Abstract

BackgroundTechnology-based mental health interventions are an increasingly attractive option for expanding access to mental health services within the primary care system. Older adults are among the groups that could potentially benefit from the growing ubiquity of technology-based mental health interventions; however, older adults are perceived to be averse to using technology and have reported barriers to use.ObjectiveThe aim of this paper is to present a case study of 3 participants from a clinical trial evaluating IntelliCare, an evidence-based mobile intervention for depression and anxiety, among adults recruited from primary care clinics. Our report of these 3 participants, who were aged 60 years or older, focuses on their engagement with the IntelliCare service (ie, app use, coach communication) and clinical changes in depression or anxiety symptoms over the intervention period.MethodsThe 3 case study participants were offered IntelliCare with coaching for 8 weeks. The intervention consisted of 5 treatment intervention apps that support a variety of psychological skills, a Hub app that contained psychoeducational content and administered weekly assessments, and coaching for encouragement, accountability, and technical assistance as needed. The 3 case study participants were selected to reflect the overall demographics of participants within the trial and because their interactions with IntelliCare provided a good illustration of varied experiences regarding engagement with the intervention.ResultsThe 3 participants’ unique experiences with the intervention are described. Despite potential barriers and experiencing some technical glitches, the participants showed proficient ability to use the apps, high levels of participation through frequent app use and coach interaction, and decreased depression and anxiety scores. At the end of the 8-week intervention, each of these 3 participants expressed great enthusiasm for the benefit of this program through feedback to their coach, and they each identified a number of ways they had seen improvements in themselves.ConclusionsThese 3 cases provide examples of older individuals who engaged with and benefitted from the IntelliCare service. Although the results from these 3 cases may not generalize to others, they provide an important, informed perspective of the experiences that can contribute to our understanding of how older adults use and overcome barriers to mental health technologies. The findings also contribute toward the ultimate goal of ensuring that the IntelliCare intervention is appropriate for individuals of all ages.

Highlights

  • Illinois Oregon Virginia Alaska North Carolina Nebraska Arizona Indiana Louisiana Utah Oklahoma Arkansas Kansas Montana Nevada* Georgia Alabama Idaho Mississippi Wyoming Florida Missouri Texas Tennessee South Carolina National

  • Figures were taken from two sets of data: annual averages from 2013-2015 and 2010-2015

  • Data set denoted for each state in the Appendix-Table 1

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Summary

THE STATE OF MENTAL HEALTH IN AMERICA 2018

# 168,000 3,127,000 1,570,000 1,107,000 756,000 2,630,000 94,000 4,997,000 402,000 2,638,000 483,000 1,299,000 372,000 644,000 110,000 387,000 97,000 394,000 823,000 438,000 1,373,000 94,000 253,000 1,803,000 925,000 634,000. Weighted Sum of Z scores Adult Alcohol Dependence and Marijuana, Heroin, Cocaine Use

50 District of Columbia
51 Tennessee*
49 Tennessee**

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