Translating Evidence-Based Psychological Interventions for Older Adults with Depression and Anxiety into Public and Private Mental Health Settings Using a Stepped Care Framework

NHMRC and Beyond Blue cofunded project grant. A universal challenge for evidence-based treatment is to integrate validated programs into routine health service delivery Stepped care delivery is increasingly
promoted as an innovative system by which to optimise the balance between outcomes and costs. Stepped delivery of evidence-based psychological interventions offers the potential to increase the effectiveness and efficiency of mental health delivery by providing low intensity (lower cost) evidence-based services first, followed by higher intensity (higher cost) evidence-based services to those who need additional assistance after the low intensity service. The feasibility of utilising stepped care models of mental health treatment in older adults with depression and anxiety are yet to be examined in Australia. It is also unclear what benefits to efficiency might be achieved using this model, including whether this model is acceptable to practitioners and older adults themselves. Our multidisciplinary team have developed evidence-based low intensity and moderate intensity interventions for depression and anxiety in older adults which we have demonstrated to be efficacious in a number of randomised controlled trials. In this project we evaluate the feasibility of utilising these evidence-based programs in a public and private health setting. We examine effectiveness and cost-effectiveness of these models compared to treatment as usual. The results of this study will have important implications for translation of evidence-based stepped care models into public and private health settings.