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Increasing Use of Mental Health Services (OpenDoor)

This study has been completed.
Sponsor:
Information provided by (Responsible Party):
Jo Anne Sirey, Weill Medical College of Cornell University
ClinicalTrials.gov Identifier:
NCT00605358
First received: January 18, 2008
Last updated: January 12, 2017
Last verified: January 2017
  Purpose
The purpose of this study is to test the effectiveness of Open Door (previously known as the Treatment Initiation Program [TIP]), a brief psychosocial intervention to address the psychological barriers to care and improve the use of mental health services by depressed community elderly. The intervention is designed to help the older adult identify the barriers, problem-solve to find solutions and mobilize the motivation to seek help. Open Door was developed to work collaboratively with an older adult who is depressed to improve access and adherence to mental health treatment.

Condition Intervention
Major Depression
Behavioral: Open Door intervention

Study Type: Interventional
Study Design: Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single Blind (Participant)
Primary Purpose: Supportive Care
Official Title: Increasing Use of Mental Health Services by Community Dwelling Adults With Depression

Resource links provided by NLM:


Further study details as provided by Jo Anne Sirey, Weill Medical College of Cornell University:

Primary Outcome Measures:
  • The Primary Outcome is Engagement Defined as at Least One Visit With a Mental Health Provider Who Can Offer Treatment of Depression. [ Time Frame: 12 and 24 weeks ]

    Engagement was defined as at least one visit with a mental health provider, due to the fact that in some treatment settings, the initial evaluation and the onset of treatment both took place in the first visit.

    The primary outcome, engagement, was counted if the participant had engaged in mental health treatment by EITHER 12 weeks OR 24 weeks, based on research suggesting that older adults may take up to 6 months to follow through on a referral.

    Therefore, while there is only a single primary outcome (engaged or not), it could be fulfilled at either of the two follow-up time points, at 12 or 24 weeks.



Enrollment: 161
Study Start Date: August 2007
Study Completion Date: January 2015
Primary Completion Date: January 2014 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Active Comparator: Open Door Intervention
Subjects who receive the Open Door Intervention will work with the study counselor to identify barriers to participation in mental health treatment, set goals, and problem-solve, in addition to receiving a referral.
Behavioral: Open Door intervention

Open Door intervention subjects will:

  1. receive an evaluation
  2. receive a referral to a local mental health provider
  3. identify barriers, set goals and problem-solve to achieve a mental health evaluation using available resources.
Other Name: West group
No Intervention: Services Referral

Subjects who do not receive the Open Door intervention will receive:

  1. an evaluation
  2. referral to a local mental health provider
  3. booklet information on depression and mental health care, and will complete an application for HEAP, a Westchester County service that provides reduced rates from oil companies on heating to seniors.

Detailed Description:
The primary aim of this research study did not change from the original application; it is to conduct a randomized controlled trial of the effectiveness of a brief, psychosocial intervention on engagement in mental health care among homebound depressed older adults. Engagement is defined as accepting a referral and attending a visit with a provider who could provide traditional mental health care (medication or psychotherapy). The intervention, now called Open Door, was developed to work collaboratively with an older adult who has depressive symptoms to address the barriers to care with the aim of helping them consider a referral and engage in mental health care. In prior research, this intervention has been found to improve treatment participation, reduce depressive symptoms and increase adherence to antidepressant therapy among depressed older adults in primary care and outpatient psychiatric settings. We propose that Open Door will improve the access to mental health care by reducing psychological barriers, providing education about care, and managing the resignation associated with the symptoms of depression among community dwelling depressed elders. Additionally, we believe that despite the heterogeneity of mental health care that may be received, Open Door will be associated with reduced depressive symptoms by empowering the older adult to initiate care for him/herself.
  Eligibility

Ages Eligible for Study:   60 Years to 90 Years   (Adult, Senior)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Age 60 years and older
  • Homebound
  • Endorse depressive symptoms

Exclusion Criteria:

  • Presence of significant alcohol or substance abuse or psychotic disorder
  • High suicide risk, i.e. intent or plan to attempt suicide
  • Cognitive impairment
  • Inability to speak English
  • Aphasia interfering with communication.
  • Current use of antidepressants or psychotherapy
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT00605358

Locations
United States, New York
Weill Cornell Medical College
White Plains, New York, United States, 10605
Sponsors and Collaborators
Weill Medical College of Cornell University
Investigators
Principal Investigator: Jo Anne Sirey, Ph.D. Weill Medical College of Cornell University
  More Information

Publications:
Responsible Party: Jo Anne Sirey, Associate Professor, Weill Medical College of Cornell University
ClinicalTrials.gov Identifier: NCT00605358     History of Changes
Other Study ID Numbers: R01MH079265-01A1 ( US NIH Grant/Contract Award Number )
Study First Received: January 18, 2008
Results First Received: April 26, 2016
Last Updated: January 12, 2017
Individual Participant Data  
Plan to Share IPD: Undecided

Keywords provided by Jo Anne Sirey, Weill Medical College of Cornell University:
geriatric depression

Additional relevant MeSH terms:
Depression
Depressive Disorder
Depressive Disorder, Major
Behavioral Symptoms
Mood Disorders
Mental Disorders

ClinicalTrials.gov processed this record on May 25, 2017