Annual progress reports

Annual Progress Reports of Funded Research

A randomised controlled trial of an online peer support intervention for reducing symptoms of depression among community-dwelling older adults living in rural Australia (1150496)

Professor Robert Sanson-Fisher (Chief Investigator A)
University of Newcastle
Budget: $496,233
Funding Period: 2018 to 2023

Project Synopsis

Social connectedness is crucial to maintaining mental health. However, peer relationships with others who are experiencing similar life situations reduce in older age. Those living in rural areas are disproportionately affected. Web-based technology is a promising platform for providing accessible, sustainable and feasible solutions to supporting older people to remain socially connected. This study will use a robust randomised controlled trial to test the effectiveness of an online community for reducing the symptoms of depression among older people at 6 months follow-up. Secondary outcomes are anxiety, loneliness, quality of life, and cost. Community-dwelling older adults living in rural Australia will be recruited via an aged care service provider and randomised to either the intervention or control group. Participants allocated to the intervention group will receive access to:

a private online community dedicated to older adults where they can engage in one-to-one and group-based communication with other participants allocated to this group, and
one-to-one training and ongoing support in the use of the intervention. Outcome data will be collected from participants via standardised self-report questionnaires at baseline, 3, 6 and 12 months follow-up and via linkage with health datasets.

This study will provide currently lacking high-level causal evidence about the effectiveness of online peer support in promoting the mental health and wellbeing of older people. The use of information and communication technology ensures that if effective, the intervention can be rapidly scaled-up and integrated within the suite of services provided by aged care, mental health and community services.

Awaiting final report

BAN-Dep: A trial to decrease the prevalence of depression in Australian Nursing Homes (1150529)

Professor Osvaldo Almeida (Chief Investigator A)
University of Western Australia
Budget: $864,282
Funding Period: 2018 to 2021

Project Synopsis

Depression is a frequent experience of older adults living in residential aged care facilities (RACF). A major depressive episode may be present in as many as 25% of residents, while sub-threshold depressive symptoms may affect up to 80% of this population. Older adults with depression have worse quality of life and function, consume significantly more health services, and have greater mortality than other residents without depression (including death by suicide). There is also evidence that staff working at RACF have limited knowledge about depression, so that clinically significant depressive symptoms among older residents are often not detected or treated. Consequently, various groups have attempted to enhance depression literacy among RACF staff, but gains are commonly short-lived, as is the sustainability of interventions to treat residents with depression. The BAN-dep trial will build on the existing beyondblue Professional Education to Aged Care (PEAC) e-learning platform to enhance knowledge about depression and anxiety among older adults living in RACF. We will add, to this platform, a behavioural activation (BA) program that has been used successfully to treat and prevent depression among older adults living in the community. The program will be adapted for use in RACF. The aim of this project is to test the efficacy of the BA-enhanced PEAC compared with PEAC only in decreasing the prevalence of depression among RACF residents over a 12-month period. The results of this trial may have important implications for training and the organisation of services provided by the residential aged care sector and may contribute to decreasing the escalating burden associated with depression in later life.

Final report June 2022

The objective was to determine if behavioural activation (BA) delivered by trained staff decreases prevalence of clinically significant symptoms of depression among older adults living in RACFs. The study used a clustered, randomised, single-blinded, controlled trial of BA for adults aged over 60 years living permanently in a RACF with symptoms of depression. The BA intervention was delivered over 8-12 weeks using a structured workbook. In total 54 RACFs and 188 residents were recruited for the study. Adherence to all stages of the intervention was poor. Disruption due to the covid-19 pandemic and staffing issues within RACFs undermined recruitment and adherence to this study.

The findings of this study indicate that behavioural activation is associated with improved, but fleeting improvements in the mental health of residents of RACFs. The COVID-19 pandemic and competing demands on the time of RACFs staff suggest that sustainable changes may need to be less reliant on currently available resources.

Publications and Other Resources

Reyes, D. V., Patel, H., Lautenschlager, N., Ford, A. H., Curran, E., Kelly, R., Lai, R., Chong, T., Flicker, L., Ekers, D., Gilbody, S., Etherton-Beer, C., Giudice, D. L., Ellis, K. A., Martini, A., & Almeida, O. P. (2019). Behavioural activation in nursing homes to treat depression (BAN-Dep): study protocol for a pragmatic randomised controlled trial. BMJ Open, 9(10), e032421. https://doi.org/10.1136/bmjopen-2019-032421

Almeida, O. P., Patel, H., Velásquez, D., Kelly, R., Lai, R., Ford, A. H., Curran, E., Flicker, L., Terence W.H. Chong, Etherton‐Beer, C., LoGiudice, D., Ellis, K. A., Martini, A., Westphal, A., Ekers, D., Gilbody, S., & Lautenschlager, N. T. (2022). Behavioral Activation in Nursing Homes to Treat Depression (BAN-Dep): Results From a Clustered, Randomized, Single-Blinded, Controlled Clinical Trial. American Journal of Geriatric Psychiatry, 30(12), 1313–1323. https://doi.org/10.1016/j.jagp.2022.05.009

Almeida, O. P., Lautenschlager, N., Ekers, D., & Carolina Velasquez Reyes, D. (2018). Mental Health is a human right in residential aged care too: The BAN-Dep trial protocol [Review of Mental Health is a human right in residential aged care too: The BAN-Dep trial protocol]. International Journal of Mental Health Nursing, 27, 51. https://doi.org/10.1111/inm.12539

‌Evidence for suicide prevention in planning transitions from employment to retirement in older age populations (1150655)

Professor Andrew Page (Chief Investigator A)
Western Sydney University
Budget: $233,914
Funding Period: 2018 to 2020

Project Synopsis

This study will investigate the impact of changes in employment status in older aged Australians on subsequent risk of suicidal behaviour, and the extent to which this risk is modified by referral pathways within mental health services and the role of other social supports. This project will capitalise on existing, large-scale, and detailed population health data sources on employment and mental health, and demonstrate the utility of innovative data linkage methods to derive policy relevant evidence to inform:

intervention and modelling tools to inform quality improvement in mental health, social and employment services in older-age cohorts
mental health referral pathways and processes and consumer choice
broader social policy recommendations in the aged care sector in the period of transition from employment to retirement in older age Australians.

