In addition to the mental health implications such as depression, studies gathered by the  demonstrate that prolonged social isolation can lead to other health complications, including cognitive decline, high blood pressure, heart disease and a weakened immune system. These side effects are particularly concerning during COVID-19 when such comorbid conditions put individuals at higher risk for adverse reactions from the virus. 

is developing technologies and services to reduce social isolation while maintaining social distancing. 

“Social distancing does not have to mean social isolation,” said Anna Faul, executive director of the UofL Trager Institute. “We are working with community partners to bring technology and social supports to older adults facing increased social isolation due to the current pandemic.”

In April, for example, the UofL Trager Institute and Dr. Brent Wright, of the UofL School of Medicine, introduced SmartGlasses technology to long-term facilities and primary care offices. This technology allows a health care professional who is with the patient to put on the web-connected glasses and dial in with an attending physician. A camera and microphone attached to the glasses allow the physician to see and interact directly with the patient in real time.

Recent awards of nearly $190,000 from multiple organizations will allow the Trager Institute to support the expansion of additional resources, including:

• Telehealth and teletherapy for residents in long-term care facilities
• Training of staff and students to offer virtual interdisciplinary care coordination and chronic disease management
• Caregiver resources such as training, support groups and counseling services focused on Jefferson County and surrounding rural counties 
• Specialized mental health services for older adults to reduce social isolation and depression ()
• A state-wide, virtual-friendly visitor program that provides patients, families, caregivers and nursing home residents and staff with resources to reduce social isolation

The funding is provided by the Geriatric Workforce Enhancement Program CARES Act, the National Family Caregiver Program Title IIIE (Administration on Aging) the Health Promotion and Disease Prevention Title IIIE (Administration on Aging) as well as others throughout Kentucky. These grants have created statewide partnerships and expanded the footprint of the institute and of the university.

“Given the expansion of social isolation in our community, our team has prioritized the dissemination of technology to community-dwelling older adults,” Faul said. “In addition to the currently funded efforts, we are looking forward to the possibility of additional funds that will allow us to provide iPads and Bluetooth technology to vulnerable community-dwelling older adults in Jefferson County and several rural counties, to establish a mini-virtual health clinic network across multiple Appalachian counties and to disseminate innovative contact tracing efforts through app-based, wearable devices and AI-based services.” 

If you or someone you know is experiencing social isolation or loneliness, contact the care team at the Republic Bank Foundation Optimal Aging Clinic at the UofL Trager Institute for assistance. The care team can be reached at 502-588-4340, Option 1, Option 1, or at tragerinstitute@louisville.edu. Additional resources are available at ���Ի���, which provide social interaction programs as well as other essential services such as in-home care and food delivery programs. 

David M. Clark, PhD, professor of experimental psychology at the University of Oxford in England and director of the Oxford Centre of Anxiety Disorders & Trauma, will present “Thrive: How Psychological Therapies Transform Lives and Save Money.” The event is part of the “Building Hope” public lecture series sponsored by the University of Louisville Depression Center and will be held at 6 p.m. at the Clifton Center, 2117 Payne St. 

“Effective psychological treatments are available for most mental health problems, but the public rarely benefits. This can be changed,” Clark said. “The clinical and economic arguments for increasing access to psychological therapies are overwhelming.”

The lecture kicks off the Depression Center’s 12th annual conference at the Clifton Center on Friday, Nov. 2, that will focus on translating science into clinical practice for depression and anxiety disorders.

Conference sessions are geared toward psychiatrists, psychologists, social workers, nurse practitioners, primary care physicians and other mental health clinicians. Focusing on some of the most promising developments in biological psychiatry and psychotherapy, participants will learn about advanced methods for challenging clinical problems. 

Keynote speakers include Clark, Mark A. Frye, MD, professor and chair of the Department of Psychiatry and Psychology at the Mayo Clinic and director of the Mayo Clinic Depression Center, and Laura Wright McCray, MD, associate professor and residency program director of the Department of Family Medicine at the University of Vermont. 

Continuing education credits are available for attendees.

Attendance is free for UofL physicians, nurses, faculty members, students, residents and fellows. For more information, call 502-588-4886 or visit the .

The conference is supported by the American Foundation for Suicide Prevention, Centerstone Kentucky, Norton Healthcare and Passport Health Plan.

Foley Hart, a Kent School of Social Work graduate student, thinks so and will soon launch a study to examine how the outdoors — including contact with horses — might help people with depression and posttraumatic stress disorder.

Hart, who graduates May 12 with a master’s degree in social work, said her interest in the topic evolved over several years and was influenced by her military experience, a newfound interest in horses and coursework at the Kent School.

