Community delivery of brief therapy for depressed older adults impacted by Hurricane Sandy.

TitleCommunity delivery of brief therapy for depressed older adults impacted by Hurricane Sandy.
Publication TypeJournal Article
Year of Publication2020
AuthorsSirey JAnne, Raue PJ, Solomonov N, Scher C, Chalfin A, Zanotti P, Berman J, Alexopoulos GS
JournalTransl Behav Med
Volume10
Issue3
Pagination539-545
Date Published2020 08 07
ISSN1613-9860
Abstract

Older adults frequently under-report depressive symptoms and often fail to access services after a disaster. To address unmet mental health needs, we developed a service delivery program (SMART-MH) that combines outreach, assessment, and therapy and implemented it in New York City after Hurricane Sandy. This study aimed to examine the feasibility, effectiveness, and patients' engagement of our brief psychotherapy ("Engage"). We predicted that Engage would result in reductions of depression, and that the benefits would be comparable to those of a historical comparison group who received Engage in a controlled experimental setting. A total of 2,831 adults (age ≥ 60) impacted by Hurricane Sandy were screened for depression. Assessments and therapy were conducted in English, Spanish, Cantonese, and Russian. Depressed individuals (PHQ-9 ≥ 10) who were not in treatment were offered Engage therapy in their native language at local senior center/nutrition sites. Twelve percent of the participants reported depression (N = 333). Of these 333 participants, 201 (60%) were not receiving treatment and 143 agreed to receive Engage therapy. Linear mixed-effects model showed that depression severity decreased significantly over time. More than two thirds had a five-point reduction in PHQ-9 scores and post-treatment scores ≤9. Post-hoc comparison of standardized slopes of change found patterns of depression reductions equivalent to Engage provided in a controlled setting. Partnerships to integrate mental health care into community settings can increase detection of mental-health needs and access to services in patients' native language. Brief reward exposure-based psychotherapy delivered in the community can provide comparable benefits to those achieved in research settings.

DOI10.1093/tbm/ibz145
Alternate JournalTransl Behav Med
PubMed ID32766863
PubMed Central IDPMC7529042
Grant ListP50 MH113838 / MH / NIMH NIH HHS / United States
R01 MH102252 / MH / NIMH NIH HHS / United States
T32 MH019132 / MH / NIMH NIH HHS / United States