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The National Depression Initiative

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					                    beyondblue:
   The National
Depression Initiative
  Presentation to Alzheimer’s Australia
          National Conference
Living with Dementia: Positive Solutions




   beyondblue
      the national depression initiative
      www.beyondblue.org.au
               What is beyondblue?
•beyondblue is a national, independent, not-for-profit organisation
working to address issues associated with depression, anxiety and
related substance-use disorders in Australia.

•Endorsed by AHMAC, established in 2000 by the Commonwealth
and Victorian Governments, beyondblue is now supported by other
State and Territory Governments, private companies and community-
based organisations.

•beyondblue works in partnership with health services, schools,
workplaces, universities, media and community organisations, as
well as people living with depression, to bring together their
expertise around depression – health promotion in action.



           beyondblue
                the national depression initiative
                www.beyondblue.org.au
           beyondblue’s 5 priorities
1 Increasing community awareness of depression, anxiety and
related substance-use disorders and addressing stigma

2 Working with people living with depression and promoting
their needs and lived experiences of depression with policy
makers in the healthcare system

3 Developing prevention and early intervention programs
around depression

4 Improving training and support for GPs and other healthcare
professionals around depression

5 Initiating and supporting depression-related research




          beyondblue
              the national depression initiative
              www.beyondblue.org.au
                beyondblue’s approach
A snapshot of beyondblue programs across the lifespan
Research                        Practice
Post Natal Depression Project
                                                       Antenatal & postnatal
beyondbabyblues
Ybblue campaign and Ybblue Crew                        Youth
National Schools Research                              Schools
Initiative
Every Family Initiative                                Parents
National Depression in the                             Workplace
Workplace Program
Beyond Ageing Project                                  Older people
Maturityblues




             beyondblue
                  the national depression initiative
                  www.beyondblue.org.au
       “Report highlights growing
            dementia cases”                                               Source: Mathers, Vos &
                                                                          Stevenson (1999)

         Six leading causes of years of life lost due to
                      disability (YLD) 1996


      Depres s ion
        Dem entia
          As thm a
    Os teoarthritis
    Hearing los s
Diabetes m ellitus

                   0.0%            2.0%              4.0%   6.0%   8.0%       10.0%
                                         YLD as a % of total YLD




          beyondblue
                the national depression initiative
                www.beyondblue.org.au
      How common is depression
     in the Australian community?
Depression is common affecting 1 in 5 Australians: 1 million people at any one time

        Twelve-month prevalence of mental disorders in Australian adults
                                    MALES                   FEMALES

                                         %           Population                     %          Population
                                                      estimate                                  estimate

   Any depressive disorder               4.2              275,300                  7.4             503,300

   Any anxiety disorder                  7.1              470,400                 12.0             829,600

   Any substance use disorder          11.1               734,300                  4.5             307,500

   Any mental disorder                 17.4              1,151,600                18.0           1,231,500

                    Source: Andrews G, Hall W, Teesson M, Henderson S. The mental health of Australians. Mental Health
                    Branch, Commonwealth Department of Health and Aged Care, 1999.




              beyondblue
                    the national depression initiative
                    www.beyondblue.org.au
   Who gets depressed?
Prevalence of depression by age and sex (community cases)

                                               1 in 6 males
                                               1 in 4 females




                                                Source: Andrews G, Hall W,
                                                Teesson M, Henderson S. The
                                                mental health of Australians.
                                                Mental Health Branch,
                                                Commonwealth Department of
                                                Health and Aged Care, 1999.




     beyondblue
          the national depression initiative
          www.beyondblue.org.au
       Depression in the elderly
However…
•Major depression rates among older people with
comorbid conditions up to 25-36%
•Prevalence rates of major depression among older
people living in residential care have been reported
as high as 26%, with rates of depressive
symptoms reported as high as 40%
•High suicide rates identified among older men
•Ageing population – number of depressed older
Australians expected to double by 2021


       beyondblue
           the national depression initiative
           www.beyondblue.org.au
beyondblue Depression Monitor
  Identification of depression as a major mental health problem in
                        Australia by age group


