Depression Prevention Utilizing a Trauma-Informed Approach - PHC6534 Grant Proposal

By the year 2050 approximately 46 million US adults aged 18 years or older will be diagnosed with a depressive disorder according to research by Heo et al¹. The magnitude of this health condition urges mental health researchers to identify common etiologies of depression. Along with what can be done to circumvent an increase of this disorder within the population. The CDC reports that preventing Adverse Childhood Experiences (ACE) could reduce up to 21 million cases of depression. This serves as an opportunity to make an impactful difference concerning ACE caused depression. Thus I propose a multilevel intervention using the CDC’s social ecological model to address this issue. Specifically, targeting factors within an individuals life and familial relationships that influence the likelihood of developing a depressive disorder. This tactic will effectively work to prevent ACEs by connecting youth to caring adults, services and activities that help to ensure children can reach their full potential.

Research has shown that some common risk factors for depression increase with age (Stordal et al., 2001)⁶, thus in order to effectively decrease the risk and development of depression we are focusing on individuals aged 10-18 using a secondary prevention method (Simons-Morton, McLeroy, & Wendel, 2012)⁷. We selected a secondary prevention method because we are targeting individuals that are at high risk of depression, as opposed to the general population with the mental illness (Simons-Morton, McLeroy, & Wendel, 2012)⁷. Using this approach we will be able to identify individuals with traumatic backgrounds at higher risk of developing depression, effectively reducing the impact of mental health disease or injury induced by ACE’s. This early identification and detection will afford early supportive action and save health costs for the healthcare system and patients.

This project will embed trauma-informed principles throughout every level of intervention development and implementation in order to be cognizant and respectful for the target audience. We will achieve this goal by ensuring the multidisciplinary team is properly trained on trauma-informedness (Substance Abuse and Mental Health Services Administration, 1970)². The foremost principle incorporated into this project will be safety, this must be highlighted because of the detriment trauma has and can cause on an individual. We will be intentional about safety within this project by requiring all facilitators of care to undergo trauma-informed approach training prior to commencing the intervention. This will help to foster an environment that the target audience will be comfortable in and willing to share (SAMHSA's concept of trauma and guidance for a Trauma-Informed Approach 2021)³. Another important principle will be peer-support which helps to affirm the purpose of the CDC SEM level of relationship and the impact it has on behavior change (The social-ecological model: A framework for PREVENTION |violence Prevention|Injury Center|CDC 2021)⁴. Furthermore, culture will play a profound role in understanding whether traumatic correlations can be made as apart of generational trends that have been adopted and accepted as normal—thus contributing to more depressive cases (SAMHSA's concept of trauma and guidance for a Trauma-Informed Approach 2021)³. Finally, we will be transparent with each individuals situation. To clarify, in trauma much of the autonomy is taken away from those with traumatic backgrounds—thus it will be imperative for the team to be transparent throughout the program, allowing the target audience control over the decisions they make (SAMHSA's concept of trauma and guidance for a Trauma-Informed Approach 2021)³.

Finally, in order to achieve the project goals for this intervention we must go beyond simply focusing on an individual expressing a depressive state. Instead we must utilize the multi-pronged approach of the CDC’s Social Ecological Model (SEM). Using this concise yet comprehensive model incorporates the importance of an individuals relationship with the community and society, and how it influences their actions. Which in this case may contribute to an increased likelihood of ACE exposure leading to depressive cases. Assessing all four levels of this SEM model (individual, relationship, community, societal) will help this team appropriately manage and prevent exposures that contribute to depression in our target groups (The social-ecological model: A framework for PREVENTION |violence Prevention|Injury Center|CDC 2021)⁵.

References:

1. Heo, M., Murphy, C., Fontaine, K., Bruce, M., & Alexopoulos, G. (2008, May 23). Population projection of US adults with lifetime experience of depressive disorder by age and sex from year 2005 to 2050. Retrieved February 15, 2021, from https://onlinelibrary.wiley.co...abs/10.1002/gps.2061
2. Substance Abuse and Mental Health Services Administration. (1970, January 01). SAMHSA's concept of trauma and guidance for a Trauma-Informed Approach. Retrieved March 23, 2021, from https://calio.dspacedirect.org/handle/11212/1971
3. SAMHSA's concept of trauma and guidance for a Trauma-Informed Approach. (2021, February 11). Retrieved March 23, 2021, from https://nicic.gov/samhsas-conc...ma-informed-approach
4. The social-ecological model: A framework for PREVENTION |violence Prevention|Injury Center|CDC. (2021, January 28). Retrieved March 22, 2021, from https://www.cdc.gov/violencepr...ecologicalmodel.html
5. The social-ecological model: A framework for PREVENTION |violence Prevention|Injury Center|CDC. (2021, January 28). Retrieved March 22, 2021, from https://www.cdc.gov/violencepr...ecologicalmodel.html
6. Stordal, E., Krüger, M., Dahl, N., Krüger, Ø, Mykletun, A., & Dahl, A. (2001, December 20). Depression in relation to age and gender in the general population: The NORD‐TRØNDELAG Health STUDY (HUNT). Retrieved March 09, 2021, from https://onlinelibrary.wiley.co...dwgpefUyyQJVsXzKqzJQ
7. Simons-Morton, B. G., McLeroy, K. R., & Wendel, M. L. (2012). Behavior theory in health promotion practice and research. Sudbury, Mass: Jones & Bartlett Learning.