Media hype regarding psychedelic treatments for depression and PTSD from 2017 to 2024.

Depression in older adults is a common and significant problem, with global prevalence rates between 28.4% and 35.1% (Cai et al., ; Hu et al., ). Adults living in residential aged care (RAC) facilities (also known as residential aged care homes, nursing homes or long‐term care homes) have disproportionately high rates of depression compared to community settings, in Australia as well as internationally (Jongenelis et al., ; Tang et al., , ; Zenebe et al., ). Over 50% of people who live permanently in RAC in Australia have clinically significant symptoms of depression compared with 10% of older adults in the general population (Australian Institute of Health Welfare, ). Depressive symptoms can be misunderstood as a normal part of ageing in such settings, and residential care staff often lack skills to identify and refer residents to treatment services (McCabe et al., ). Adding to the complexity, access to mental health services in RAC is poor, mental health clinicians are largely absent and there is an over‐reliance on psychotropic medication as the primary or sole treatment strategy (Cations et al., ; Stargatt et al., ; Westbury et al., ). Psychological treatments for depression such as cognitive behaviour therapy (CBT), behavioural therapy and reminiscence therapy have been found to be effective for older adults (Ji et al., ). However, few high‐quality studies have been conducted in RAC. A recent Cochrane review of randomised controlled trials (RCTs) found that in the last 50 years, only 19 studies had been conducted in RAC, and the quality of research was poor (Davison et al., ). Aged care residents are more likely to be frail and experience higher levels of cognitive impairment and chronic ill health than community‐dwelling adults. Aged care residents are also more likely to be functionally impaired and to be dependent on others for daily assistance and care, and have difficulty travelling to outpatient mental health services. Psychological treatments may need to be adapted to suit the profile of RAC residents (Chan et al., ). The application of treatments that were originally designed for outpatient community‐dwelling patients to RAC populations is believed to require adaptation to include a more systemic approach (Bhar et al., ). Systemic approaches are those that include the patients' families and staff carers in treatment. Such approaches are typically used for individuals who are highly dependent on others for day‐to‐day care. An example of such an approach is that used by the Peaceful Mind program where families were considered instrumental co‐therapists in a program for reducing anxiety in individuals with dementia (Paukert et al., ). In RAC, several treatment programs have included staff as such treatment collaterals, a feature which increased their effectiveness (Cody & Drysdale, ). Given that nearly 50% of individuals living in such settings also have significant levels of cognitive impairment (Australian Institute of Health Welfare, ), the involvement of staff and family is expected to help residents with memory and attentional difficulties more successfully implement and practice therapeutic strategies.