Very few studies focused on racial/ethnic minority populations. ages, major depression in older adults will be an increasing concern that has significant public health implications.
Models of geriatric service delivery are highlighted and implications for ethnic minority older adults are discussed in light of health care reform. More than 20 % of older adults in hospital and institutional long term care settings experience significant depressive symptoms while 5–15 % of older adults living in the community present with signs of depression .
A review of home health-based interventions reported positive results from a series of problem solving-based intervention studies with home health professionals and patients .
For example, home care nurses improved their identification of depression through the Training in the Assessment of Depression program.
We then reviewed the titles and abstracts to identify service-oriented intervention studies, and exclude studies that focused on the effectiveness of pharmacotherapy or reported on population-based surveys.
This review yielded 27 articles; of these, 21 were included for analysis in this paper.The authors identified Problem Solving Therapy (PST), Cognitive Behavioral Therapy (CBT), and the Treatment Initiation and Participation (TIP) to be of demonstrated efficacy with one RCT showing improvement on depression outcomes in relation to the control group.Each of these approaches is likely to be efficacious pending replication by additional independent investigators.Currently, depression in older adults is treated mainly in primary care or home-based settings, as opposed to specialty mental health settings.These care settings do not always take into consideration the influence of the social context of service delivery on service use.Moreover, studies that examine the models used to deliver mental health services have been limited.In light of an aging and diversifying population, this article reviews current depression interventions for older adults in non-mental health clinics.Studies examining the effects of race, culture, and ethnicity on mental health status and service utilization suggest that the current mental health system under-serves racial and ethnic minority groups , but not enough research has been done on older adults.In light of population aging and the growing diversity among older adults, the development of effective and culturally appropriate interventions is critical in addressing the health and mental health disparities affecting minority older adults.Of the articles included in this review, five presented findings from meta-analyses or systematic reviews irrespective of location (n = 5).The remaining depression intervention articles were categorized by setting: primary care, home-based, or community-based.