The primary aim of the project is:

To investigate the association between the transition from employment to retirement on the risk of suicide and attempted suicide in older age Australians. A series of secondary aims are also proposed to investigate the modifying role of mental health service use, socio-economic resources, and social support on associations between employment transition and suicidal behaviour.

The secondary aims of the study are:

To investigate the modifying role of mental health service use on the risk of suicide and attempted suicide in those who retire involuntarily compared to those who remain employed or who retire voluntarily.
To investigate the impact of socio-economic resources in reducing the risk of suicide and attempted suicide in those who retire involuntarily compared to those who remain employed or who retired voluntarily.
To investigate the impact of social support in reducing the risk of suicide and attempted suicide in those who are retire involuntarily compared to those who remain employed or who retired voluntarily.

Final Report

Findings from this project showed that employment and retirement status were associated with increased risk of suicidal behaviour (both suicide and attempted suicide), particularly among those who were involuntarily retired and those with illness (not in the labour force, and not retired), and that the transition from employment to retirement may be an important precipitating factor affected by current and previous mental health status.

Findings suggested that interventions relating to social interaction, social connection, and communication are important drivers of mental health, particularly during the transition from employment to retirement. The study also highlighted the importance of access to mental health services and treatment among older people who engage in self-harm or who are in distress, given the large proportions of those who died by suicide and did not have any record of access to services in the period prior to their death. The project emphasised the importance of employing a more systematic approach to enumerating cases of self-harm in service contexts to facilitate evaluation of service interactions to prevent suicidal behaviour.

Previous approaches to suicide prevention in older adults have focused predominantly on risk factor screening and treatment, and have been more effective in women than in men. Implications of the findings suggest that services and programs facilitating continued or re-employment in older age (particularly for men) and preparation for the financial, social and emotional transition to retirement may be of potential benefit.

Key findings for consumers and carers are the importance of social interaction and social connection as drivers of positive mental health outcomes, and facilitation of access to social and health services. Facilitating access and engagement to appropriate mental health services and treatments was an important finding. The majority of those who died by suicide in this study cohort had no contact with mental health services in the 12-months prior to their death.

Publications and Other Resources

Page A, Sperandei S, Spittal MJ, Milner A, Pirkis J. The impact of transitions from employment to retirement on suicidal behaviour among older aged Australians. Social psychiatry and psychiatric epidemiology. 2021 May;56:759-71.

Page A, Sperandei S, Spittal MJ, Pirkis J. Ensuring older Australians remain socially connected during the COVID-19 isolation period. Australian & New Zealand Journal of Psychiatry. 2021 Mar;55(3):326-7.

Sperandei S, Page A, Spittal MJ, Witt K, Robinson J, Pirkis J. Using the ‘presenting problem ‘field in emergency department data improves the enumeration of intentional self-harm in NSW hospital settings. Australian & New Zealand Journal of Psychiatry. 2021 Oct;55(10):1019-20.

Carter G, Sperandei S, Spittal MJ, Chitty K, Clapperton A, Page A. Characteristics of suicide decedents with no federally funded mental health service contact in the 12 months before death in a population‐based sample of Australians 45 years of age and over. Suicide and Life‐Threatening Behavior. 2023 Feb;53(1):110-23.

Sperandei S, Page A, Spittal MJ, Pirkis J. Low education and mental health among older adults: the mediating role of employment and income. Social psychiatry and psychiatric epidemiology. 2023 May;58(5):823-31.

Arya V, Sperandei S, Spittal MJ, Page A. Employment transitions and mental health in a cohort of 45 years and older Australians. International Journal of Environmental Research and Public Health. 2021 Aug 27;18(17):9030.

Carter G, Sperandei S, Chitty KM, Page A. Antidepressant treatment trajectories and suicide attempt among Australians aged 45 years and older: A population study using individual prescription data. Suicide and Life‐Threatening Behavior. 2022 Feb;52(1):121-31.

Elders AT Ease Program (ELATE): A cluster randomised controlled trial of a sustainable and scalable mental health service for Australian residential aged care facilities (1150902)

Professor Sunil Bhar (Chief Investigator A)
Swinburne University of Technology
Budget: $985,751
Funding period: 2018 to 2024

Project Synopsis

Drawing upon the best available research evidence and clinical expertise on treating psychological morbidity in older adults, this program uses an integrated care approach, in which counsellors, staff and family carers collaborate to provide tailored, systemic, and evidence-based psychological interventions to residents living with symptoms of depression, anxiety or suicide ideation. The program has been found to be clinically feasible and highly acceptable to residents and aged care staff. It is sustainable, scalable and has capacity to be highly cost-effective whilst building workforce capacity to detect and manage depression and anxiety. It can be implemented directly as an augmentation to the present system of care.

Our multidisciplinary team comprises all necessary expertise including clinical geropsychology; geropsychiatry; behavioural science and multisite clinical trial management; biostatistics; health economics; consumer perspectives, and aged care nursing and service provision. Our research seeks to test the clinical and health economic impact of this innovative model of service on depression and associated psychological comorbidity in older people living in residential aged care facilities and their family carers.

Progress report April 2023

75 residential aged care facilities have been recruited to the project. Of the recruited facilities, 69 have been randomised (34 facilities in the intervention group). 6 facilities will not be randomised due to either having no eligible and consenting participants, the facility withdrawing from the project or COVID-19 related disruptions. A total of 1203 aged care residents have been referred to the project. We have screened 817 residents for eligibility. Of these, 310 residents were eligible, 260 consented and completed baseline assessments and 259 were randomised (136 in the intervention). One participant will not be randomised due to COVID-19 disruptions.

