Despite the benefits of treatment for late-life depression, underutilization of mental health services by older adults and nonadherence to offered interventions exist. This article describes psychosocial and interactional barriers and facilitators of treatment engagement among depressed older adults served by community health care settings. The authors describe the need to engage older adults in treatment using interventions that: (1) target psychological barriers such as stigma and other negative beliefs about depression and its treatment; and (2) increase individuals' involvement in the treatment decision-making process. Personalized treatment engagement interventions designed by the authors' group for various community settings are presented.