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Healthy IDEAS: Implementation of a Depression Program Through Community-Based Case Management

Correspondence: Address correspondence to Dr. Banghwa L. Casado, 525 West Redwood St., Baltimore, MD 21201. E-mail: bcasado{at}ssw.umaryland.edu

Purpose: Healthy IDEAS (HIDEAS; IDEAS stands for Identifying Depression, Empowering Activities for Seniors) is an evidence-based depression program addressing commonly recognized barriers to mental health care for older adults. The purpose of this study was to describe the implementation of HIDEAS and assess its feasibility. Design and Methods: Three community agencies implemented the program with 94 eligible older adults who were identified from 348 screened older adults. We assessed program implementation by using the Core Implementation Component framework, using a client-tracking database, written survey of case managers, focus-group interview with coaches, and agency and project progress reports. Results: We identified several challenges: clients' reluctance to acknowledge depressive symptoms and difficulty in engaging in behavioral changes; differences among case managers' mental health knowledge, skills, and "buy-in" and difficulty managing limited time; and differences in agency culture that foster in-agency supervision. Implications: Successful adoption and sustainability of HIDEAS are more likely when essential elements of the Core Implementation Component framework are addressed to bring about behavioral changes at all treatment-implementation levels—clients, practitioners, and organizations.

Key Words: Case management • Community-based services • Elder depression • Mental health intervention