ACFI raises awareness of depression

Linking depression to the funding model has drawn attention to it but staff need more assistance with assessments.

The Aged Care Funding Instrument (ACFI) has helped draw attention to depression in residential aged care but staff members still need more training on how to use the Cornell Scale for Depression (CSD).

A survey conducted by the Aged and Community Services Association of NSW & ACT (ACS) suggests that since the introduction of the new tool in March 2008, the number of residents being screened for depression has increased.

The survey was completed among 97 ACS members earlier this year.

ACS CEO, Jill Pretty told the HammondCare Conference on Depression in the Elderly that before the ACFI was introduced, 63.5 per cent of respondents regularly screened residents for depression but this figure rose to 80 per cent after the tool came into effect.

But some staff members are having trouble coming to grips with the prescribed tool for assessing depression.

The majority of staff members covered by the survey only completed basic training and just two of the 97 facilities organised for training sessions from a professional psychologist or psychiatrist.

Among the concerns of staff were the length of the scale, difficulties getting GPs to address their concerns and the scarcity of interpreters.

“The staff are feeling quite threatened because they don’t understand depression and they don’t understand what they are doing when they assess for it,” said Ms Pretty.

“And because the Cornell Scale is used as part of the funding tool because they feel under pressure to get extra money.”

“Some questions are hard to answer but for validation purposes, every question needs to be answered.”

On the upside, the survey suggests that the widespread use of the CSD has led to a more active treatment of depression and greater engagement with mental health teams.

“I think it has raised staff awareness of depression and there is increased interest in the area,” Ms Pretty said.

“But they need the skills to apply the tool and that’s where the focus should be now.”

Richard Rosewarne from Applied Aged Care Solutions told delegates that under the ACFI, a significant proportion of residents had received high ratings for depression.

Data obtained from the Department of Health and Ageing showed that 17 per cent of the 125,000 residents appraised before March 2009 were classified as ‘C’ or ‘D’ – the two highest ratings.

Mr Rosewarne said this was consistent with the department’s modelling.

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