In addition, 76 Residential aged care homes staff and 79 family members have participated in the project and have completed baseline assessments.

Data analysis has not yet been undertaken.

The impact of befriending on depression, anxiety, social support and loneliness in older adults living in residential aged care facilities (1151065)

Professor Colleen Doyle (Chief Investigator A)
National Ageing Research Institute
Budget: $652,734
Funding Period: 2018 to 2023

Project Synopsis

Approximately half of people living in residential aged care facilities (RACFs) may have significant depression symptoms. The reasons for such high prevalence are a mix of individual physical health factors, high prevalence of grief and loss among the residents, and the social environment. Many residents are socially isolated in RACFs even though they are in communal living, and social isolation is a contributor to depression. The literature provides some evidence for befriending in alleviating depression, anxiety, social isolation and loneliness as well as improving quality of life and wellbeing, but few studies have been conducted for older adults living in RACFs. Befriending is non-directive emotional and social support generally provided by volunteers. The investigators have experience of examining befriending in three previous published studies and have also published on the use of volunteers in RACFs. We have conducted a randomized controlled trial of befriending compared with treatment as usual to improve depression, anxiety, social support and loneliness among residents. An economic evaluation will importantly examine the costs and benefits of the program. We have 85 aged care providers and 346 residents participating in the trial. Volunteers are trained using videos, face to face and remote workshops anda manual for befriending developed by the investigators. If successful the program can be translated to the wider aged care sector to enable volunteers and the Community Visitors Scheme to more effectively support residents and reduce the prevalence of depression, anxiety and loneliness and improve social support in RACFs.

Awaiting final report

Publications and Other Resources

Fearn M, Harper R, Major G, Bhar S, Bryant C, Dow B, Dunt D, Mnatzaganian G, O'Connor D, Ratcliffe J, Samuel S, Bagnall AM, Doyle C. Befriending Older Adults in Nursing Homes: Volunteer Perceptions of Switching to Remote Befriending in the COVID-19 Era. Clin Gerontol. 2021 Jul-Sep;44(4):430-438. doi: 10.1080/07317115.2020.1868646. Epub 2021 Jan 6. PMID: 33403935.

Doyle C, Bhar S, Bryant C, Dow B, Dunt D, Mnatzaganian G, O'Connor D, Ratcliffe J, You E, Bagnall AM, Major G, Harper R, Fearn M. BEFRIENding for Depression, Anxiety and Social support in older adults living in Australian residential aged care facilities (BEFRIENDAS): randomised controlled trial protocol. BMC Geriatr. 2021 May 12;21(1):305. doi: 10.1186/s12877-021-02233-7. PMID: 33980168; PMCID: PMC8115389.

Major G, Bagnall AM, Bhar S, Bryant C, Dow B, Dunt D, Fearn M, Harper R, Leung WY, Mnatzaganian G, O’Bree B, Doyle C. A scoping review of the measurement of depression in older adults with cognitive impairment. Clinical Gerontologist: the journal of aging and mental health. 2022 ISSN 0270-3122 DOI: https://doi.org/10.1080/07317115.2022.2126809

Newspapers and newsletters

Be a friend – befriend an elder, article in Sunshine Coast Daily, 31 Jan 2019

The joy of being a friend, article in Brisbane Seniors newspaper, January 2019

Virtual karaoke and museum tours: how older people can cope with loneliness during the coronavirus crisis, article in The Conversation, 20 March 2020

NARI news – the BEFRIENDAS project regularly features in the NARI newsletters and on the NARI website.

Industry specific magazine articles

NARI researchers are delving into the causes of loneliness in older Australians and providing help to address it, Aged Care News, 26th April 2022

Workshop addressing loneliness in aged care oversubscribed, Australian Ageing Agenda, 18th February 2022

Aged Care Homes Sought for ‘Befriending’ Research Project, Aged Care Weekly, Feb 1 2021

Helping Hand partners with NARI, Community Care Review, 29th January 2021

Helping Hand partners with NARI, Australian Ageing Agenda, 29th January 2020

Training helps volunteers set boundaries, Australian Ageing Agenda, 29th August 2019

Trial testing a friendship approach to reduce depression, Australian Ageing Agenda, 15th August 2018

Translating Evidence-Based Psychological Interventions for Older Adults with Depression and Anxiety into Public and Private Mental Health Settings Using a Stepped Care Framework (1151138)

Professor Viviana Wuthrich (Chief Investigator A)
Macquarie University
Budget: $1,022,889
Funding period: 2018 to 2024

Project Synopsis

A universal challenge for evidence-based treatment is to integrate validated programs into routine health service delivery. Evidence-based treatments are more likely to be incorporated within public services when they can demonstrate maximum cost-effectiveness. Stepped care delivery is increasingly promoted as an innovative system by which to optimise the balance between outcomes and costs. Stepped care relies on provision of low intensity (lower cost) evidence-based services first, followed by higher intensity (higher cost) evidence-based services only to those who need additional assistance.

We currently have solid, scientific evidence for the efficacy of both low intensity and high intensity treatments for older adults suffering depression and anxiety, laying the groundwork for a translational (effectiveness) evaluation. Therefore, delivery of treatments for anxiety and depression in older adults through the Australian health service network is highly feasible. What we now need to know is whether evidence-based treatments for older-adult anxiety and depression can be delivered through existing health services utilising a stepped care model; whether this model reduces costs and/or increases outcomes over existing treatments; and whether this model of service delivery is acceptable and viable for consumers and providers.

Our multidisciplinary team has developed evidence-based low intensity and higher intensity psychological 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 delivering these evidence-based programs within existing services representing public (urban, regional) and private organisations. We will examine effectiveness and cost-effectiveness of these stepped psychological interventions compared to treatment as usual. The results of this study will inform the translation of evidence-based stepped care models of psychological interventions for anxiety and depression in older adults into the Australian mental health system.

Progress report April 2023

122 participants have been enrolled of which, 106 have completed the trial. COVID-19 has continued to affect recruitment in the following ways.

