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Healthy IDEAS

A Depression Intervention Delivered by Community-Based Case Managers Serving Older Adults

Houston Center for Quality of Care & Utilization Studies Michael E. DeBakey Veterans Affairs Medical Center Baylor College of Medicine

Melinda A. Stanley

Houston Center for Quality of Care & Utilization Studies Michael E. DeBakey Veterans Affairs Medical Center Baylor College of Medicine

Nancy J. Petersen

Houston Center for Quality of Care & Utilization Studies Michael E. DeBakey Veterans Affairs Medical Center Baylor College of Medicine

Banghwa Lee Casado

University of Maryland, Baltimore

Esther H. Steinberg

Care for Elders, Sheltering Arms Senior Services, Houston

Jeffrey A. Cully

Houston Center for Quality of Care & Utilization Studies Michael E. DeBakey Veterans Affairs Medical Center Baylor College of Medicine

Nancy L. Wilson

Houston Center for Quality of Care & Utilization Studies Michael E. DeBakey Veterans Affairs Medical Center Baylor College of Medicine, nwilson{at}bcm.edu

This study evaluated an evidence-based intervention for depression delivered by case managers in three community-based service agencies to high-risk, diverse older adults. Case managers were trained to provide screening and assessment, education, referral and linkage, and behavioral activation. Outcomes addressed depression, general health status, social and physical activation, and mental health services use at baseline and 6 months. Participants (n = 94) were predominantly women (79%) and Hispanic (44%), with a mean age of 72 years. Mean Geriatric Depression Scale—15 scores differed significantly between baseline and 6 months (9.0 versus 5.5). At 6 months, significantly more participants knew how to get help for depression (68% versus 93%), reported that increasing activity helped them feel better (72% versus 89%), and reported reduced pain (16% versus 45 %). The authors conclude that nonspecialty providers can be trained to successfully implement an evidence-based self-management intervention for depression with frail, high-risk, and diverse older adults.

Key Words: depression • community-based • case managers • evidence-based

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