Research On The Construction Of The Social Support System For Mental Health Among Older Adults With Disabilities In Community-dwelling

With the acceleration of the aging of the population,the group of disabled elderly people in our country continues to expand.Disabled older adults not only face physical problems such as physical aging,the decline in physiological function,and disease distress,but also face poor mental health problems such as social role change,the decline in social status,and reduced social participation lead to loneliness,uselessness,and depression.In order to obtain "family happiness",disabled older adults mainly choose to live in community-dwelling.However,with the acceleration of urbanization and the increase of population flow,the informal social support of family spiritual protection and the emotional mutual assistance of neighbors have gradually weakened.With the improvement of social security system,although the material and services are basically guaranteed,mental health is often overlooked.Compared with the ones living in institutions,the disabled older adults living in community are at higher risk of mental illness.Due to insufficient social support,they cannot enjoy professional mental health services.Therefore,this article explores the impact of formal and informal social support on the mental health,and proposes countermeasures and suggestions for improving the social support system for the mental health of disabled older adults living in community-dwelling.It has important practical significance and academic value.Aiming at the problem of constructing a social support system for the mental health,this article takes the needs of mental health services as a logical starting point.And we analyze the impact of social support on mental health among disabled older adults living in community-dwelling from both qualitative and quantitative aspects.First,we sort out the literature and theories related to mental health and social support,and construct the analysis framework of this article.Secondly,we use grounded theory methods to explore the dimensions of the mental health,the need for mental health social support,and the mechanism of the impact of social support on mental health.And then we propose research hypotheses that formal and informal social supports affect the mental health of disabled older adults living in community-dwelling.Third,we use the data of The Chinese Longitudinal Healthy Longevity Survey(CLHLS)from 2011 to 2018 to explore the current status of the mental health and social support of the disabled older adults and their changes with the time of disability.Then we construct a "point-individual" multi-level model to verify the impact of formal social support and informal social support on mental health among the older adults with disabilities.Besides,we explore the impact of social support on the mental health among disabled older adults living in community-dwelling under a different group of disability,gender,age,and urban-rural areas.Finally,we analyzes the problems and reasons in the construction of the mental health social support system in China and puts forward countermeasures and suggestions for the construction of the social support system for the mental health of disabled older adults living in community-dwelling.Through in-depth research on the above issues,this article draws the following conclusions:First,the mental health of disabled older adults living in community-dwelling can be divided into three dimensions: cognitive function,depressive symptoms,and life satisfaction.These three dimensions can measure and reflect the mental health quality of disabled older adults living in community-dwelling.Second,with the increase in disability time,the proportion of patients with cognitive dysfunction and depressive symptoms among disabled older adults living in community-dwelling has increased rapidly,from 9.72% and 11.06% in 2011 to32.10% and 30.60% in 2018,respectively.People who are dissatisfied with their lives have dropped from 6.51% in 2011 to 4.19% in 2018.The average score of cognitive function of disabled older adults showed a downward trend,and it declined slowly from 2011 to 2014 and dropped sharply from 2014 to 2018.The average score of depression in disabled older adults declined from 2011 to 2014,and rose sharply from2014 to 2018,showing a "U" trend.The average life satisfaction score of disabled older adults increased slightly from 2011 to 2014,and decreased slightly from 2014 to2018,and remained basically stable.Third,informal social support affects the mental health quality of disabled older adults living in community-dwelling.Among them,adult children’s financial support improved the scores of cognitive function and reduced the scores of depressive symptoms;adult children’s emotional support improved the cognitive function and life satisfaction scores.However,adult children’s services support reduced the scores of cognitive function among disabled older adults living in community-dwelling.From the group of disability,age,rural and city areas,and gender,those who have higher cognitive function scores when they enjoy adult children’s service support are the semi-disabled elderly,the elderly living in rural community-dwelling,the female older adults,and senior age older adult.This reveals that the phenomenon of ―use advancement and abandonment retreat‖ exists in this population.Therefore,when formulating policies of social support to protect mental health,we should pay attention to the subjective initiative of the disabled older adults living in community-dwelling.Fourth,formal social support affects the mental health of disabled older adults living in community-dwelling.Among them,community service improved the cognitive function score and life satisfaction of disabled older adults;medical insurance improved the cognitive function scores of disabled older adults;pension insurance improved the life satisfaction degree.From the group of disability,age,urban and rural areas,and gender,older adults with complete disability and female have higher scores of depressive symptoms when they enjoy pension insurance.The reason may be that pension insurance squeezes out adult children’s financial support and service support,which can easily cause family conflicts.Besides,the low pension insurance payment standard is difficult to meet their needs.This psychological gap fails to meet their expectations,which leads to the increase of depressive symptoms scores in the disabled elderly.Fifth,there are problems of social support objects of disabled older adults living in community-dwelling such as unsound targeting mechanism,ignoring mental health appeals,not motivate subjective initiative.The problems of content of social support are a single service content,insufficient specialization,and insufficient resource allocation,uneven distribution.The problems of social support subjects are absence,offside,confusion of responsibilities between subjects,and imperfect professional teams.The problems of social support path are the problems of single channels,poor paths,and few communication platforms.Sixth,the problem of mental health and social support for disabled older adults living in community-dwelling is due to the imperfect laws and regulations on social support for mental health,the single source of funds,the low degree of information,the failure to create a good atmosphere.The social support objects have insufficient awareness of mental health.And the subjects of social support lack attention on social support for mental health of disabled older adults living in community-dwelling.Seventh,put forward countermeasures and suggestions for the construction of a social support system among disabled older adults living in community-dwelling from the aspects of subject,object,content,and path.In terms of the subject of social support,the government should play a leading role,guide social organizations to participate in an orderly manner,improve the content of community mental health services,give play to the spiritual mutual assistance of the community and neighbors,and introduce family support policies and social welfare forces.In terms of objects of social support,it is necessary to respect the mental health service demands of the disabled elderly,aim at the needs of the disabled elderly group,give play to the subjective initiative of the disabled elderly,and achieve self-adjustment of mental health.In terms of content of social support,it integrates resources and enriches content.In terms of pathways of social support,use the smart community information service platform to comprehensively coordinate the responsibilities of multiple service entities to form a relatively complete community-based social support system for the mental health of disabled older adults living in community-dwelling.The innovations of this article are as follows: First,the research framework innovation.Constructed a new theoretical analysis framework for disabled older adults living in community-dwelling to explore the impact of social support on the mental health of disabled elderly;and analyzed social support and mental health under different levels of disability,gender,age,and urban and rural groups The influence of the relationship.The second is the innovation of research content.To verify the impact of formal social support on the mental health of disabled older adults living in community-dwelling,and explore the construction of a new type of community mental health society for elderly disabled at home in which the subject of formal and informal social support effectively collaborates with subjects,objects,content and paths Support system.The third is that research discovers innovation.The cognitive function scores of disabled older adults living in community-dwelling with adult children’s service support are low,and there is a phenomenon of "use advancement and abandonment retreat".Regression based on the group of disability,gender,age,and urban-rural grouping found that semi-disabled,rural,female and senior-aged disabled older adults have lower cognitive function scores when they enjoy adult children’s service support.The complete disability and female disability seniors have higher depressive symptoms scores when they have pension insurance.