Increasing Use of Mental Health Services

NCT ID: NCT00605358

Last Updated: 2017-03-03

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: NA
• Total Enrollment: 161 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2007-08-31
• Study Completion Date: 2015-01-31

Brief Summary

The purpose of this study is to test the effectiveness of Open Door (previously known as the Treatment Initiation Program [TIP]), a brief psychosocial intervention to address the psychological barriers to care and improve the use of mental health services by depressed community elderly. The intervention is designed to help the older adult identify the barriers, problem-solve to find solutions and mobilize the motivation to seek help. Open Door was developed to work collaboratively with an older adult who is depressed to improve access and adherence to mental health treatment.

Detailed Description

The primary aim of this research study did not change from the original application; it is to conduct a randomized controlled trial of the effectiveness of a brief, psychosocial intervention on engagement in mental health care among homebound depressed older adults. Engagement is defined as accepting a referral and attending a visit with a provider who could provide traditional mental health care (medication or psychotherapy). The intervention, now called Open Door, was developed to work collaboratively with an older adult who has depressive symptoms to address the barriers to care with the aim of helping them consider a referral and engage in mental health care. In prior research, this intervention has been found to improve treatment participation, reduce depressive symptoms and increase adherence to antidepressant therapy among depressed older adults in primary care and outpatient psychiatric settings. We propose that Open Door will improve the access to mental health care by reducing psychological barriers, providing education about care, and managing the resignation associated with the symptoms of depression among community dwelling depressed elders. Additionally, we believe that despite the heterogeneity of mental health care that may be received, Open Door will be associated with reduced depressive symptoms by empowering the older adult to initiate care for him/herself.

Conditions

Major Depression

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: SUPPORTIVE_CARE
• Blinding Strategy: SINGLE

Study Groups

Open Door Intervention

Subjects who receive the Open Door Intervention will work with the study counselor to identify barriers to participation in mental health treatment, set goals, and problem-solve, in addition to receiving a referral.

Group Type: ACTIVE_COMPARATOR

Open Door intervention

Intervention Type: BEHAVIORAL

Open Door intervention subjects will:

1. receive an evaluation

2. receive a referral to a local mental health provider

3. identify barriers, set goals and problem-solve to achieve a mental health evaluation using available resources.

Services Referral

Subjects who do not receive the Open Door intervention will receive:

1. an evaluation

2. referral to a local mental health provider

3. booklet information on depression and mental health care, and will complete an application for HEAP, a Westchester County service that provides reduced rates from oil companies on heating to seniors.

Group Type: NO_INTERVENTION

No interventions assigned to this group

Interventions

Open Door intervention

Open Door intervention subjects will:

1. receive an evaluation

2. receive a referral to a local mental health provider

3. identify barriers, set goals and problem-solve to achieve a mental health evaluation using available resources.

Intervention Type: BEHAVIORAL

Other Intervention Names

West group

Eligibility Criteria

Inclusion Criteria

• Age 60 years and older
• Homebound
• Endorse depressive symptoms

Exclusion Criteria

• Presence of significant alcohol or substance abuse or psychotic disorder
• High suicide risk, i.e. intent or plan to attempt suicide
• Cognitive impairment
• Inability to speak English
• Aphasia interfering with communication.
• Current use of antidepressants or psychotherapy

• Minimum Eligible Age: 60 Years
• Maximum Eligible Age: 90 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Weill Medical College of Cornell University

OTHER

Sponsor Role: lead

Responsible Party

Jo Anne Sirey

Associate Professor

Responsibility Role: PRINCIPAL_INVESTIGATOR

Principal Investigators

Jo Anne Sirey, Ph.D.

Role: PRINCIPAL_INVESTIGATOR

Weill Medical College of Cornell University

Locations

Weill Cornell Medical College

White Plains, New York, United States

Countries

United States

References

Sirey JA, Bruce ML, Alexopoulos GS. The Treatment Initiation Program: an intervention to improve depression outcomes in older adults. Am J Psychiatry. 2005 Jan;162(1):184-6. doi: 10.1176/appi.ajp.162.1.184.

Reference Type: BACKGROUND

PMID: 15625220 (View on PubMed)

Other Identifiers

R01MH079265-01A1

Identifier Type: NIH

Identifier Source: org_study_id

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