A Systematic Review of the Effectiveness of Community-Based Mental Health Outreach Services for Older Adults

Citters, Aricca D. Van; Bartels, Stephen J.

doi:10.1176/appi.ps.55.11.1237

Cited by 60 publications

(48 citation statements)

References 37 publications

(59 reference statements)

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“…The benefit is even greater if the program targets individuals at risk of, suffering from, or recovering from depression [46]; incorporates clinician education [26,45,47]; and involves an enhanced role for the nurse [45,48], proactive follow-up and outcomes monitored by a care manager, enhanced IP communication, and integration between primary and specialist mental healthcare services [48-50]. These conclusions have been substantiated by systematic reviews and meta-analyses of many randomized controlled trials (RCTs) [32,45,51-53] and by consensus panels of experts who have developed evidence-based practice guidelines for the prevention, detection, and management of depression [9,26,54-56]. …”

Section: Introductionmentioning

confidence: 99%

An interprofessional nurse-led mental health promotion intervention for older home care clients with depressive symptoms

et al. 2014

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BackgroundDepressive symptoms in older home care clients are common but poorly recognized and treated, resulting in adverse health outcomes, premature institutionalization, and costly use of health services. The objectives of this study were to examine the feasibility and acceptability of a new six-month interprofessional (IP) nurse-led mental health promotion intervention, and to explore its effects on reducing depressive symptoms in older home care clients (≥ 70 years) using personal support services.MethodsA prospective one-group pre-test/post-test study design was used. The intervention was a six-month evidence-based depression care management strategy led by a registered nurse that used an IP approach. Of 142 eligible consenting participants, 98 (69%) completed the six-month and 87 (61%) completed the one-year follow-up. Outcomes included depressive symptoms, anxiety, health-related quality of life (HRQoL), and the costs of use of all types of health services at baseline and six-month and one-year follow-up. An interpretive descriptive design was used to explore clients’, nurses’, and personal support workers’ perceptions about the intervention’s appropriateness, benefits, and barriers and facilitators to implementation.ResultsOf the 142 participants, 56% had clinically significant depressive symptoms, with 38% having moderate to severe symptoms. The intervention was feasible and acceptable to older home care clients with depressive symptoms. It was effective in reducing depressive symptoms and improving HRQoL at six-month follow-up, with small additional improvements six months after the intervention. The intervention also reduced anxiety at one year follow-up. Significant reductions were observed in the use of hospitalization, ambulance services, and emergency room visits over the study period.ConclusionsOur findings provide initial evidence for the feasibility, acceptability, and sustained effects of the nurse-led mental health promotion intervention in improving client outcomes, reducing use of expensive health services, and improving clinical practice behaviours of home care providers. Future research should evaluate its efficacy using a randomized clinical trial design, in different settings, with an adequate sample of older home care recipients with depressive symptoms.Trial registrationClinicaltrials.gov identifier: NCT01407926.

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Section: Introductionmentioning

confidence: 99%

An interprofessional nurse-led mental health promotion intervention for older home care clients with depressive symptoms

et al. 2014

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“…A systematic review, however, found support for the positive effects of outreach services. 522 This is clearly an area for development. There is also a paucity of comparisons of needs among older and younger persons with serious mental illnesses, and of longitudinal research investigating how needs change over time.…”

Section: Individuals In Need Of Daily Living Assistance or Social Skimentioning

confidence: 99%

Directions for Future Patient-Centered and Comparative Effectiveness Research for People With Serious Mental Illness

Green¹,

Estroff²,

Yarborough³

et al. 2014

Schizophrenia Bulletin

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“…Overall, only 10% of older adults with mental health conditions receive appropriate services (Eden, Maslow, Le, & Blazer, 2012). In contrast, the effectiveness of community-based mental health interventions for depression in older adults is supported by numerous randomized trials (Bartels et al, 2003; Bruce, Van Citters, & Bartels, 2005; Van Citters & Bartels, 2004). For example, PEARLS (the Program to Encourage Active, Rewarding Lives for Seniors) has been shown to reduce depressive symptoms and has been successfully implemented in community-based settings (Ciechanowski et al, 2004; Steinman, Cristofalo, & Snowden, 2012).…”

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confidence: 99%

A Multi-Stakeholder Process to Transform a Community-based Screening and Referral Program to Implement Evidence-Based Depression Care

Pepin

Hoyt

Seifert

et al. 2016

Journal of Evidence-Informed Social Work

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Background Screening and referral for geriatric depression by service agencies is associated with poor treatment engagement indicating the need to transform services to directly provide depression care. Objective To describe a multi-organization workgroup implementation planning process used to transform a community-based screening and referral program to provide a brief evidence-based intervention for older adults with depressive symptoms. Methods An iterative implementation procedure use by a multi-stakeholder group that selected an evidence-based practice, planned implementation rollout, planned counselor training, and designed an implementation evaluation. Results The workgroup successfully followed the implementation procedure and developed a plan for the implementation of an evidence-based intervention. Overall, the workgroup prioritized decisions that favored feasibility and low implementation burden. Conclusion A multi-organization workgroup can benefit from a semi-structured implementation planning procedure because it provides all stakeholders with a shared roadmap for implementation planning.

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A Systematic Review of the Effectiveness of Community-Based Mental Health Outreach Services for Older Adults

Cited by 60 publications

References 37 publications

An interprofessional nurse-led mental health promotion intervention for older home care clients with depressive symptoms

An interprofessional nurse-led mental health promotion intervention for older home care clients with depressive symptoms

Directions for Future Patient-Centered and Comparative Effectiveness Research for People With Serious Mental Illness

A Multi-Stakeholder Process to Transform a Community-based Screening and Referral Program to Implement Evidence-Based Depression Care

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