Change in Depression Severity Among Depressed Older Crime Victims.

The crime rates in urban centers are rising. The psychological impact of crime can range from distress to longstanding mental health impairment. Despite the rising crime rates and psychological impact on victims, little research has been conducted on older adult crime victims' mental health. In this manuscript we describe the profile of older adult crime victims in New York City referred for mental health services, their rates of depression, and the preliminary outcome data from a brief therapy intervention (PROTECT) targeting depression among victims. Building on prior research demonstrating the efficacy of PROTECT for depressive symptom reduction in elder abuse victims, the present study hypothesized elder crime victims who completed PROTECT therapy would demonstrate clinically meaningful depression symptom reduction as measured by the Patient Health Questionnaire-9 (PHQ-9). Additionally, it was hypothesized that these clinically significant depression symptom reductions would be demonstrated regardless of sex, gender, victimization type, victimization frequency, or living status. The results demonstrate that 67.7% (21/31) of participants had a clinically significant reduction in PHQ-9 scores (≥5 points) upon completion of PROTECT. There were no significant group differences in clinically significant depression symptom reduction, suggesting that PROTECT is an effective intervention for a diverse sample of elder crime victims. Future research should focus on the mental health impact of crime against older adults and explore reductions in anxiety and PTSD symptoms among crime victims. Through our partnerships we aim to bridge the divide between victim service providers, and mental health service providers to assist victims to recover, heal, and thrive.

Improved outcomes for depressed elder abuse victims with video-delivered psychotherapy during COVID-19.

OBJECTIVE: There is a lack of evidence-based scalable therapies for elder abuse victims, with no current remotely delivered tailored psychotherapy. The purpose of this manuscript is to (a) examine the effectiveness of a brief therapy for depression for elder abuse victims, and (b) to compare remote intervention delivery via phone or video to the traditional in-person delivery. METHOD: PROTECT, Providing Options to Elderly Clients Together, is a brief therapy developed in collaboration with partners at the Department for the Aging (DFTA) of New York City. During the COVID-19 outbreak, PROTECT delivery shifted from in-person to phone or video delivery. Depression severity was tracked using the Patient Health Questionaire-9 (PHQ-9). Reduction in depression severity was evaluated using a linear mixed effects model with non-inferiority test to compare the effectiveness of video vs in-person delivery of PROTECT. RESULTS: PROTECT reduced depression (average 5.15 PHQ-9 points). Video and phone delivery were non-inferior to in-person delivery. The video group completed therapy more quickly than the in-person group and had a more rapid improvement in depression symptoms. CONCLUSIONS: PROTECT therapy delivered remotely reduces depression among diverse elder abuse victims. Video delivery of PROTECT could increase reach and scalability to serve more vulnerable older depressed victims.

Lay-delivered behavioral activation for depressed senior center clients: Pilot RCT.

OBJECTIVE: We describe the development of a lay-delivered behavioral intervention ("Do More, Feel Better") for depressed senior center clients, and we present preliminary data from a pilot randomized controlled trial (RCT) on (a) the feasibility of training lay volunteers to fidelity and (b) the acceptability, impact, and safety of the intervention. METHODS: We trained 11 volunteers at two aging service settings in "Do More, Feel Better" and randomized 18 depressed clients to receive the intervention or referral to mental health services. RESULTS: Pilot data indicated that we can successfully train and certify 64% of older volunteers and that depressed clients receiving the intervention reported high levels of session attendance and satisfaction. While there were no significant differences in 12-week reduction in Hamilton Depression Rating Scale scores between groups, intervention clients showed an 8-point reduction in comparison with a 0-point reduction among referral clients. CONCLUSIONS: "Do More, Feel Better" has the potential of transferring evidence-based behavioral interventions to the hands of supervised lay volunteers and can address the insufficient workforce providing geriatric mental health services.