.15, No.4, pp.331-337, 2007.
  10. Y. O. Gwak, Y. S. Kim, and G. H. Seo, "Factors of Stress Responses and Quality of Life among Stroke Patients' Family Caregivers: Focused on ADL and Social Supports," The Korean Journal of Stress Research, Vol.16, No.3, pp.261-269, 2008.
  11. G. H. Seo and G. I. Cheon, "The Moderating Effect of Social Support on Family Caregivers' Burdens and Health and Quality of Life While Taking Care of Demented Patients," The Korean Journal of Culture and Social Issues, Vol.15, No.3, pp.339-357, 2009.
  12. M. S. Jeon, "Effects of the Characteristics of the Elderly and Family Caregivers on the Caregiving Stresses," The Journal of the Korea Contents Association, Vol.14, No.12, pp.274-282, 2014.
  13. S. Y. Kwon, H. J. Lee, and J. Y. Lee, "The Effects of Care Hours on the Burden Placed on the Family Caregiver with regard to the Elderly with Dementia-Focusing on the Moderating Effects of the Attachment," Journal of Social Science, Vol.31, No.2015.2, pp.317-337, 2015.
  14. H. S. Yoon, "Factors Affecting the Intention and Necessity to Use Home Welfare Services in Family Carers of Elderly Patients," Journal of the Korea Gerontological Society, Vol.21, pp.141-161, 2001.
  15. G. O. Lee and M. J. Lee, "A Study on Older Adults' Utilization Determinants of Community Care Services," Journal of the Korea Gerontological Society, Vol.21, pp.113-124, 2001.
  16. D. Y. Song, "A Study on Factors Affecting the Intention of Family Caregivers to Use Home Welfare Services," Korean Journal of Social Welfare, Vol.53, No.5, pp.105-128, 2003.
  17. E. Y. Kim, E. S. Nam, Y. R. Chae, and H. K. Lee, "Factors Affecting the Elderly's Preference for Utilization of Long-Term Care Services Based on Andersen's Behavioral Model," Journal of the Korea Gerontological Society, Vol.28, No.3, pp.585-602, 2008.
  18. C. J. Park and B. M. Yang, "Determinants of Hospital Care Choice of Family with the Demented Elderly," Journal of Welfare for the Aged Institute, Vol.41, pp.79-102, 2008.
  19. C. J. Park, "Determinants of Long Term Care Service Use of Family Caregiver," Journal of Community Welfare, Vol.33, pp.69-92, 2010.
  20. G. Y. Lee, S. S. Choi, H. S. Park, and H. J. Lim, "A Study of Factors Affecting on the Preference of the elderly's Mental Health Services Utilization in Rural Areas-Application of Andersen and Newman's Model," Korean Journal of Social Welfare, Vol.62, No.2, pp.257-278, 2010.
  21. J. B. Neese, I. L. Abraham, and K. C. Buckwalter, "Utilization of mental health services among rural elderly," Archives of Psychiatric Nursing, Vol.13, No.1, pp.30-40, 1999.
  22. F. Amaddeo and J. Jones, "What is the impact of socio-economic inequalities on the use of mental health services?," Epidemiologia e Psichiatria Sociale, Vol.16, pp.16-19, 2007.
  23. V. Donisi, F. Tedeschi, M. Percudani, A. Fiorillo, L. Confalonieri, C. De Rosa, D. Salazzari, M. Tansella, G. Thornicroft, and F. Amaddeo, "Prediction of community mental health service utilization by individual and ecological level socio-economic factors," Psychiatry research, Vol.209, No.3, pp.691-698, 2013.
  24. J. Volkert, S. Andreas, M. Harter, M. C. Dehoust, S. Sehner, A. Suling, B. Ausín, A. Canuto, M. J. Crawford, C. Da Ronch, L. Grassi, Y. Hershkovitz, M. Munoz, A. Quirk, O. Rotenstein, A. B. Santos-Olmo, A. Y. Shalev, J. Strehle, K. Weber, K. Wegscheider, H. U. Wittchen, and H. Schulz, "Predisposing, enabling, and need factors of service utilization in the elderly with mental health problems," International psychogeriatrics, Vol.30, No.7, pp.1027-1037, 2018.
  25. C. Guo, N. Li, G. Chen, and X. Zheng, "Mental health service utilization and its associated social factors among elderly people with a mental disability in China: A national population-based survey," Scandinavian journal of public health, Vol.47, No.2, pp.215-220, 2017.
  26. J. Y. Park, "Characteristics of Elderly Mental Health and Clinical Intervention," The proceedings of the Korea Academy of Mental Health Social Work Symposium, pp.363-386, 2004.
  27. E. P. Stoller and K. L. Pugliesi, "Other roles of caregivers: Competing responsibilities or supportive resources," Journal of Gerontology, Vol.44, No.6, pp.S231-S238, 1989.
  28. Y. H. Yang, "The Relationship among the Care Conditions of Family Members Caring for Chronic Patients, Stress and Social Support," Korean Journal of Adult Nursing, Vol.7, No.1, pp.85-105, 1995.
  29. Y. R. Kim, "Analysis on Factors Affecting Elderly Care work Hours and Stresses in Care work among Family Caregivers," Journal of Women's Studies, Vol.72, pp.31-72, 2007.
  30. Y. O. Lim and H. S. Yoon. "Longitudinal Study on Factors Affecting Older Adults' Welfare Service Utilization," Journal of the Korea Gerontological Society, Vol.29, pp.1063-1085, 2009.