Due to significant periods of trial suspension at 4/5 sites during the pandemic (February 2020 to April 2021-14 months; followed by Sydney lockdown June to October 2021), coupled with significant staff loses at all sites, 3/5 sites required clinicians to be retrained in the delivery of the treatment program and new research assistants recruited and trained.

Since the trial restarted, sites have reported increasing difficulty identifying eligible participants (with increasing numbers of ineligible participants presenting to services i.e. older people with acute psychosis, bipolar, or dementia). 4/5 sites report that the nature of patients presenting to services has changed with 85-95% being ineligible for the trial. The Chief Investigator team recently met to discuss options for finalising recruitment. The research team are waiting on advice from the trial statistician regarding a futility analysis.

Recruitment is ongoing, however, since the start of this trial, the following outcomes have occurred: presented at 11 conferences, in 12 professional training workshops, 7 media articles, 14 social media stories, 14 peer-reviewed papers, 2 book chapters, 3 consumer talks, and 3 resources.

Publications and other resources

Green, T.A., Johnco, C.A., & Wuthrich, V.M. (2023) Age Differences in Peritraumatic and Posttraumatic Processing, Journal of Experimental Psychology: General, 152 (10), 2793-2803. https://doi.org/10.1037/xge0001424

Wuthrich, V.M., & Mohlman, J. (2024) Examining Differences in Behavioural Avoidance Between Younger and Older Adults, Clinical Gerontologist, 47 (2), 329-340. https://doi.org/10.1080/07317115.2023.2204079

Chen˜, J. T-H., Wuthrich, V.M., & Zagic, D. (2022). Practitioners’ use of exposure therapy in older adults with anxiety disorders, Australian Psychologist, 57 (6), 332-337. https://doi.org/10.1080/00050067.2022.2134757

Brydon, A., Bhar, S., Doyle, C., Batchelor, F., Lovelock, H., Almond, H., Mitchell, L., Nedeljkovic, M., Savvas, S., & Wuthrich, V. (2022). National survey on the impact of COVID-19 on the mental health of Australian residential aged care residents and staff, Clinical Gerontologist, 45(1):58-70. doi: 10.1080/07317115.2021.1985671.

Strutt, P.A., Johnco, C., Chen, J., Muir, C., Maurice, O., Dawes, P., Siette, J., Botelho Dias, C., Hillebrandt, H., Wuthrich, V. (2022). Stress and Coping in Older Australians during COVID-19: Health, Service Utilization, Grandparenting, and Technology Use. Clinical Gerontologist, 45 (1), 106-119. DOI: 10.1080/07317115.2021.1884158

Siette, J., Seaman, K., Dodds, L., Ludlow, K., Johnco, C., Wuthrich, V., Earl, J., Dawes, P., Strutt, P., & Westbrook, J.I. (2021). A national survey on COVID-19 second-wave lockdowns on older adults’ mental wellbeing, health-seeking behaviours and social outcomes across Australia, BMC Geriatrics, 21, 400. https://doi.org/10.1186/s12877-021-02352-1

Meuldijk, D˜., Wuthrich, V.M., Rapee, R.M., Draper, B., Brodaty, H., Cuijpers, P., Cutler, H., Hobbs, M., Johnco, C., Jones, M., Chen, J.T.H., Partington, A., & Wijeratne, C. (2021). Translating Evidence-Based Psychological Interventions for Older Adults with Depression and Anxiety into Public and Private Mental Health Settings using a Stepped Care Framework: Study Protocol, Contemporary Clinical Trials, 104: 106360. https://doi.org/10.1016/j.cct.2021.106360

Johnco, C. J., Chen, J. T. H., Muir, C., Strutt, P., Dawes, P., Siette, J., Dias, C. B., Hillebrandt, H., Maurice, O., & Wuthrich, V. M. (2021). Long-term relapse rates after cognitive behaviour therapy for anxiety and depressive disorders among older adults: a follow-up study during COVID-19. Australasian Journal on Ageing, 40 (2), 208-212. https://doi.org/10.1111/ajag.12928

Wuthrich, V.M., Meuldijk, D., Jagiello, T., González Robles, A., Jones, M.P., & Cuijpers, P. (2021). Efficacy and effectiveness of psychological interventions on co-occurring mood and anxiety disorders in older adults: A systematic review and meta-analysis, International Journal of Geriatric Psychiatry. 36(6), 858-872, http://dx.doi.org/10.1002/gps.5486

Townsend*, B.G., Chen, J. T-H., & Wuthrich, V.M. (2021). Barriers and Facilitators to Social Participation in Older Adults: A Systematic Literature Review, Clinical Gerontologist, 44:4, 359-380. doi: 10.1080/07317115.2020.1863890

Smith˜, R., Wuthrich, V.M., Johnco, C., & Belcher, J. (2021). Effect of Group Cognitive Behavioural Therapy on Loneliness in a Community Sample of Older Adults: A Secondary Analysis of a Randomised Controlled Trial. Clinical Gerontologist, 44:4, 439-449, DOI: 10.1080/07317115.2020.1836105.

Dawes, P., Siette, J., Earl, J., Johnco, C., & Wuthrich, V. (2020). Challenges of the COVID-19 pandemic for social gerontology in Australia. Australasian Journal on Ageing, 39(4), pp. 383-385. https://doi.org/10.1111/ajag.12845

Siette, J., Wuthrich, V., & Low, L-F. (2020). Social preparedness in response to spatial distancing measures for aged care during COVID-19, Journal of the American Medical Directors Association, 21 (7), 985-986. doi: https://doi.org/10.1016/j.jamda.2020.04.015

Meuldijk˜, D., & Wuthrich, V.M. (2019). Stepped Care Treatment of Anxiety and Depression in Older Adults: a narrative review, Australian Journal of Rural Health, 27, 275-280, DOI: 10.1111/ajr.12524.

