Regular Article Depression in Public Community Long-Term Care: Implications for Intervention Development

The objective of this paper is to increase understanding of geriatric depression in the public community long-term care system to guide intervention development. Protocols included screening 1,170 new clients of a public community long-term care agency and interviewing all clients with major, dysthymia, or subthreshold depression (n=299) and a randomly selected subset of non-depressed older adults (n=315) at baseline, 6-month, and 1 year. Six percent had major depression, one-half of a percent had dysthymia only, and another 19 % had subthreshold depression. Over the year observation period, 40 % were persistently depressed; 32 % were assessed as depressed only at the first observation; and the remainder was intermittently depressed. There were high levels of comorbid medical, functional, and psychosocial conditions. Mental health service use was low, an