    60
    50
    40
  % 30
    20
    10
     0
         18-24       25-34         35-44       40-54   55-64   65+
                                      age group




    beyondblue
          the national depression initiative
          www.beyondblue.org.au
 beyondblue Depression Monitor
Older respondents (aged 65 and over) were
less likely to assign highest ratings of
disability to depression when compared with
younger age groups:
•19.4% perceived depression affects 1 in 5
•25.9% perceived depression affects 1 in 20
•25% perceived depression affects 1 in 50




      beyondblue
         the national depression initiative
         www.beyondblue.org.au
  Prevalence of depression among
  elderly people in residential care
(Centre for Health Risk Behaviours & Mental Health, Deakin University 2004)
                                                      Number of   Percentage of
                                                        cases        sample
Diagnosis of Depression
 Major Depressive disorder                               54           18.0
 Minor Depressive Disorder                               30           10.0

Prescribed antidepressant                                61           20.3
medication
No incidence of depression                              155           51.7

Total                                                   300           100


           beyondblue
                 the national depression initiative
                 www.beyondblue.org.au
Screening for depression among older people
 •Currently no routine screening for depression in
 residential care
 •ACAT mini-mental instrument not adequate
 •Research found that depression instruments are valid
 indicators of major depression, including where
 moderate dementia is present
 •Need for research into whether the routine use of
 depression instruments can result in improved outcomes
 for residents with depression



         beyondblue
              the national depression initiative
              www.beyondblue.org.au
Satisfaction with health services for depression
 General satisfaction with health service provider
 but poor engagement around non-physical
 symptoms:
 “He (GP) is a very nice gentleman, but he’s too busy to
 spend much time with people”
 “…more interested in the physical parts of me”
 •Poor understanding of illness and low awareness
 of treatment
 •Poor perception of improvements in mental state
 following treatment



          beyondblue
              the national depression initiative
              www.beyondblue.org.au
         The need for action
• Low level of literacy in the general population
  and among health care professionals and older
  people
• Chronic under-treatment of depression – older
  people the most vulnerable
• Failure to recognise and diagnose depressive
  symptoms
• Major depression often untreated or wrongly
  treated
• Nihilistic belief that depression ‘is to be
  expected’ in old age



       beyondblue
           the national depression initiative
           www.beyondblue.org.au
         Potential interventions
Prevention methods proposed:

• Increasing literacy about depression in old age

• Improving recognition/diagnosis in primary care

• Promotion of physical exercise to alleviate symptoms of
  mild to moderate depression

• Nutritional supplements

• Partnerships: Better Outcomes in Mental Health Care -
  increased training for GPs




       beyondblue
            the national depression initiative
            www.beyondblue.org.au
      Beyond Ageing Project

•Largest research project into depression
and the elderly

•Will examine whether vitamin
supplements, exercise and improving
knowledge of depression can prevent
depression in older people




    beyondblue
        the national depression initiative
        www.beyondblue.org.au
  Other beyondblue research into
    depression and the elderly
•Caring for depressed older people in the emergency
department
•Using physical activity to promote wellbeing in older
people in the primary care setting
•An interdisciplinary approach to recognising and
treating depression among older Australians living in
residential care
•MAP Project: sector module for aged care workers


        beyondblue
            the national depression initiative
            www.beyondblue.org.au
                 Where to now?
•Beyond Ageing project

•Maturityblues/blueVoices
 -   Training program on depression for staff in
     aged care settings
-     Research with elderly consumers and carers
-     Increase community awareness and improve
      literacy
•Partnership with Alzheimer’s Australia and
Baptist Community Care


      beyondblue
          the national depression initiative
          www.beyondblue.org.au

				
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