Book chapters

Chen, J.T.H., Belcher, J., Zagic, D., Wuthrich^, V.M., (2022). 7.10. Anxiety Disorders in Later Life. In: Asmundson, G.J.G. (Ed.), Comprehensive Clinical Psychology, 2nd edition, vol. 7. Elsevier, pp. 144–160. https://dx.doi.org/10.1016/B978-0-12-818697-8.00020-0

Wuthrich, V., Chen J. T-H., & Matovic, D. (2022). Advances in treatment for older adult mental health, Advances in Psychiatry and Behavioral Health, Vol 2 (1), 193-210. https://doi.org/10.1016/j.ypsc.2022.05.008

Peer Development workshops

26th May 2023. Invited talk to Prince of Wales Sydney psychiatry team, Online treatments for anxiety and depression in older adults. Euora Prince of Wales (online).

29th June 2022. Age, frailty, loneliness and suicide invited webinar for the Mental Health Practitioners Network (n=2700 registrations, 1500 online)

2022- 30th October, 2022. Ageing Wisely program for treating depression and anxiety in older adults. Momentum Conference, New England North-West Branch Australian Psychological Society.

2021–21st April, Wuthrich, V.M. CBT for late life anxiety and depression. Australian Psychological Society Institute Professional Development webinar.

2020 – October. Wuthrich, V.M. (2020). Invited Conference Workshop – Treating anxiety and depression in older adults. Australian Psychological Society Annual Conference PSY2020 (virtual conference), Saturday 17th October.

2020 - October, Treatment of anxiety and depression in older adults, Training for Older Adult Mental Health Team, Royal North Shore hospital, Sydney.

2020 - May Webinar organised for the Australian Psychological Society, Psychology and Ageing Interest group, “Supporting aged care residents through COVID-19: Interventions for mental health and loneliness in residential aged care”, 8th May, 2020 (10.30am-12pm). 288 registrants, and 127 participated live.

2019 - October, Step 2 -Treatment of anxiety and depression in older adults, Western NSW Older Adult Mental Health team, Orange.

2019- 9th September, Assessment and Treatment of Older Adults in the Community and Residential Aged Care Facilities, Australian Psychological Society Sydney Branch, Mecure Hotel, Sydney.

2019- August, Step 1- Treatment of anxiety and depression in older adults, Prince of Wales hospital, Specialist Older Adult Mental Health team, Sydney.

2019- July, Step 1 -Treatment of anxiety and depression in older adults, Western NSW Older Adult Mental Health team, Orange.

2019 - Enhancing treatment of anxiety and depression in older adults by increasing social participation, Department of Psychiatry, University College London, UK.

Conference Presentations

Wuthrich V, Rapee R, Draper B, Brodaty H, Cuijpers P, Hobbs M, Johnco C, Cutler H, Jones M, Chen J, Meuldijk D, Partington A, Wijeratne C. Using stepped care to increase access to psychological interventions for depression and anxiety in older adults (STOP Trial) (2021). APS Psychology & Ageing Interest Group (PAIG) 2021 National Conference (online).

Wuthrich V, Rapee R, Draper B, Brodaty H, Cuijpers P, Hobbs M, Johnco C, Cutler H, Jones M, Chen J, Meuldijk D, Partington A, Wijeratne C (2021). Utilising stepped care to treat depression, anxiety and social isolation in older adults: A multi-site clinical trial. Australian Association for Cognitive Behavioural Therapy (online Perth, WA).

McArthur, G., Francis, D., Robidoux, S., Jones, A., Hudson, J., Wuthrich, V., & Parrila, R. (2021 July). The relationship between poor reading and anxiety across the lifespan. Society for the Scientific Study of Reading. World-wide virtual conference hosted from the UK.

Wuthrich, V. (2020). Stepped Care for Older Adults with Anxiety and Depression, Annual Conference of the Centre for Ageing, Cognition and Wellbeing, Macquarie University.

Wuthrich, V. Rapee, R.M., Draper, B., Brodaty H., Low, L-F., Johnco, C., Cutler, H., Jones, M., Chen, J., Meuldijk, D., Partington, A. (2019). Improving psychological treatment through social participation for anxious and depressed older adults, Australasian Association for Gerontology, Sydney, 6-8th November.

Wuthrich, V.M. (2022). Invited keynote – “Depression and Anxiety in Older Adults: State of Play”, Momentum Conference, New England North-West Branch Australian Psychological Society (Tamworth/Armidale), 30th October, Sydney.

Wuthrich, V.M. (2021). Invited panellist –“Anxiety and Depression in Dementia” international symposium (ADDResearch) online- Friday 17th September, 2021 - (virtual symposium attended by n= 470).

Wuthrich, V.M. (2020). Invited speaker “Psychosocial Interventions to Reduce Anxiety and Depression in Dementia”, anxiety and depression in dementia research (ADDResearch) online symposium (DCRC)- 11th November 2020 (virtual symposium attended by n= 75 online).

Wuthrich, V.M. (2020). Invited panellist –“Anxiety and Depression in Dementia”, anxiety and depression in dementia research (ADDResearch) online symposium (DCRC)- 11th November 2020 (virtual symposium attended by n= 75 online).

Wuthrich, V.M. (2019). Invited Keynote – “Evaluation of a Stepped Care Model for Psychological Treatment of Anxiety & Depression in Australian Older Adult Mental Health Services,” Dorset Psychology Conference, Dorset, UK, 30th April, 2019.

Wuthrich, V.M. (2018). Invited speaker – “Translating Evidence-Based Psychological Interventions Using a Stepped Care Framework” , Brisbane Diamantina Health Partners (BDHP) in collaboration with the UQ School of Psychology’s Centre for Healthy Outcomes, Innovation and Clinical Education (CHOICE); the UQ Ageing Mind Initiative (AMI); and Metro South Hospital and Health Service Conference on “Improving the Health of Older People”. 3rd August, 2018.

Consumer talks

2021- CACW-CEH Public Lecture for International Day of the Older Person and Mental Health Month, Social Connections and Mental Health: Impacts of a pandemic?

