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Effective care for older people with depression

Posted on 9 September 2011

The UK's largest ever study into the primary care of older people with depression is being carried out by researchers at the University of York.

Under the £1.6 million CASPER project, the York Mental Health Research Group – a partnership between the University’s Department of Health Sciences and the Hull York Medical School – is examining the effectiveness of screening and psychological treatments for people aged over 75 with depression.

People sometimes see unhappiness and clinical depression as an inevitable consequence of growing old

Dr Dean McMillan

The treatments have been specially adapted to address social isolation and physical health problems common in older people and do not require hospital referral, with people remaining under the care of their general practitioner.

Depression is directly targeted by identifying older people with symptoms of depression and offering brief evidence-based psychological treatment delivered by York-trained psychological wellbeing practitioners over the telephone.

The five-year CASPER study is funded by the National Institute for Health Research Health Technology Assessment programme and involves the York Mental Health Research Group, the York Trials Unit at the University of York and academics from the Universities of Leeds and Durham.   

Dr Dean McMillan from the University of York’s Department of Health Sciences and the Hull York Medical School helped design the treatment programme. He said: “Depression is very common in older people and often goes untreated. People sometimes see unhappiness and clinical depression as an inevitable consequence of growing old. This is unfortunate as in many cases effective treatments exist.

“In the CASPER project we have developed a treatment that can be offered over the phone which directly targets depression in older people.”

Dr Helen Lewis from the University’s Department of Health Sciences manages the trial. She said: “We have now trained therapists to deliver this intervention and we began recruiting participants to CASPER in June. People registered with GP practices in York have been the first to be offered the chance to participate in the trial.

“Later this year, the trial will be rolled out in Leeds and the North East as we need to recruit 450 people to test whether the treatment offers significant benefit in reducing depression symptoms and improving people’s quality of life.”

The Mental Health Research Group at York researches into common mental health problems such as depression, anxiety and obsessive compulsive disorder (OCD). It is directed by Professor Simon Gilbody, who is also leading the CASPER project.

He said: “These disorders are disabling and often go unrecognised and under-treated, particularly in older people. As a group we look into the causes, consequences and treatments for these conditions, focusing on brief psychological treatments which can be delivered over the telephone, via computer or in the GP surgery. This is one of several publicly-funded trials which we have been commissioned to undertake on behalf of the NHS into common mental health problems.

“We are keen to expand the range of psychological and social interventions offered in the NHS, but only if they are shown to be effective and good value for money. Therefore as part of any project we work very closely with colleagues at the University in the York Trials Unit and the Centre for Health Economics.” 

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