Barriers and facilitators to depression screening in older adults: a qualitative study

Author/Creator ORCID

Date

2018-12-27

Department

Program

Citation of Original Publication

Colligan, Erin M. et al.; Barriers and facilitators to depression screening in older adults: a qualitative study; Aging & Mental Health , Volume 24, Issue 2, 27 December, 2018; https://doi.org/10.1080/13607863.2018.1531376

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Public Domain Mark 1.0
This work was written as part of one of the author's official duties as an Employee of the United States Government and is therefore a work of the United States Government. In accordance with 17 U.S.C. 105, no copyright protection is available for such works under U.S. Law

Subjects

Abstract

Objectives: The objective of this qualitative study was to better understand facilitators and barriers to depression screening for older adults. Methods: We conducted 43 focus groups with 102 providers and 247 beneficiaries or proxies: 13 focus groups with Medicare providers, 28 with older Medicare beneficiaries, and 2 with caregivers of older Medicare beneficiaries. Each focus group was recorded, transcribed, and analyzed using principles of grounded theory. Results: There was widespread consensus among beneficiary and provider focus group participants that depression screening was important. However, several barriers interfered with effective depression screening, including stigma, lack of resources for treatment referrals, and lack of time during medical encounters. Positive communication with providers and an established relationship with a trusted provider were primary facilitators for depression screening. Providers who took the time to put their beneficiaries at ease and used conversational language rather than clinical terms appeared to have the most success in eliciting beneficiary honesty about depressive symptoms. Respondents stressed the need for providers to be attentive, concerned, non-judgmental, and respectful. Conclusion: Findings indicate that using person-centered approaches to build positive communication and trust between beneficiaries and providers could be an effective strategy for improving depression screening. Better screening can lead to higher rates of diagnosis and treatment of depression that could enhance quality of life for older adults.