Final report: Stay Connected — developing an intervention to promote mental health among isolated senior housing residents

Department News | December 1, 2021

In April 2021, we announced the recipients of our 2020 Small Grants Program aimed at advancing the clinical, educational, research, and/or advocacy missions of our department. We were able to allocate nearly $100,000 to a terrific set of diverse, one-year proposals from faculty, staff and trainees on a wide range of topics. This is the final report for the “Stay Connected: Developing an Intervention to Promote Mental Health Among Isolated Senior Housing Residents” project led by Patrick Raue, PhD, Patricia Areán, PhD, and Brenna Renn, PhD.

Summary of the work completed
We surveyed 35 older residents of 4 public housing facilities in Seattle. 20% of residents reported depression or anxiety at moderate to severe levels, corresponding to a diagnosable mental health condition. An additional 31.4% reported milder levels of distress in response to COVID-19, including loneliness, elevated depressive symptoms, or elevated anxiety symptoms. The majority of residents (82.9%) reported one or more negative consequences related to COVID, such as obtaining medical care, obtaining food, finances, seeing family, and exercise. Overall distress was significantly associated with greater number of such consequences, lower perceived social support, and lower physical health. The majority (82.9%) of residents responded positively to the question: “If you were to feel depressed, anxious or isolated, would you consider working with somebody to try and feel better?”

Following these surveys, we developed a telemedicine-supported intervention with both housing staff and residents experiencing distress called Stay Connected.  Stay Connected strategies focused on meeting social service needs, enhancing social connections, and teaching self-management strategies for depression and anxiety. We developed training materials including webinars, a structured manual, in-session worksheets, and a list of personalized community resources. 

We are conducting an ongoing pilot randomized controlled trial comparing Stay Connected to Usual Care plus Resource Guide among 29 older adults experiencing emotional distress to date.  Preliminary analyses have revealed a small reduction in both depression and anxiety at 9 weeks for participants in the Stay Connected group, versus no change in depression and an increase in anxiety among Usual Care participants.

What did you learn because of this work?
We learned that as many as 50% of older public housing residents have been experiencing distress since COVID, which may take the form of depressive symptoms, anxiety, or loneliness.  In addition, the majority have reported significant difficulty getting basic needs met and medical care due to COVID. Residents found an intervention focused on learning skills to increase social connections, increase enjoyable activities, and reduce anxiety to be acceptable and helpful.

What future activities might result from this award?
We have received a positive review of a fully powered R01 study at the National Institute of Aging. This study will be discussed at the NIH Council meeting for possible funding.

The City of Seattle and Aging and Disability Services funded an implementation of Stay Connected. This project supported seven social service contractors in implementing the program to older adults representing English, Spanish, Chinese, and Indian communities. We will continue to partner with Aging and Disability Services for future implementation projects.