BAN-Dep: A Trial to Decrease the Prevalence of Depression in Australian Nursing Homes.

The intervention includes 2 components: (1) Completion of the Professional Education to Aged Care (PEAC) e-learning program by care staff (2) Implementation of a structured behavioural activation (BA) program. All staff at Residential Aged Care Facilities (RACF) recruited into the study will complete the PEAC e-learning program at baseline via the Beyondblue website. They will be given 4 weeks to complete 7 modules: (i) understanding anxiety and depression, (ii) anxiety and depression in older people, (iii) promoting the mental health of community aged care clients, (iv) promoting the mental health of aged care residents, (v) identifying and responding to suicide in aged care settings, (vi) managing anxiety and depression in aged care clients and residents, (vii) looking after your mental health at work. The program was designed to address the specific needs of professionals working in the residential aged care sector and can be accessed using an internet browser (The address of the relevant website: https://www.beyondblue.org.au/about-us/about-our-work/older-adults-program/professional-education-in-to-aged-care-peac-program). Each module takes about 25 minutes to complete. A Mental Health Champion (MHC) will be nominated by the Facility Manager for each facility (both control and intervention sites) and will be the central point of contact for the research team. All MHCs will be asked to ensure staff complete the PEAC e-learning program and upon successful completion a certificate of achievement will be granted. Copies of certificates for staff that have completed the PEAC e-learning program will be sent to the trial coordinator. Staff at all facilities will be required to incorporate knowledge gained from PEAC e-learning program into their daily work routine. The BA training will be delivered to MHCs of intervention facilities in a group setting off site during the first 4 weeks by a trained BA therapist. The 12 hour training session is a validated structured program that has been shown to deliver benefits to older adults with depressive symptoms and incorporates 8 sessions of BA. These sessions address: (i) recognition of the symptoms of depression, (ii) the value of keeping a diary, (iii) types of activities, (iv) breaking jobs down into easier tasks, (v) the benefits of activities, (vi) finding ways to be active, (vii) spotting symptoms of depression and, (viii) action plan and activity scheduling. The trained MHCs of intervention facilities will deliver the BA program to residents (participants) recruited by research staff from weeks 5-8 on a one to one basis working through the self–help workbook designed specifically for the study with each participant over a 4 week period. Recruitment of participants will be conducted by the research team at all RACFs. The BA therapist will provide weekly supervision via phone during the 4 week period. These supervision sessions will ensure the MHCs adhere to delivering the BA program to participants. Using knowledge gained through the PEAC e-learning program and principles of BA, they will identify symptoms of depression, encourage participants to complete activities from the workbook enhancing their daily routine, reduce avoidant behaviours and increase pleasurable behaviours. The BA therapist will liaise with MHCs at week 10 to obtain feedback in relation to delivery of the intervention and if any concerns were raised by participants. They will continue to interact with GPs at the facilities and the BA therapist, should any issues arise that are of clinical concern in relation to the study.