Collaborative Stepped-Care and Productive Ageing Program for Older People With Depressive Symptoms

Evaluation Study of a Collaborative Stepped-Care and Productive Ageing Model for Elderly Mental Wellness in Hong Kong

The Jockey Club Holistic Support Project for Elderly Mental Wellness (JC JoyAge) has developed and implemented a collaborative stepped care model for older persons at-risk of or with depression in four districts in Hong Kong since 2015 (Clinical Trials Identifier: NCT03593889). Results from JC JoyAge show that the collaborative stepped-care model is effective in improving older persons' mental wellness, and the specialised training and engagement of Peer Supporters are effective in building capacity in the community. The proposed impact extension programme lasts for four years (from 2020 to 2023), and the overall goal is to expand the JC JoyAge model to all 18 districts in Hong Kong, to provide integrated and evidence-based mental health services to older adults with subclinical depressive symptoms, with the hope of model adoption in regular service upon project completion.

This four-year extension project includes three main elements: 1) Trainings, including different programmes for social services staff, Mental Wellness Ambassadors, and Peer Supporters; 2) Implementation of JoyAge service model: standardized collaborative stepped-care and Peer Support programmes for prevention and early intervention of depression in older adults; and 3) Public awareness campaign: coordinated programmes to increase mental health literacy and raise public awareness.

Specific goals of the programmes through the above three elements include:

1. To implement JC JoyAge clinical protocol and guidelines to coordinate care among community mental health and aged care services centres for elderly mental wellness in 18 districts;
2. To engage vulnerable and at-risk older adults in the community through productive ageing activities and mental wellbeing self-management training;
3. To enhance the capacity of social service staff in handling elderly depression through specialized and infusion training and knowledge exchange;
4. To raise public awareness and elderly mental health literacy among family members, neighbours, community stakeholders, and the general public to encourage early detection/help-seeking on depressive risk of older adults; and
5. To establish evidence of the effectiveness and cost-effectiveness of JC JoyAge Phase II model.

Inclusion Criteria:

• age 60 years or above; and
• have depressive symptoms of mild level or above; and
• able to give informed consent to participate

Exclusion Criteria:

• known history of autism, intellectual disability, schizophrenia-spectrum disorder, bipolar disorder, Parkinson's disease, or dementia; and
• (temporary exclusion criteria) imminent suicidal risk; and
• difficulty in communication