Factors associated with mental health service utilization among chronically ill minority older adults in Thailand's remote highland regions

Objective This study investigated factors associated with access to mental health services among older adults from ethnic minority groups with chronic conditions living in remote highland areas. Methods A cross-sectional survey was conducted among 468 ethnic minority older adults with chronic conditions. Data were collected between January 8, 2024 and October 10, 2024. Pearson correlation and multiple linear regression analyses were used to identify factors associated with mental health service accessibility. Results Multiple linear regression identified factors associated with accessibility of mental health services. Lower accessibility was associated with age ≥ 70 years, Christian religion, employment, government officer health benefit scheme, higher Thai Geriatric Mental Health scores, and reliance on ethnic-belief mental health care. Higher accessibility was associated with financial security, overall social support, female gender, Muslim religion, higher education, living with children and grandchildren, technology access, emotional and instrumental support, and personal and community-level mental health promotion. The final model explained 87% of the variance in accessibility (adjusted R 2 = 0.86). Conclusion Accessibility to mental health services among ethnic minority older adults is shaped by sociodemographic, cultural, psychosocial, and support-related factors. Culturally responsive and community-based strategies that strengthen instrumental support and address mental health needs are essential to improve equitable access.