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Improving Mental Healthcare for Older Adults: Community Based Screening for Social and Emotional Loneliness and Major Depressive Disorder

Abstract Purpose: Major depressive disorder (MDD) is a devastating mental health disorder affecting older adults that is often misdiagnosed or untreated due to a lack of screening and the stigma that MDD symptoms are a normal and expected part of aging. The goal of this quality improvement (QI) project was to implement a community-based screening intervention to identify community-dwelling older adults at risk for or suffering from MDD, and facilitate further evaluation and care. Methods: Participants were community dwelling older adults, age 56 and older, in Massachusetts. Two screening tools were administered in two sites that screened for social and emotional loneliness and MDD, and follow-up was measured two weeks post initial interview. Quantitative methods including a Pearson-Chi-Squared test of independence and a One-Way ANOVA analysis were subsequently performed to analyze the data. Results: Of the 53 participants, 4% scored positive for MDD, 22% scored positive for MDD and social and emotional loneliness, 28% scored positive for only social and emotional loneliness. A significant association was shown between MDD and social and emotional loneliness (Chi-Squared = 3.847, p=0.050). 86% of participants that scored positive for MDD and 59% of participants that scored positive for social and emotional loneliness pursued further evaluation and social activities. Conclusion: Implementation of early screening for MDD in older adults by psychiatric metal health nurse practitioners (PMHNP) through home visits can be effective at identifying MDD and its precursors, and facilitating further evaluation and interventions. Keywords: older adults, advanced practice nursing, community-dwelling, depression, loneliness, screening tools.