If you or someone you know is experiencing a mental health emergency, get help by calling 988 to reach the national suicide and crisis hotline.
Mary Jones was depressed. It was 2021, and the COVID-19 pandemic had been disrupting lives for nearly a year. Jones was in her early 60s with chronic health conditions, so she stayed home to avoid the virus.
Jones was living alone in Tampa. She missed traveling and socializing with local women’s group and being around others at the medical office she worked at five days a week. She was starting to feel helpless.
“For me to go from being that person that was active into different programs to being locked in my home, and that fear of COVID, it was very devastating for me,” said Jones, now 65.
Then a local aging services worker suggested she try the Do More, Feel Better program. It’s a national research project the University of South Florida is involved with that pairs adults 60 and older with peer coaches to boost mental health.
Older adults face a lot of challenges that can lead to depression. They're more likely to be grieving the deaths of loved ones. They may have physical health problems that limit what they can do. And some struggle to live on fixed incomes.
“Someone can get kind of stuck, and then once you’re depressed, it’s just really hard to motivate yourself,” said Tampa study lead Amber Gum, a professor in the Department of Mental Health Law and Policy at USF’s College of Behavioral and Community Sciences.
How visiting a park or cooking can treat depression
Do More, Feel Better aims to help seniors stay active and connected with others so that they may live happier, healthier lives. The program is based on a mental health care approach known as behavioral activation.
“We’ve got decades of research, and also just common sense, that shows us that for any of us when we do more of things that we value and enjoy, we feel better,” Gum said. “And this is a proven treatment for depression, that if you can help someone to schedule and plan and start to do more of those kinds of activities, their depression will lift.”
What sets this program apart is that it trains seniors to stand in for professional therapists to motivate their peers. A researcher at the University of Washington developed the approach and successfully piloted it before inviting USF and Weill Cornell Medicine in New York to get involved in the study, which the National Institute of Mental Health is funding.
The effort has a larger goal: addressing a national shortage of mental health professionals by making support services more accessible.
“So another benefit of this approach is that you could potentially really expand the workforce of people who can deliver an effective intervention to older adults with depression,” Gum said.
Participants are assigned at random to work with a traditional therapist or peer coach. They meet over the course of nine weeks and set manageable goals for the client to get active again. Researchers supervise and evaluate the results.
Jones worked with a coach, who advised her to visit a park along the Hillsborough River in Tampa. There, she could get fresh air and stretch her legs. She also had a relaxing place to read the motivational books she enjoys and could be around people while keeping a distance.
Going there once or twice a week was a fairly simple task, but it meant a lot to Jones.
“This became like one of my spots, and kind of like my sanctuary where I felt OK and safe,” she said one recent afternoon while sitting on a park bench, books in hand.
The "been there, done that" factor
Chatting with her coach each week was also helpful for Jones, she said, adding that their generational bond made it easier to connect.
“It really helped because we could talk about some of our aches and pains and, you know, she understood. And I mean her being her age, me being my age, we could relate to how things used to be when we were 30 as opposed to how things are going now in our 60s,” she said.
Gum called the “been there, done that” element the “special ingredient” older adult coaches can bring to the table. Whereas therapists have the education to respond to seniors’ mental health challenges but may lack the lived experience to relate to what they’re going through.
Fewer than half of older adults who have mental health or substance use disorders receive treatment, the National Council on Aging reports.
Some have a hard time finding an available provider while others struggle to afford care. Hesitancy is another problem.
Nearly 75% of adults 65 and older reported feeling like their problems weren’t “bad enough” to be stressed about, believing others had it worse, according to a 2023 survey from the American Psychological Association.
The five clients that Carita Wells of Brandon coached shared similar feelings with her. She recalled one woman who was “bored to death,” and didn’t realize how much that was affecting her mentally, until Wells helped her identify a passion: cooking.
“That lady went to town, and she would recite recipes to me almost every day, and she was so excited about telling me, 'Guess what I cooked yesterday?’ ” said Wells. “She was a different person by the end of the program; she was vibrant and she was excited about life."
Wells, 69, is a former attorney who learned about the program at her local senior center. She has previous teaching experience, and had already navigated things like health challenges and retirement, so she felt she could empathize with her peers.
“Helping other people who are also seniors was to me a natural fit,” Wells said.
What's next for the study?
USF partners with Hillsborough County's Aging Services Department to find clients and coaches. So far, they have enrolled 64 English-speaking and three Spanish-speaking clients, along with 10 English-speaking and two Spanish-speaking coaches.
Coaches receive manuals with scripts about how to evaluate each client’s emotional state and how to motivate them to do activities that are meaningful to them. They go through role-play exercises before they can start seeing clients, and even after that, supervisors check in to ensure they’re sticking to the structure so as not to skew results.
The study has been underway for more than four years. Initial observations suggest peer coaching is working as well as therapy, but Gum said each of the three research sites needs to enroll more people and do in-depth data analysis to get a better sense.
The next step would be to expand the program to more communities. Gum said her team is collecting information to determine what they'll need to do logistically to help senior centers across the U.S. implement the program.
Research shows improving seniors' mental health can also slow declines in physical health, memory and other cognitive functions.
There was a big need for a program like this in Hillsborough County, especially after the pandemic, said Mary Jo McKay, a nutrition and wellness manager in the Aging Services department. She’s heard positive feedback from seniors who have participated.
“Some of them have said, ‘I can’t believe it was that easy for me to feel better.’ And some of them admitted that their families had told them, ‘Get up and get out!’ and they weren’t researchers or mental health professionals, but it took this research project for them (seniors) to actually do it,” McKay said.
And it's not just the clients who benefit. Wells said coaching kept her engaged, and it felt good to help others.
“The back and forth with the client was just a real joy,” she said.
Resources
To get involved in Do More, Feel Better, email domorefeelbetter@usf.edu or call (813) 974-3576 for English or (813) 974-2758 for Spanish.
Interested clients can also fill out an online screening form.
Get support from Senior Connection Center, the Tampa Bay region's area agency on aging, by calling the Elder Helpline at 1-800-96-ELDER.
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