As the winter holidays can be a difficult time for many, it is important now more than ever to remember that untreated depression among rural older adults poses great health risks and concerns.
Effective treatments for depression do exist; however, older adults in Tuolumne and Calaveras counties have less access to those treatments than their urban or suburban counterparts. Although older adults report benefits to life in rural areas, such as proximity to nature and greater participation in religious or spiritual communities, research has shown that they are more likely to have chronic conditions and experience more social isolation due to distance, lack of transportation or mobility issues.
The 2016 Community Health Needs Assessment – a publication put out by the Tuolumne County Public Health Department and Adventist Health, Sonora – indicates that depression is more common among Tuolumne and Calaveras residents than other California residents (12 percent here versus 9 percent across the state). However, as in many rural communities, both Tuolumne and Calaveras counties have fewer than half the number of behavioral health providers than the rest of the state.
Tuolumne and Calaveras also have relatively older populations –24 percent over age 65, compared to 12 percent over that age in California as a whole – and older adults have especially low rates of receiving needed behavioral health care services for depression. When depression remains untreated in older adults, their use of other health care services increases.
In an effort to address these challenges, the Mother Lode Office of Catholic Charities collaborated with the University of California, San Francisco (UCSF), to create the Senior Peer Alliance for Rural Research on Wellness (SPARROW) program in 2013. With funding from the National Institute on Aging, SPARROW began serving older adults with depression in Tuolumne and Calaveras counties with 12 weeks of in-home case management and problem-solving therapy provided to individuals over age 60 with depression. The treatment method uses a trained case manager or senior peer counselor and a “self-guided” approach. These methods are intended to give older adults new tools and resources to manage overwhelming life problems.
While meeting with older adults in their own homes or other convenient settings, SPARROW clinicians and senior peer counselors offer support with accessing a range of health and wellness-related resources to meet unmet needs, such as nutrition programs and transportation services.
Now coming into its sixth and final year, SPARROW has served more than 90 participants in Calaveras, Tuolumne, Stanislaus and rural San Joaquin counties. Federal funding for the SPARROW project concludes in October. However, Catholic Charities is pursuing alternative funding in hopes that counseling services can continue past that time.
As the SPARROW project continues to be successful at reducing depression and other unmet needs, it could serve as a solution to the problems of depression and social isolation among older adults in rural regions all over the country. Furthermore, by utilizing the available workforce of clinicians and senior peer counselor volunteers, SPARROW fulfills the Community Health Needs Assessment recommendation to make greater use of community health workers and affiliated health professionals. Continuing the SPARROW project would build on a model that addresses peoples’ needs with minimal investment of resources.
If you are interested in receiving free case management and counseling services, or know a senior who might, call Catholic Charities at 532-7632 and ask about the SPARROW project.
Sandi Kaplan, a UCSF researcher and Catherine Driver and C’Anne Johnson, with the Mother Lode Office of Catholic Charities