2020-1st October, Ageing Wisely: Maintaining Social Connections during COVID19, October is Mental Health Month Public Lecture -streamed live to 65 attendees. https://macquarie.zoom.us/rec/share/PXogYsMG56WUhlhCrAqy-9Cq3Lbs2q8fnz5KVr-v7iw9M2wV5FG5LlIq8m63CHA5.32eeziYMfXC0R5jW?startTime=1601538852000

2019-28th October, Maintaining good mental health in older adulthood, October is Mental Health Month public lecture series, Macquarie University.

Media Articles & Appearances (TV & radio)

28th August, 2021, Dealing with Lockdowns, Breakfast ABC Central West.

23rd August, 2021, Over 60s cope better in lockdown, research finds, The Lighthouse. https://lighthouse.mq.edu.au/article/august-2021/over-60s-cope-better-in-lockdown,-research-finds

15th June, 2020. Mental health concerns and addressing the issue with Professor Viviana Wuthrich, 2SER, Sydney. https://2ser.com/mental-health-concerns-and-addressing-the-issue-with-professor-viviana-wuthrich/

27th May 2020.Chen, J. & Wuthrich, V. “COVID-19: how it can affect the wellbeing of our ageing population”, The Weekly Times.

19th May, 2020, Delivering remote mental health treatment to older adults, ABC radio Orange, Ewen Gilbert.

18th May, 2020, Delivering remote mental health treatment to older adults during COVID19, 2BS (Bathurst), James Knight.

14th February 2020, Prevalence of depression and suicide in the elderly, 2SER. https://2ser.com/the-prevalence-of-depression-and-suicide-in-the-elderly/

Social media

10th November, 2020. “New program targets mental health issues in older Australians”, Aged Care Guide. https://www.agedcareguide.com.au/talking-aged-care/new-program-targets-mental-health-issues-in-older-australians

1st November, 2020. “TV icons Noeline Brown and Gregory Ross on ageing and mental health”, Starts at Sixty, https://startsat60.com/media/health/health-issues/noeline-brown-gregory-ross-on-ageing-wisely-online-mental-health

23rd October, 2020, “Ageing Wisely Online: new online program designed older people deal with depression”, Aged Care 101, https://www.agedcare101.com.au/the-donaldson-sisters/ageing-wisely-online-new-online-program-designed-older-people-deal-with-depression/

16th October 2020, Mental health support program for older Australians being trialled, yourLife Choices. https://www.yourlifechoices.com.au/health/your-health/mental-health-support-for-older-aussies

20th September, 2020, Mental Health Support: The internet is breaking down barriers for older Aussies, Starts at Sixty, https://startsat60.com/media/health/good-health/internet-delivered-mental-health-treatments-older-people

31st August, 2020, The important health issue going untreated in older Australians, OverSixty website, http://www.oversixty.com.au/health/mind/the-important-health-issue-going-untreated-in-older-australians

10th August, 2020 - Novel online program helps older people with depression, the Lighthouse, https://lighthouse.mq.edu.au/article/october-2020/novel-online-program-helps-older-people-with-depression

12th July, 2020, Grumpy old man syndrome could be a sign of something more serious, Starts at Sixty, https://startsat60.com/media/health/ageing-stereotypes-mental-health-grumpy-old-man-viviana-wuthrich

18th May, 2020 - A study investigating the effectiveness of mental health services delivered remotely to people over the age of 65, Mirage News. https://www.miragenews.com/people-aged-over-65-encouraged-to-take-part-in-mental-health-services-study-from-home/

31st August, 2021. How over 60s are coping better with lockdown restrictions. https://www.oversixty.com.au/lifestyle/retirement-life/how-over-60s-are-coping-better-with-lockdown-restrictions

30th August, 2021. Over 60s cope better in lockdown: grandkids, life experience the key, Aged Care insight. https://www.agedcareinsite.com.au/2021/08/over-60s-cope-better-in-lockdown-grandkids-life-experience-the-key/

30th August, 2021. Tech-savvy over-60s cope better through the long COVID-19 lockdowns_ - Aged Care 101 2021

28th August, 2021, the New Daily, Why older people are handling lockdown better than youngsters (plus 3 other outlets)

27th August, 2021, Why older people cope better with foreclosure than younger people, India, https://www.thebharatexpressnews.com/

Resources

Managing COVID19 Anxiety for Older Adults handout developed for the Australian Psychological Society (April 2020)

Recognising Anxiety and Depression in Older Adults Consumer trifold prepared for Beyond Blue (2019)

Helping GPs recognise anxiety and depression in older adults prepared for Beyond Blue (2019)

Improving Mental Health and Social Participation Outcomes in Older Adults with Depression and Anxiety (1151186)

Professor Ronald Rapee (Chief Investigator A)
Macquarie University
Budget: $780,652
Funding period: 2018 to 2024

Project Synopsis

Untreated depression and anxiety are associated with significant risk for future disability, mortality, suicide, dementia and health care costs. Cognitive behavioural therapy (CBT) is the gold standard intervention for older adults with depression and anxiety, yet a significant number of older adults fail to respond sufficiently at the end of treatment. More powerful interventions to reduce anxiety and depression among older adults are needed. Social participation (such as community participation, socialising, volunteering, child minding, paid employment) is a strong protective factor from suicide risk, depression, anxiety, loneliness and poor quality of life. Therefore, paying particular attention to maximising social participation should boost the efficacy of standard CBT for depressed and anxious older adults. Our multidisciplinary team recently developed a comprehensive CBT program that incorporates strategies to boost social participation in older adults. Pilot data indicates that this enhanced program leads to greater reductions in depression and anxiety and larger increases in quality of life and social participation than traditional CBT. This program should also be more cost effective than traditional CBT by reducing health costs and utilising the social capital associated with increased social participation by older adults.

