• The primary outcome is engagement defined as at least two visits with a mental health provider who can offer treatment of depression. [ Time Frame: 12 and 24 weeks ] [ Designated as safety issue: No ]
  

The goal of this study is to conduct a randomized controlled trial of the impact of a brief, psychosocial intervention -- the Treatment Initiation Program (TIP) -- on access to care, defined as engagement (attending two sessions with a mental health provider), among depressed community dwelling older adults participating in a home delivered meal program. The Treatment Initiation Program (TIP) was developed to work collaboratively with an older adult who has depressive symptoms to address the barriers to care with the aim of helping them consider a referral and engage in mental health care. In prior research TIP has been found to improve treatment participation, reduce depressive symptoms and increase adherence to antidepressant therapy among depressed older adults in primary care and outpatient psychiatric settings. We propose that TIP will improve the access to mental health care by reducing psychological barriers, providing education about care, and managing the resignation associated with the symptoms of depression among community dwelling depressed elders. Additionally, we believe that despite the heterogeneity of mental health care that may be received TIP will be associated with reduced depressive symptoms by empowering the older adult to initiate care for him/herself.