title: An Evaluation of IMPACT for the Treatment of Late-Life Depression in a Public Mental Health System.
abstract: IMPACT (Improving Mood--Promoting Access to Collaborative Treatment) has a large body of evidence demonstrating its effectiveness for treating late-life depression in clients enrolled in a clinical research study, but little is known about how well the collaborative care model translates into treatment provided in a public mental health setting. This evaluation examines the influence of clinical and demographic characteristics in 112 older adults treated for late-life depression through publicly funded IMPACT in a large San Francisco Bay Area county. Depression severity decreased for 85% of clients between enrollment and treatments' end and 46% of clients realized a 50% reduction in symptom severity. Depression severity at enrollment, number of treatment sessions attended, ethnicity, and gender reliably predicted depression severity at the end of treatment. Men, clients attending more therapy sessions, and clients without substance abuse diagnoses had an increased likelihood of realizing a 50% reduction in symptoms. Results highlight the success of this evidence-based treatment program offered through the public mental health system but suggest that the demographic and clinical characteristics of the population being treated must be considered when adopting evidence-based practices.
authors.affiliation: Research and Evaluation Unit, Contra Costa Behavioral Health Services, 1340 Arnold Drive, Suite 200, Martinez, CA, 94553, USA, Michael.Penkunas@hsd.cccounty.us.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Penkunas
authors.forename: Stephen
authors.initials: S
authors.lastname: Hahn-Smith
mesh_terms: D000368:Aged; D003866:Depressive Disorder / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008605:Mental Health Services; D008875:Middle Aged; D010348:Patient Care Team; D015397:Program Evaluation; D011613:Psychotherapy / Q000379:methods*; D011634:Public Health; D011788:Quality of Life; D012720:Severity of Illness Index