This project aims to evaluate the incremental efficacy and cost-effectiveness of our newly enhanced CBT plus social participation program against our standard transdiagnostic CBT program for depressed and anxious older adults. Outcomes will provide evidence for a powerful psychosocial treatment for older adults suffering anxiety and/or depression, which is supported by structured manuals enabling reliable dissemination. This will provide therapists in the private and public health systems, a clear means to reduce the impact of poor emotional health in older age and reduce its economic burden, while providing beyondblue the ability to disseminate the most up-to date scientific evidence.

Progress report April 2023

Over the past year the project has continued to recruit participants and allocate them to receive treatment through one of the two study conditions. Recruitment has required a continual emphasis on promotion, which has been achieved through media stories, newspaper advertisements, promotion through local councils, public talks (four), and notices on community noticeboards. These promotional efforts have led to a steady flow of participants and we are approaching the final numbers that are needed to complete the trial. Plans to finalise recruitment at target population (n = 172) in the next few months are in place. As at 18th April 2023, 128 participants have been enrolled in the trial. There are currently 28 participants in the treatment stage or awaiting post or follow-up assessments. Results will not be known until after completion of treatment of the final participant. Since the beginning of the project the following outcomes have occurred: 16 scientific publications, 2 book chapters, 8 peer-development workshops, 15 national and international conference presentations, 3 public lectures, 7 media appearances, 14 social media and 3 downloadable resources.

Publications and other resources

Chen, J.T-H., Wuthrich, V., Matovic, D., & Rapee, R.M. (Published online 21 June 2023). Necessary but Not Sufficient: Examination of Older Adults’ Connectedness with their Online Social Contact during COVID-19. Australian Psychologist, https://doi.org/10.1080/00050067.2023.2225696

Wolter, N. E., Mobach, L., Wuthrich, V. M., Vonk, P., van der Heijde, C. M., Wiers, R. W., Rapee, R. M., & Klein, A. M (2023). Emotional and social loneliness and their unique links with social isolation, depression and anxiety. Journal of Affective Disorders, 329, 207-217. https://doi.org/10.1016/j.jad.2023.02.096

Green, T.A., Johnco, C.A., & Wuthrich, V.M. (2023) Age Differences in Peritraumatic and Posttraumatic Processing, Journal of Experimental Psychology: General, 152 (10), 2793-2803. https://doi.org/10.1037/xge0001424

Wuthrich, V.M., & Mohlman, J. (2024) Examining Differences in Behavioural Avoidance Between Younger and Older Adults, Clinical Gerontologist, 47 (2), 329-340. https://doi.org/10.1080/07317115.2023.2204079

Chen˜, J.T.-H., Wuthrich, V.M., Rapee, R.M., Draper, B., Brodaty, H., Cutler, H., Low, L.-F., Georgiou, A., Johnco, C., Jones, M., Meuldijk, D., & Partington, A. (2022). Improving mental health and social participation outcomes in older adults with depression and anxiety: Study protocol for a randomised controlled trial. PLoS One, 17 (6), e0269981. https://doi.org/10.1371/journal.pone.0269981

Zagic*, D., Wuthrich, V.M., Rapee, R.M., & Wolters, N (2022). Interventions to Improve Social Connections: A Systematic Review and Meta-Analysis, Social Psychiatry and Psychiatric Epidemiology, 57, 885–906. https://doi.org/10.1007/s00127-021-02191-w (impact factor 4.328)

Strutt, P.A., Johnco, C., Chen, J., Muir, C., Maurice, O., Dawes, P., Siette, J., Botelho Dias, C., Hillebrandt, H., Wuthrich, V. (2022). Stress and Coping in Older Australians during COVID-19: Health, Service Utilization, Grandparenting, and Technology Use. Clinical Gerontologist, 45 (1), 106-119. DOI: 10.1080/07317115.2021.1884158

Pachana, N.A. & Wuthrich, V.M. (2021) Social Inclusion and Isolation: Research for the Post-COVID Era and Beyond, Clinical Gerontologist, 44:4, 355-358. DOI: 10.1080/07317115.2021.1934283

Johnco, C. J., Chen, J. T. H., Muir, C., Strutt, P., Dawes, P., Siette, J., Dias, C. B., Hillebrandt, H., Maurice, O., & Wuthrich, V. M. (2021). Long-term relapse rates after cognitive behaviour therapy for anxiety and depressive disorders among older adults: a follow-up study during COVID-19. Australasian Journal on Ageing, 40 (2), 208-212. https://doi.org/10.1111/ajag.12928

Wuthrich, V.M., Meuldijk, D., Jagiello, T., González Robles, A., Jones, M.P., & Cuijpers, P. (2021). Efficacy and effectiveness of psychological interventions on co-occurring mood and anxiety disorders in older adults: A systematic review and meta-analysis, International Journal of Geriatric Psychiatry. 36(6), 858-872, http://dx.doi.org/10.1002/gps.5486

Townsend*, B.G., Chen, J. T-H., & Wuthrich, V.M. (2021). Barriers and Facilitators to Social Participation in Older Adults: A Systematic Literature Review, Clinical Gerontologist, 44:4, 359-380. doi: 10.1080/07317115.2020.1863890

Smith˜, R., Wuthrich, V.M., Johnco, C., & Belcher, J. (2021). Effect of Group Cognitive Behavioural Therapy on Loneliness in a Community Sample of Older Adults: A Secondary Analysis of a Randomised Controlled Trial. Clinical Gerontologist, 44:4, 439-449, DOI: 10.1080/07317115.2020.1836105.

Dawes, P., Siette, J., Earl, J., Johnco, C., & Wuthrich, V. (2020). Challenges of the COVID-19 pandemic for social gerontology in Australia. Australasian Journal on Ageing, 39(4), pp. 383-385. https://doi.org/10.1111/ajag.12845

Siette, J., Wuthrich, V., & Low, L-F. (2020). Social preparedness in response to spatial distancing measures for aged care during COVID-19, Journal of the American Medical Directors Association, 21 (7), 985-986. doi: https://doi.org/10.1016/j.jamda.2020.04.015

Book chapters

Peer Development workshops

2022- 30th October 2022. Ageing Wisely program for treating depression and anxiety in older adults. Momentum Conference, New England North-West Branch Australian Psychological Society.

