Engaging in Late-Life Mental Health Research: a Narrative Review of Challenges to Participation.

This narrative review seeks to ascertain the challenges older patients face with participation in mental health clinical research studies and suggests creative strategies to minimize these obstacles. Challenges to older adults' engagement in mental health research include practical, institutional, and collaboration-related barriers applicable to all clinical trials as well as more personal, cultural, and age-related patient barriers specific to geriatric mental health research. Universal research challenges include (1) institutional barriers of lack of funding and researchers, inter-researcher conflict, and sampling bias; (2) collaboration-related barriers involving miscommunication and clinician concerns; and (3) practical patient barriers such as scheduling issues, financial constraints, and transportation difficulties. Challenges unique to geriatric mental health research include (1) personal barriers such as no perceived need for treatment, prior negative experience, and mistrust of mental health research; (2) cultural barriers involving stigma and lack of bilingual or culturally matched staff; and (3) chronic medical issues and concerns about capacity. Proposed solutions to these barriers include increased programmatic focus on and funding of geriatric psychiatry research grants, meeting with clinical staff to clarify study protocols and eligibility criteria, and offering transportation for participants. To minimize stigma and mistrust of psychiatric research, studies should devise community outreach efforts, employ culturally competent bilingual staff, and provide patient and family education about the study and general information about promoting mental health.

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Déclaration de conflit d'intérêts

Conflict of InterestDr. Karp reports receipt of medication supplies for investigator-initiated studies from Pfizer and Indivior. He receives compensation for editorial work for the American Journal of Geriatric Psychiatry and the Journal of Clinical Psychiatry and has received an honorarium from Otsuka for a disease-state medical education webinar. The other authors report no conflicts with any product mentioned or concept discussed in this article. Ms. Newmark is supported by NIMH T32 MH 19986.