Author ORCID Identifier

Date of Award


Degree Type


Degree Name

Doctor of Philosophy (PhD)


Counseling and Psychological Services

First Advisor

Catherine Y. Chang

Second Advisor

Audrey Leroux

Third Advisor

Erin Mason

Fourth Advisor

Mary Chase Mize


Suicide is a serious public health concern, especially among older adults who present with historically high rates of suicide (CDC, 2023). Despite these disproportionate rates of suicide, little research has examined help-seeking behavior among older adults at risk of suicide (Wang et al., 2023). By furthering our understanding of facilitators and barriers to service use among older adults, we can work to inform targeted strategies to promote engagement with services. The primary aim of the present study was therefore to examine predictors of help-seeking behavior among older adults at risk of suicide using the Andersen Behavioral Model of Health Services Use (Andersen, 1995). This cross-sectional, quantitative analysis included a national sample of 806 older adults. Roughly half the sample met at least one clinical cutoff score for distress due to suicide, however, the majority of participants did not receive services for mental health or suicide concerns over the past year. Age, income, and access to care all served as predictors of proximal suicide risk factors. Further, the odds of engaging in help-seeking behavior among participants at elevated risk of suicide was associated with suicide behavior, psychological distress, and pain-related emotional burden. Overall, these findings emphasize the current need to address belongingness and low mental health service use among older adults.


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