“I just put all of the pieces together,” Hart said. “I’m drawn to help individuals who have major depressive order and PTSD. My thinking was to find ways to make treatment more affordable and to embrace natural therapies.”

Hart has landed a job with Healing Trails, an Ohio-based nonprofit that specializes in equine assisted psychotherapy (EAP). In this new role, she will earn EAP certification, work with girls aged 13-17 who have faced trauma, and conduct research on how lifestyle can influence mental health.

“I will be looking specifically at how various aspects of a person’s life (such as their diet, exercise, amount of time spent outdoors, etc.) can impact the success or failure of their therapy plan,” Hart said. “The Kent School set me up with a foundation that gave me the confidence to pursue this particular path in therapy and I feel very lucky to be a part of it all.”

While other studies have examined the correlation between the outdoors and depression, Hart says few of those studies adhere to research evidence examining protocols.

A Texas native, Hart graduated in 2012 from University of Texas at Arlington with a degree in psychology and, building on her college ROTC experience, joined the Army and went to Fort Knox for military training.

“I started looking into horses after moving to Kentucky,” she said. “I was inspired by a friend who was into horse racing and he showed me ‘the horse life.’”

Hart started working on her UofL degree in 2014 and completed her coursework online while serving in Kuwait. She has never set foot on a UofL campus.

She remains on active duty until September and is currently stationed at Fort Leonard Wood, Missouri. After she moves to Ohio to begin her career in social work, she will also take command of the 304^th Engineer Company, based in Lima.

In what seems like destiny, the move to Ohio also means that Hart’s husband, John, will realize his own dream of taking over the family farm, which is located nearby. The Harts, who have four children in their blended family, plan to live on the farm.

Hart said she appreciates how much UofL has done to help her realize her dreams.

“Kent School has been so wonderful and flexible in allowing me to juggle work, family and school,” she said. “Without this support, I don’t know if I ever could have completed my degree.”

Patients experienced a positive and robust response to online cognitive behavioral therapy (CBT), equaling a traditional in-person CBT treatment course with three times more therapist contact, according to , which published in the March issue of the American Journal of Psychiatry.

While one of the most effective non-pharmacological treatments for depression, traditional in-person CBT poses barriers to those who need treatment.

“Traditional CBT takes a fair amount of time, money and resources, and there aren’t enough cognitive behavioral therapists,” said Jesse Wright, MD, PhD, director of the , Gottfried and Gisela Kolb Endowed Chair in Outpatient Psychiatry in the UofL School of Medicine, and an author of the study. “The technology delivers treatment more efficiently and reduces cost by allowing many more people to be treated by the same therapist.”

For the study, more than 150 medication-free patients with major depressive disorder were randomly assigned to 16 weeks of either traditional CBT, which entails up to 20 sessions of 50 minutes each, or computer-assisted CBT using the  and 12 abbreviated therapy sessions.

The program, which Wright helped develop, consists of nine Internet-based modules that use video, psychoeducation, mood graphs to measure progress and interactive skill-building exercises that help users apply CBT methods in daily life. A dashboard allows clinicians to assess progress and coordinate aspects of treatment.

Both treatment groups experienced significant improvements and similar rates of symptom reduction across the 16 weeks of treatment. Patients with chronic and severe depression benefitted from both treatment courses.

The research was funded by grants totaling more than $2.5 million from the National Institute of Mental Health, the lead federal agency for research on mental disorders and part of the National Institutes of Health.

Many patients diagnosed with head and neck cancer experience symptoms of depression, which can make it difficult for them to manage treatment side effects, quit smoking, or maintain adequate nutrition or sleep habits. A team led by ., of the , was interested to see if depressive symptoms might also affect patients’ health outcomes.

The researchers studied 134 of these patients being treated at the UofL James Graham Brown Cancer Center multidisciplinary head and neck clinic from October 2012 to October 2013 who reported depressive symptoms during the planning of their treatment. In this group, 67.2 percent expressed measurable depressive symptoms. When the investigators examined the patients’ clinical data over the following two years, they found that patients with greater depressive symptoms had shorter survival, higher rates of chemo-radiation interruption, and poorer treatment response.

“We observed that head and neck cancer patients who reported more depressive symptoms at their initial appointment were more likely to miss scheduled treatment appointments and were more likely to have tumors that persisted after medical treatment,” said Cash, who serves as the director of research for the . “We also observed that patients with depressive symptoms suffered greater two-year overall mortality rates, and this was especially true for those who did not achieve optimal response to medical treatment.”

Poorer treatment response partially explained the depression-survival relationship; however, there were no significant effects from factors commonly used to determine cancer prognosis — such as the patient’s age, the stage of tumor advancement or extent of smoking history.

