Reducing Barriers to Mental Health Care: Bringing Evidence-Based Psychotherapy Home.
Aged
Aged, 80 and over
Aging
/ psychology
Anxiety
/ therapy
Caregivers
/ psychology
Dementia
/ therapy
Depression
/ therapy
Evidence-Based Practice
/ organization & administration
Geriatrics
/ methods
Health Services Accessibility
/ organization & administration
Humans
Middle Aged
Outcome Assessment, Health Care
/ statistics & numerical data
Program Evaluation
Psychotherapy
/ methods
Quality of Life
access
depression
geriatrics
Journal
Journal of the American Geriatrics Society
ISSN: 1532-5415
Titre abrégé: J Am Geriatr Soc
Pays: United States
ID NLM: 7503062
Informations de publication
Date de publication:
10 2019
10 2019
Historique:
received:
27
02
2019
revised:
24
06
2019
accepted:
26
06
2019
pubmed:
26
7
2019
medline:
26
5
2020
entrez:
26
7
2019
Statut:
ppublish
Résumé
Barriers to treatment for depression and anxiety are prevalent among older adults and caregivers living in the community. We designed and implemented an evidence-based psychotherapy program to reduce obstacles to care. A practice improvement initiative providing no-fee evidence-based mental health care at home in clients' primary languages. Independence at Home, a community service of SCAN Health Plan in Southern California. Diverse older adults and adult caregivers of older people with age-related disability (mainly dementia). Redesign of an existing supportive counseling program to improve access to validated models of psychotherapy for depression and anxiety. We describe program content, phases of development, equity in participation from referral to program completion, clinical outcomes, and estimated direct program delivery costs. Insights successfully served demographically diverse clients experiencing a broad range of barriers to mental health care. A total of 211 clients completed therapy using one of three evidence-based approaches in the first 33 months of operation (2015-2018). Clinical efficacy was high and equivalent across demographic groups and therapy models. Depression, anxiety, quality of life, self-rated disability, and patient activation all improved significantly. We supported therapists' transition to the new model, modified workflows, and used clinical outcome data and therapist focus groups to improve referral, selection, and enrollment processes and simplify treatment assignment. With program maturation, treatment duration and direct costs both declined. The Insights model could add value to healthcare organizations seeking to provide effective, equitable mental health services for older adults and caregivers who have difficulty accessing care for depression, anxiety, or difficult life challenges. J Am Geriatr Soc 67:2174-2179, 2019.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
2174-2179Subventions
Organisme : SCAN Health Plan
ID : n/a
Pays : International
Informations de copyright
© 2019 The American Geriatrics Society.
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