Engaging Depressed Low-Income Seniors in Mental Health Services

NCT01094951 | Completed

• 2 other identifiers: P30MH085943-03P30MH085943
• Study Type: interventional
• Target: 12
• Locations: 0 countries
• Sites: N/A

Brief Summary

This two-stage research study will

1. 1.train caseworkers in three participating New York City Neighborhood Houses to screen their clients for depression, and
2. 2.examine the usefulness of training these caseworkers in an intervention that targets barriers seniors face in receiving mental health services. In this intervention, called ENGAGE, Case Workers will: 1. identify and address seniors' barriers to receiving mental health services; 2. include the seniors' preferences in deciding which treatment options to choose; and 3. help seniors connect with affordable mental health services of their choice.

Conditions

Depression

Keywords

Depression

Outcome Measures

Primary Outcomes (1)

• Feasibility of ENGAGE intervention

  Examine the feasibility of training case workers in 3 Neighborhood Houses in ENGAGE - an intervention that identifies and addresses attitudinal and concrete barriers to pursuing evaluation and care; incorporates shared decision making in service and treatment options; and facilitates connection to affordable mental health services.

  Measured at Baseline, 4, 8, and 12 weeks

Secondary Outcomes (1)

• Increase in referrals for mental health evaluation

  Measured at Baseline, 4, 8, and 12 weeks

Study Arms (1)

ENGAGE

OTHER

In stage 1, study investigators will train Neighborhood House caseworkers to screen their clients for depressive symptoms. In stage 2, study investigators will train Neighborhood House caseworkers to use the ENGAGE intervention in referring their clients to mental health services

Behavioral: ENGAGE

Interventions

ENGAGE BEHAVIORAL

During Stage 2, investigators will train Neighborhood House caseworkers to 1. provide psychoeducation that addresses client-specific barriers to evaluation and care; 2. use shared decision-making strategies to engage seniors and arrive at a decision about where and from whom to receive an evaluation and possible care; and 3. provide connections to preferred community-based mental health services.

ENGAGE

Eligibility Criteria

• Age: 60 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Age 60 years and older.
• Positive screen for major depression (PHQ-9 greater than 10): We chose standard PHQ-9 screening to correspond to routine procedures within each House that identify seniors in need of evaluation for treatment.
• Capacity to provide written consent for both research assessment and treatment. This criterion is necessary because subjects must be able to participate meaningfully in the interventions offered by the study and the assessment procedures.
• Working knowledge of English. Fluency in English sufficient for comprehending questionnaires of the study and/or for understanding the case worker. English does not have to be the subject's first language.

You may not qualify if:

• MMSE score \< 24 or clinical diagnosis of dementia. Dementia, or cognitive impairment at this level may limit the senior's ability to participate in the intervention.
• Psychotic or manic symptoms or alcohol or substance dependence. These symptoms and disorders will be determined by the SCID assessment and require alternative interventions than those offered by the study. We focus in this project on seniors with depressive symptoms given existing Neighborhood House procedures for standard depression screening, and given difficulties in training case worker staff on screening for other psychiatric disorders. If this project is successful, we may then expand our efforts to target other disorders such as psychotic, manic, and alcohol and substance abuse and dependence disorders.
• Antidepressant medication or psychotherapy in the 4 weeks prior to baseline evaluation. The intervention is focused on linking depressed seniors who are in need of mental health services rather than those currently receiving treatment.
• Acute or severe medical illness: i.e., delirium, metastatic cancer, decompensated cardiac, liver or kidney failure, major surgery, stroke or myocardial infarction during the three months prior to entry; or drugs often causing depression, e.g., steroids, reserpine, alpha-methyl-dopa, tamoxifen, vincristine.
• Antisocial personality by DSM-IV: This disorder will possibly interfere with adherence to research procedures and treatment.

Sponsors & Collaborators

• Weill Medical College of Cornell University: lead
• National Institute of Mental Health (NIMH): collaborator

MeSH Terms

Conditions

Depression

Interventions

engage 8200

Condition Hierarchy (Ancestors)

Behavioral Symptoms; Behavior

Study Officials

• Patrick J. Raue, Ph.D.

  Weill Medical College of Cornell University

  PRINCIPAL INVESTIGATOR

• George S. Alexopoulos, M.D.

  Weill Medical College of Cornell University

  STUDY DIRECTOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NA
• Masking: NONE
• Purpose: OTHER
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: March 26, 2010
• First Posted: March 29, 2010
• Study Start: March 1, 2010
• Primary Completion: April 1, 2015
• Study Completion: April 1, 2015
• Last Updated: November 8, 2017

Record last verified: 2017-11

Data Sharing

• IPD Sharing: Will not share