An Innovative Model of Depression Care Delivery: Peer Mentors in Collaboration with a Mental Health Professional to Relieve Depression in Older Adults

Abstract

Objectives Traditional mental health services are not used by a majority of older adults with depression, suggesting a need for new methods of health service delivery. We conducted a pilot study using peer mentors to deliver depression care to older adults in collaboration with a mental health professional. We evaluated the acceptability of peer mentors to older adults and examined patient experiences of the intervention. Methods Six peer mentors met 30 patients for 1 hour weekly for 8 weeks. A mental health professional provided an initial clinical evaluation as well as supervision and guidance to peer mentors concurrent with patient meetings. We measured depressive symptoms at baseline and after study completion, and depressive symptoms and working alliance at weekly peer-patient meetings. We also interviewed participants and peer mentors to assess their experiences of the intervention. Results Ninety-six percent of patients attended all eight meetings with the peer mentor and PHQ-9 scores decreased for 85% of patients. Patients formed strong, trusting relationships with peer mentors. Patients emphasized the importance of trust, of developing a strong relationship, and of the credibility and communication skills of the peer mentor. Participants described benefits such as feeling hopeful, and reported changes in attitude, behavior, and insight. Conclusions Use of peer mentors working in collaboration with a mental health professional is promising as a model of depression care delivery for older adults. Testing of effectiveness is needed and processes of recruitment, role definition, and supervision should be further developed.

Effectiveness of peer counseling, social engagement, and combination interventions in improving depressive symptoms of community-dwelling Filipino senior citizens

“…The instruments used in this study were described in detail in previous research [18,32,40]. We followed the WHO's guideline for the process of translation and adaptation of instruments [41].…”

“…reported in the USA [18], and we adopted and modified it in our study using various health providers. Social engagement also improved the mental health outcomes of Filipino senior citizens.…”

“…Both the peer counseling and social engagement programs were well accepted by the senior citizens as exemplified by the low dropout rates across the three intervention groups and by the positive ratings obtained from the survey. We adopted an innovative model of depression care delivery [18] and proved that collaboration among academic, social welfare and health sectors in coordinating care is feasible in a low-resource setting.…”

“…To our knowledge, this is the first intervention study that evaluated the effects of peer counseling, social engagement, and combined intervention concurrently in improving depressive symptoms of community-dwelling senior citizens. A few intervention studies have evaluated peer counseling [16][17][18] or social engagement [19] singly, without differentiating their individual effects.…”

“…Based on existing literature, peer counseling and social engagement were found to be effective in alleviating depressive symptoms and improving the quality of life of community-dwelling senior citizens [16][17][18][19]. Peer counseling contributes to a positive social context that is necessary for recovering from mental disorders [20].…”