Although older women have been identified as utilizing the mental health care system more than older men, they account for a small percentage of mental health care use (NCHS, 1987a, 1987b). Little is known about how older women take care of their mental health, including help-seeking.

This qualitative research study was conducted to explore how older women take care of their mental health. The grounded theory approach, employing partially structured interviews, was used to collect and analyze data. All interviews were taped and transcribed. The constant comparative method was used to generate substantive theory about how older women define and manage their mental health. The subjects of this study were 30 community living women ages 55-86 who resided in two areas: San Francisco Bay area and a rural Wisconsin area.

A grounded theory of EMOTIONAL REFERENCING emerged as the process that these older women used to define and manage their mental health. EMOTIONAL REFERENCING is a three-step process of comparing, defining, and managing. During the comparing step, the older woman compares her present mental health with her own prior experiences and the experiences of others. This intrapersonal and interpersonal comparing serves to find affective, cognitive, and behavioral reference points on which to define her mental health. It is at the defining step that the older woman defines her mental health in one of three phases. Depending on the phase, the woman then identifies strategies that she can use to maintain or improve her mental health. These strategies include activities she can do alone or to get help. Biographical and situational conditions influence the process of EMOTIONAL REFERENCING, while other conditions influence the management of mental health.

Findings of this study indicate that older women: (a) use a process to define and manage their mental health, (b) have a different definition for mental health than for mental illness, (c) define mental health differently than professionals do, (d) perceive mental health as regularly fluctuating, and (e) most often manage their mental health alone, without seeking professional help.