Mark Yaffe
Scientific Series: February 22, 2024
Lay mental health self-care: the innovative DIRECT care model
The DIRECT research group will present an overview of its comprehensive program of studies aiming to improve the management of depression for older adults. This interdisciplinary team of researchers, primary care physicians, mental health specialists, trained non-medical mental health workers, and community stakeholders has focused on understanding the complex needs of older adults with chronic physical conditions and depression. Recognizing the urgent need for mental health support in this population, it has collaboratively developed, evaluated and disseminated depression self-care interventions for use in different contexts. These models utilize brief, low-intensity psychological interventions that encourage self-care.
The DIRECT team developed a depression self-care toolkit specifically for community-based patients. The toolkit, which can be modified according to the needs of specific target populations, acknowledges the interconnectedness of mental and physical health and addresses both aspects in a coordinated manner. The team has shown the feasibility of delivering supported depression self-care based on cognitive behavioral therapy principles using telephone or internet modalities. This model of guided mental health self-care is innovative, accessible, and employs low-cost self-care tools and trained lay guides who may be recruited from communities-at-large.
Multiple randomized trials of this guidance model have been conducted by the team, demonstrating better mental health outcomes compared to both self-directed use of self-care tools as well as usual care. The team has also explored dyadic interventions involving family or friends in depression self-care to further enhance outcomes. The patient-centered approach promotes empowerment and active participation of older adults in decisions regarding their mental health and overall well-being. This model offers an option for older adults’ active management of mental health issues; and from work done using these tools on younger populations (e.g., depression in post-partum women and in cancer survivors), it appears that what is learned from using the tools may be applied preventively in later life.
At the end of this session, participants will:
Describe the components in a supported mental-health self-care intervention.
Understand how supported mental-health self-care interventions can be adapted to various clinical populations.
Describe the outcomes of studies having evaluated supported mental-health self-care interventions.
Dr. Mark Yaffe is a Tenured Professor of Family Medicine at McGill University, a Full Scientist at St. Mary's Research Centre and a practicing family physician at the St. Mary's Family Medicine Group. Dr. Yaffe maintains a large family practice and has received the Quebec College of Family Physicians’ Award of Excellence for his work as a clinician. He is also the recipient of a Lifetime Achievement in Family Medicine Research Award from the College of Family Physicians of Canada, and an early inductee into the McGill Faculty of Medicine Honour Roll for teaching excellence. He led an interdisciplinary team that developed and validated the Elder Abuse Suspicion Index (EASI), a simple tool to assist family physicians in detecting elder abuse. The EASI has been translated into 17 languages and the World Health Organization has found it to be valid in a number of countries. Dr. Yaffe has also extensively studied family caregiving, depression and patient-self-care. Today, he speaks about the DIRECT program in which he has been involved for over 15 years. Dr. Yaffe and the DIRECT research team have recently been awarded a Seniors’ Mental Health Outstanding Care and Integrative Practice Award from the Canadian Coalition for Seniors' Mental Health.