BackgroundThere is little evidence available about what service models are effective in the treatment of elderly people with depression.AimsTo test the effectiveness of home treatment for elderly people with depression living independently.MethodIn a randomised controlled trial, 60 out-patients aged over 64 years with major depression were allocated to a home treatment model over a 1-year period or to conventional psychiatric out-patient care. The primary outcome was the level of depressive symptoms after 3 and 12 months. The secondary outcomes were global functioning, subjective quality of life (SQOL), admissions to nursing homes, duration of psychiatric hospital treatments and the cost of care.ResultsIndividuals receiving home treatment had significantly fewer symptoms of depression, better global functioning and a higher SQOL at 3 months and at 12 months. Over 1 year they had fewer admissions to nursing homes, spent less time in psychiatric in-patient care and the cost of care was lower.ConclusionsHome treatment appears an effective and cost-effective service model for elderly people with depression.