2022 - 29th June 2022. Age, frailty, loneliness and suicide invited webinar for the Mental Health Practitioners Network (n=2700 registrations, 1500 online)

2021–21st April, Wuthrich, V.M. CBT for late life anxiety and depression. Australian Psychological Society Institute Professional Development webinar.

2020 - Webinar organised for the Australian Psychological Society, Psychology and Ageing Interest group, “Supporting aged care residents through COVID-19: Interventions for mental health and loneliness in residential aged care”, 8th May, 2020 (10.30am-12pm). 288 registrants, and 127 participated live.

2019 - 9th September, Assessment and Treatment of Older Adults in the Community and Residential Aged Care Facilities, Australian Psychological Society Sydney Branch, Mecure Hotel, Sydney.

2019 - Enhancing treatment of anxiety and depression in older adults by increasing social participation, Department of Psychiatry, University College London, UK.

2019 – 20th September, Increasing Social Connections might be the key, Older Adult Mental Health Service, Sydney North Local Health District, Staff Education Day.

Conference Presentations

Wuthrich, V.M., Rapee, R.M., Draper, B., Brodaty, H., Low, L-F., Georgiou, A., Johnco, C., Cutler, H., Jones, M., & Chen, J. T-H. (2022). Improving Psychological Treatment through Social Participation in Anxious and Depressed Older Adults (SPAA Trial), 4th Centre for Ageing, Cognition & Wellbeing annual conference, Macquarie University.

Chen, J., Wuthrich, V., Rapee, R, Matovic, D. (2021). Adapting social activities to COVID-19 health restrictions. Joint Centre for Ageing, Cognition & Wellbeing and BioNetwork conference, Macquarie University (online)

Zagic, D., Wuthrich, V., Rapee, R. (2021). Interventions to improve social connections: A systematic review and meta-analysis, Joint Centre for Ageing, Cognition & Wellbeing and BioNetwork conference, Macquarie University (online)

Zagic D, Wuthrich VM, Rapee RM, Wolters N (2021). Interventions to improve social connections: A systematic review and meta-analysis. Australian Association for Cognitive Behavioural Therapy (online Perth, WA).

Zagic D, Wuthrich VM, Rapee RM (2021). Targeting maladaptive cognitions related to loneliness using focused cognitive restructuring alleviates feelings of loneliness and promotes social connectedness. Australian Association for Cognitive Behavioural Therapy (online Perth, WA).

Chen J, Wuthrich V, Rapee R, Draper B, Brodaty H, Cutler H, Low L-F, Georgiou A, Johnco C, Jones M, Meuldijk D, Partington A (2021). Improving mental health and social participation outcomes in older adults with depression and anxiety – a randomised controlled trial. Australian Association for Cognitive Behavioural Therapy (online Perth, WA).

Chen JTH, Wuthrich VM, Matovic D Rapee RM. Adapting social activities to COVID-19 health restrictions (2021). Australian Association for Cognitive Behavioural Therapy (online Perth, WA).

Wuthrich, V.M. (2020). Invited Panellist – Loneliness. Australian Psychological Society Annual Conference PSY2020 (virtual conference), Sunday 18th October.

Wuthrich, V.M. (2019). Invited Speaker – - Improving Social Connections might be the key, NSW Branch of the Royal Australian and New Zealand College of Psychiatrists Conference on "State of Play in Psychiatry of Old Age - What's New in the Field?", Friday 26 Jul 2019, Sydney.

Consumer talks (public lectures)

2021- CACW-CEH Public Lecture for International Day of the Older Person and Mental Health Month, Social Connections and Mental Health: Impacts of a pandemic?

2019-28th October, Maintaining good mental health in older adulthood, October is Mental Health Month public lecture series, Macquarie University.

Media Articles & Appearances (TV & radio)

28th August, 2021, Dealing with Lockdowns, Breakfast ABC Central West.

23rd August, 2021, Over 60s cope better in lockdown, research finds, The Lighthouse. https://lighthouse.mq.edu.au/article/august-2021/over-60s-cope-better-in-lockdown,-research-finds

27th May 2020.Chen, J. & Wuthrich, V. “COVID-19: how it can affect the wellbeing of our ageing population”, The Weekly Times.

19th May, 2020, Delivering remote mental health treatment to older adults, ABC radio Orange, Ewen Gilbert.

18th May, 2020, Delivering remote mental health treatment to older adults during COVID19, 2BS (Bathurst), James Knight.

14th February 2020, Prevalence of depression and suicide in the elderly, 2SER. https://2ser.com/the-prevalence-of-depression-and-suicide-in-the-elderly/

Social media

16th October 2020, Mental health support program for older Australians being trialled, yourLife Choices. https://www.yourlifechoices.com.au/health/your-health/mental-health-support-for-older-aussies

10th August, 2020 - Novel online program helps older people with depression, the Lighthouse, https://lighthouse.mq.edu.au/article/october-2020/novel-online-program-helps-older-people-with-depression

31st August, 2021. How over 60s are coping better with lockdown restrictions. https://www.oversixty.com.au/lifestyle/retirement-life/how-over-60s-are-coping-better-with-lockdown-restrictions

30th August, 2021. Tech-savvy over-60s cope better through the long COVID-19 lockdowns_ - Aged Care 101 2021

28th August, 2021, the New Daily, Why older people are handling lockdown better than youngsters (plus 3 other outlets)

27th August, 2021, Why older people cope better with foreclosure than younger people, India, https://www.thebharatexpressnews.com/

Other resources

Managing COVID19 Anxiety for Older Adults handout developed for the Australian Psychological Society (April 2020)

Recognising Anxiety and Depression in Older Adults Consumer trifold prepared for Beyond Blue (2019)

Helping GPs recognise anxiety and depression in older adults prepared for Beyond Blue (2019)

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