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Author List:
Bonner LM (Northwest Center for Outcomes Research in Older Adults)
Chaney EF (Northwest Center for Outcomes Research in Older Adults)
Lanto A (Center for the Study of Healthcare Provider Behavior)
Yano E (Center for the Study of Healthcare Provider Behavior)
Simon BF (Center for the Study of Healthcare Provider Behavior)
Rubenstein LV (Center for the Study of Healthcare Provider Behavior)
Simon A (Center for the Study of Healthcare Provider Behavior)
Objectives:
Adequate social (family, community, and spiritual) support plays an important role in recovery for many depressed individuals, but is often lacking. We describe the demographic characteristics associated with amount of social support in a depressed primary care veteran population.
Methods:
WAVES is a patient-level evaluation of disseminating a depression quality improvement collaborative care intervention (TIDES). TIDES was implemented at the clinic level in 7 VA outpatient primary care clinics across VISNs 10, 16 and 23. WAVES participants were screened for depression using the nine-item Patient Health Questionnaire (PHQ-9). Those who screened positive for depression were invited to join the study and were given a Patient Assessment Questionnaire (PAQ), which asks about social support, and other relevant domains. 768 patients completed the PAQ.
Results:
A significant association existed between age and social support (p<.001) such that older veterans reported less support. The small number (6%) of female veterans in the sample reported lower levels of social support than men (p<.01). Although a majority of both genders lived with others, a higher proportion of women lived alone (44.4% v. 27.5%, p<.05). Participants living with others reported more social support than those living alone (p<.001). African-American and Latino participants reported higher levels of seeking spiritual support than Whites (p<.05). Unemployed participants had lower levels of support than employed participants (p<.005). Individuals who were likely to seek help from a spiritual counselor were also likely to seek help from mental health clinicians (p<.001). Those who were likely to seek help from a spiritual counselor were also likely to discuss treatment options with a family member (p=.001).
Implications:
Participant resources and preferences for social support varied with their demographic characteristics. Individuals seeking support from mental health professionals also tend to seek help from spiritual counselors and family members.
Impacts:
Preferences and resources for social support are not uniform in the VA patient population. Patients seek support from multiple sources including family and spiritual counselors as well as professional caregivers. Quality improvement programs should consider including these preferences and resources when planning depression care.
