An ounce of prevention

A scalable behavioural solution to prevent depression

The Problem:  People with low severity symptoms of depression rarely receive psychological treatment, and are often prescribed antidepressants with no clinical benefit.  They are at a very high risk of developing severe depressive illness. 

This is important since depression is potentially preventable, and if ignored it leads to increased hospitalisation, poor quality of life and increased mortality. 

The BTx Lab solution: We worked with experts by experience to devise a structured telephone support solution to prevent depressive symptoms becoming entrenched.  We used strategies to ensure people at risk of clinical depression were able to build rewarding and purposeful activities into their day to day lives, even if they were impaired by long term health difficulties. 

What we found & key publications.  CASPER is one of the largest trials undertaken in primary care to prevent depression among older people.  We found the chances of becoming clinically depressed were halved, and this preventative benefit was maintained over 12 months.  The brief behavioural intervention met patients’ needs and was well received, with high levels of engagement.  It was good value for money, and saved NHS resources in the longer term.  CASPER was published in the JAMA in 2017.  You can read a summary of the clinical and cost effectiveness of the CASPER preventative intervention

How this research was funded:  The CASPER study was supported by a £1.6M programme grant from NIHR [study number 08/19/04].  We worked in partnership with experts by experience and Age UK.

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