1. beyondblue the national depression initiative www.beyondblue.org.au beyondblue: the national depression initiative Presentation to Alzheimer’s Australia National Conference Living with Dementia: Positive Solutions Leonie Young Chief Executive Officer www.beyondblue.org.auwww.beyondblue.org.au May 2005 www.beyondblue.org.au

2. beyondblue the national depression initiative www.beyondblue.org.au 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. What is beyondblue?

3. beyondblue the national depression initiative www.beyondblue.org.au 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’s 5 priorities

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

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

6. beyondblue the national depression initiative www.beyondblue.org.au How common is depression in the Australian community? Twelve-month prevalence of mental disorders in Australian adults MALES FEMALES Any depressive disorder4.2275,3007.4503,300 Any anxiety disorder7.1470,40012.0829,600 Any substance use disorder11.1734,3004.5307,500 Any mental disorder17.41,151,60018.01,231,500 %Population estimate 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. Depression is common affecting 1 in 5 Australians: 1 million people at any one time

7. beyondblue the national depression initiative www.beyondblue.org.au Prevalence of depression by age and sex (community cases ) 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. Who gets depressed? 1 in 6 males 1 in 4 females

8. 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

9. beyondblue the national depression initiative www.beyondblue.org.au beyondblue Depression Monitor

10. 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

11. beyondblue the national depression initiative www.beyondblue.org.au Prevalence of depression among elderly people in residential care Number of cases Percentage of sample Diagnosis of Depression Major Depressive disorder Minor Depressive Disorder Prescribed antidepressant medication No incidence of depression 54 30 61 155 18.0 10.0 20.3 51.7 Total300100 ( Centre for Health Risk Behaviours & Mental Health, Deakin University 2004)

12. beyondblue the national depression initiative www.beyondblue.org.au 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 Screening for depression among older people

13. beyondblue the national depression initiative www.beyondblue.org.au 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 Satisfaction with health services for depression

14. beyondblue the national depression initiative www.beyondblue.org.au 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 The need for action

15. beyondblue the national depression initiative www.beyondblue.org.au 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 Potential interventions

16. 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

17. 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

18. 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