The Problem:  Treatment of established depression is the dominant approach to care of older adults, but prevention holds much promise. Self-help interventions are a feasible preventive approach, since they are scalable and low cost.  Older people sometimes struggle to access digital interventions for depression, but most have access to a phone. 

The BTx Lab solution:  We designed the Self Help for People at Risk for Depression [SHARD] RCT.  We worked with experts by experience to devise a structured telephone support solution to prevent depressive symptoms become entrenched using behavioural principles.  We targeted older people with low-level depression. Using telephone guided behavioural activation they integrated purposeful activities into their day to day living. 

What we found & key publications.  SHARD is one of the largest trials undertaken in primary care to prevent depression using guided self-help.  Published in 2022 in the American Journal of Geriatric Psychiatry, we found the chances of becoming clinically depressed were halved at four months.  The benefit was clinically significant, but became attenuated at 12 months. 

You can read an editorial on the importance of the SHARD preventative intervention. 

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