Mental Illness and Aging
Depression is a serious problem among senior citizens. According to the National Institutes of Health, approximately 2 million adults aged 65 and older suffer from full-blown depression, and another 5 million suffer from less severe forms of the illness. Unfortunately, depression symptoms are often overlooked by clinicians or may be attributed to the aging process.
Building upon a prior study that focused only on nursing home residents, the state Executive Office of Elder Affairs asked UMass Medical School's Center for Health Policy and Research to evaluate the depression screening process among MassHealth members and recommend improvements. Researchers had several goals for the study:
- Determine the percentage of study site clients screened for depression who score positive for depression symptoms and warrant further clinical depression assessment.
- Conduct a process evaluation to identify staff and client responses to the depression screening process.
- Determine what treatment for depression clients were receiving. For clients treated with antidepressants, determine whether pharmacological treatment is consistent with elder treatment guidelines.
- Recommend a depression screening protocol for Aging Services Access Point (ASAP) vendors.
The results of the two-year project highlighted the extent of depression among the elderly:
- Nearly 50 percent of the clients in the study were diagnosed with depression.
- More than 70 percent of those diagnosed with depression were being treated with anti-depressant medications. Treatment dosages were overwhelmingly in line with national standards.
- Use of depression screening tools was inconsistent among various sites and staff. A standardized depression toolkit is needed for all steps of the screening process.