Developing a community-based psycho-social intervention with older people and third sector workers for anxiety and depression: a qualitative study

Abstract

BackgroundOne-in-five people in the UK experience anxiety and/or depression in later life. However, anxiety and depression remain poorly detected in older people, particularly in those with chronic physical ill health. In the UK, a stepped care approach, to manage common mental health problems, is advocated which includes service provision from non-statutory organisations (including third/voluntary sector). However, evidence to support such provision, including the most effective interventions, is limited. The qualitative study reported here constitutes the first phase of a feasibility study which aims to assess whether third sector workers can deliver a psychosocial intervention to older people with anxiety and/or depression. The aim of this qualitative study is to explore the views of older people and third sector workers about anxiety and depression among older people in order to refine an intervention to be delivered by third sector workers.MethodsSemi-structured interviews with participants recruited through purposive sampling from third sector groups in North Staffordshire. Interviews were digitally recorded with consent, transcribed and analysed using principles of constant comparison.ResultsNineteen older people and 9 third sector workers were interviewed. Key themes included: multiple forms of loss, mental health as a personal burden to bear, having courage and providing/receiving encouragement, self-worth and the value of group activities, and tensions in existing service provision, including barriers and gaps.ConclusionsThe experience of loss was seen as central to feelings of anxiety and depression among community-dwelling older people. This study contributes to the evidence pointing to the scale and severity of mental health needs for some older people which can arise from multiple forms of loss, and which present a significant challenge to health, social care and third sector services. The findings informed development of a psychosocial intervention and training for third sector workers to deliver the intervention.

Supporting frail older people with depression and anxiety: a qualitative study

“…Management of anxiety in frail older people has frequently been neglected in research, despite evidence suggesting comorbid anxiety impacts negatively upon treatment outcomes in late-life depression (Tunvirachaisakul et al, 2018). Participants in our study were much less likely to seek support or medical advice for anxiety symptoms, which reflects the difficulty recognising anxiety and the reluctance to discuss it found in other qualitative studies of older people with anxiety (Kingstone et al, 2017;Knight & Winterbotham, 2019). It may be that there is less public discourse relating to anxiety than depression which older people can use to explain and legitimise their feelings, although a few were comfortable describing their symptoms as 'anxiety'.…”

The influences of family interaction and spiritual well-being on anxiety and depression among older adults in the United States

“…The symptoms of depression and anxiety are often accompanied by physical illnesses, deterioration of body function, and loss of self-confidence, social status, low selfacceptance and respect, which can lead to the feelings of low selfesteem, unhappiness and depression [3] . The experiences of loss, chronic disease, disability and bereavement are important risk factors for anxiety and depression in older adults [4,5] . It is estimated that 20% of people age 55 years or older experience some type of mental health concern [6] .…”

Research on Supportive Psychosocial, Drug Treatment, and Health Education Intervention and Health Management Model of Community-Residing Elderly Adults With Late Life Depression in Liaoning Province: A Protocol

“…Given the different causes, courses, and clinical manifestations of LLD, the treatment response of antidepressants varies. Evidence from literature reviews on depressive disorders indicates that comprehensive psychosocial intervention can effectively make up for the shortcomings of single drug treatments, while improving therapeutic effect (41). Our study regards community-residing elderly adults with LLD as the research subjects, unlike previous studies, which were restricted to inpatients or discharged patients.…”