“This suggests that depressive symptoms may be as powerful as the clinical features that physicians typically use to determine the prognosis of patients with head and neck cancer,” Cash said.

She also noted that most patients in the study did not meet criteria for diagnosis of major depressive disorder, suggesting that even mild symptoms of depression may interfere with head and neck cancer treatment outcomes. She said that while the findings need to be replicated in a larger study, they do suggest that depressive symptoms may affect head and neck cancer patients’ survival through mechanisms that potentially coincide with the activities of their tumor.

“We want patients to know that it is normal to get depressed when they are diagnosed, but it is important to seek help for any depression symptoms because (not doing so) may lead to poorer outcomes related to their cancer treatment,” Cash said.

She and her colleagues are hopeful that this information can facilitate discussions between patients and psycho-oncologists or behavioral oncology specialists to expedite the development of targeted behavioral interventions, which may have high potential to complement medical treatment efficacy.

John F. Greden, MD, Rachel Upjohn Professor of Psychiatry and Clinical Neurosciences and executive director of the University of Michigan Depression Center, will present “Depression 2017: Finding the Best Treatment for Each Person.” The event is part of the “Building Hope” public lecture series sponsored by the University of Louisville Depression Center and will be held at 6 p.m. at the Clifton Center, 2117 Payne St.

“Personalized medicine is an overused but essential concept,” Greden said. “The right treatment for the right person at the right time is the only way to attain and maintain wellness for most of those struggling with depressive and bipolar illnesses.”

The lecture kicks off the Depression Center’s 11th annual conference at the Clifton Center on Friday, Nov. 10, that will focus on advancements in the treatment of mood and personality disorders.

Conference sessions are geared toward psychiatrists, psychologists, social workers, nurse practitioners, primary care physicians and other mental health clinicians. Focusing on some of the most promising developments in biological psychiatry and psychotherapy, participants will learn about advanced methods for challenging clinical problems.

Keynote speakers include Greden, Kate Comtois, PhD, professor of psychiatry at the University of Washington and director of the dialectical behavior therapy program at Harborview Mental Health Services in Seattle, and G. Randolph Schrodt, MD, associate clinical professor of psychiatry at UofL and managing partner and principal investigator for transcranial magnetic stimulation research at Integrative Psychiatry in Louisville.

Continuing education credits are available for attendees.

Attendance is free for UofL physicians, nurses, faculty members, students, residents and fellows. Registration for other health care professionals costs $100. . For more information, call 502-588-4886 or visit the .

The conference is supported by the American Foundation for Suicide Prevention, Norton Healthcare, Centerstone, Passport Health Plan and The Brook Hospitals.

Scott is one of five community members, along with health experts, psychologists and UofL faculty with expertise in health disparities, who helped design a health literacy campaign that began Nov. 14. The ‘Depression is Real’ campaign is aimed at helping African Americans in West Louisville find help for depression, a common but serious mental health condition. The effort will include radio ads, posters, TARC ads, website and social media posts, along with a public outreach component at grocery stores, churches and community centers.

“We know one in 10 African Americans struggle with depression; those with few resources are particularly susceptible due to mental health disparities like persistent discrimination, physiological and psychological stress and sometimes clinician implicit bias,” said Ryan Combs, PhD, MA, an assistant professor for the Commonwealth Institute of Kentucky, an entity of the University of Louisville School of Public Health and Information Sciences.

Combs says health literacy is a critical factor for good health, and affects a person’s ability to navigate health services and make appropriate health decisions. He says the campaign messaging developed through community-based participatory research hopes to raise awareness and understanding of depression among West Louisville residents and improve outcomes for those living with depression. The key messages are: depression is real; you don’t have to suffer; you are not alone; and there are options to help you get better. The ads direct individuals to call 2-1-1, a phone line through Metro United Way dedicated to connecting people to needed services.

Scott says although she experienced depression for several months during her time of grief, it was her faith and church, along with her work in a labor and delivery unit at a local hospital, that helped her regain joy.

Although Scott recovered without the help of a health care provider, she understands that sometimes it is needed. But, she says it can be difficult for those in the African American community to seek help.

“Sometimes Black people are afraid to ask, we can be suspicious at times to even allow others to know we are struggling,” she said.

Scott says she hopes people facing depression will see the campaign messages and talk to someone who can help.

Depression is one of several topics Combs and his team will explore through the end of 2017 as part of the health literacy research project funded through the Jewish Heritage Fund for Excellence. The Louisville Metro Department of Public Health and Wellness also is a partner on the ‘Depression is Real’ campaign, which runs through Dec. 25.