Helping Homebound Older Adults with Moderate to Severe Depression Subject of New University of Texas at Austin School of Social Work Study

A University of Texas at Austin School of Social Work researcher has received a $680,000 National Institute of Mental Health award to study the feasibility of a telehealth problem-solving treatment (PST) for homebound older individuals suffering from depression.

The short-term structured PST focuses on teaching and strengthening problem-solving coping skills for older adults in the Austin area.

"An easy access to low-cost videoconferencing tools is providing health providers the potential to meet the needs of this underserved population," said Dr. Namkee Choi, a gerontologist who specializes in late life depression research. "With the current and projected shortage in mental health workforce to meet the needs of an increasing number of homebound older adults, we need to test the feasibility and cost-effectiveness of depression treatment via videoconferencing."

Choi found that 17.3 percent of 762 homebound older adults who were screened for depression by the case managers of the Meals on Wheels and More program in Austin had clinically significant depressive symptoms and 8.4 percent of them had probable major depressive disorder.

"These rates are significantly higher than those among older adults in general," Choi said. "However, only a few depressed homebound older adults reported that they received any psychotherapy."

Social isolation imposed by chronic illness and functional limitations makes homebound individuals more vulnerable to depression than their mobility-unimpaired peers, Choi said. Their homebound state is a barrier to their receiving appropriate depression treatment.

The study will compare three groups of participants 50 years old and over totaling 100 for the next two years: those participating in telehealth PST (tele-PST), those participating in traditional in-person PST and those who will receive telephone support and monitoring. Tele-PST will be conducted through video calls initiated by the project's two therapists.

"The approach is likely to allow the therapist and the client most of the benefits of in-person sessions," said Choi. Both tele-PST and in-person PST will be provided by two licensed master's-level social workers, Mary Lynn Marinucci and Leslie Sirrianni.

Choi's collaborators for the project include geriatric depression researchers from Cornell Weil Medical School, Dartmouth Medical School, Baylor Medical School and the University of Pennsylvania Medical School. Dr. Martita Lopez of the Department of Psychology also is a consultant.
The Austin community partners for the project are the Meals on Wheels and More, Family Eldercare, Helping the Aging, Needy and Disabled, the Capital Area Agency on Aging and the St. David's Community Health Foundation.