Innovation: Bounce Back: Reclaim Your Health

Canada

AAI Domains:

• Independent, healthy and secure living (mental well-being, physical exercise)

• Participation in society (social connectedness)

Major depressive disorders affect approximately 10–12% of all adults in Canada, which is around 1.5 million people, in any one year and it is forecast that within a decade they will be the second leading cause of ill health after ischaemic heart disease. Improving the mental health and well-being of adults is a major challenge that requires evidence-based social innovations that can have a significant impact on population health.

The Bounce Back: Reclaim Your Health initiative was commissioned from the Canadian Mental Health Association in British Columbia by the province’s Ministry of Health in 2006. Bounce Back received an initial $6 million of funding and this enabled the Association to adopt and adapt a suitable community-based intervention for adults with anxiety and mild to moderate depression. The Association adopted and adapted the Living Life to the Full programme, developed in Scotland by Professor Chris Williams from Glasgow University, to provide a low intensity and high capacity means of providing cognitive behavioural therapy for people with major depressive disorders.

The Bounce Back programme is delivered in two ways: firstly, adults can request a free DVD from Bounce Back or their primary health care centre or they can request up to 16 workbooks and receive up to five telephone coaching sessions from one of around 20 trained coaches who can answer questions, help people to develop new skills and monitor how participants are doing. The Bounce Back coaches do not provide individual counselling but they enable and empower participants to develop coping strategies and greater resilience and a referral from a primary health care practitioner is required if a participant wants to have telephone coaching.

Bounce Back was launched in 2008 and was primarily aimed at patients with long-term physical conditions who were also experiencing mental health issues but it quickly became apparent that it could also be an appropriate intervention for all adults experiencing anxiety or depression. Bounce Back offers practical tips on managing moods, building self-confidence, problem solving, healthy living and ways to increase physical and social activities that build individual resilience.

Since it began operating across the whole of British Columbia (population 4.4 million), Bounce Back had distributed more than 120,000 DVDs and has grown to receive more than 25,000 referrals from more than 1,700 primary health care professionals right across the province. Around 75% of participants are female, the average age of participants is 44 years and 48 years for those who complete the course through the telephone coaching route.

There is a Participant Advisory Committee that plays a role in monitoring the programme and advising on future developments and there are high levels of satisfaction with Bounce Back from participants and health care professionals. Bounce Back has improved population health by reducing the severity of depression, as measured by the PHQ9 questionnaire, by about half for those who complete the course. British Columbia is currently the only province that offers this innovative intervention as a free to use part of the health care system but it is also being trialled in Nova Scotia.

In relation to the active ageing index, the Bounce Back programme has had measurable positive effects on mental well-being by reducing the severity of anxiety and depression among participants who have completed the course. The programme is based on the general principles of cognitive behavioural therapy so it encourages individuals to be more socially connected and to take more physical exercise as ways of improving general mood.

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Bounce Back

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