Worldwide, poor mental health is common and destructive. One in four people experience challenges with mental wellness; many more live with negative physical health outcomes due to the impact of mental distress on non-psychological ailments. In order to address these challenges, it is imperative that older adults’ mental health perspectives and priorities are incorporated into research aims and study designs. We aim to disrupt traditional psychiatric approaches to mental health, by using stakeholder priorities as research outcomes rather than for mental disorders. When adequate attention and support are provided for mental health, not only will there be improvement of the quality of life but a much needed increase of public health resources will become more available.

Computational modelling of these priorities will inform a risk assessment platform that identifies individuals at risk for poor mental health. Precision medicine approaches take into account differences in individuals' unique characteristics (beyond the scope of traditional medicine) to treat and prevent illness. Using Big Data resources focusing on older Canadians, we will develop a precision mental health model to predict the degree to which individuals are vulnerable to poor mental health. 

Application of these models in community partners’ real-world databases will enable the early identification of at-risk individuals. We will also use quasi-experimental computational modelling techniques to identify interventions that are most likely to succeed for individuals. A series of co-creation workshops will translate these intervention models into tangible products, guided by older adults’ needs. Our risk profiling and intervention technologies will be implemented with our partners to improve existing programs, exploit new pathways for intervention, and aid in the development of commercialization opportunities. Incorporating older adults’ perspectives and using innovative, analytical approaches, we will identify, develop and implement tangible intervention products for better mental health.

One in five older adults will experience difficulties with mental wellness. Many more experience negative physical health outcomes due to the impact of mental distress on non-psychological conditions. To address these challenges, it is imperative that older adults’ mental health perspectives and priorities are incorporated into research aims and study designs. We aim to disrupt traditional psychiatric approaches to mental health, by using stakeholder priorities as research objectives rather than strictly using biomedical diagnostic criteria for mental disorders. We will examine protective factors associated with better mental health outcomes in large-scale longitudinal studies as well as a local BC health authority's dataset. Existing technology-driven mental health interventions that aim to foster greater levels of these protective factors will be user-tested with older adults to assess which interventions are the most feasible and acceptable to older adults.

One of the most at-risk groups during the COVID-19 crisis are older adults, especially if they live in seniors’ care facilities, are immune-compromised, or have underlying illnesses. Older adults were among the first groups to have restrictions on face-to-face contact. There are significant negative psychosocial implications of social distancing.

Older adults experience the highest rates of social isolation and loneliness and social distancing measures will have negative impacts on those living in the community who rely on support and care from family or friends, or who use church or community centers as social hubs, as well as those in supportive or assisted living  who gather for meals and activities.This double burden of age-related diminishing social spheres and the implementation of measures that require social distancing and enforced isolation presents significant mental health risks for older people.

Sweeping transitions to online communication platforms have been adopted, but older adults use technology at disproportionately low rates compared to younger ones. The digital divide is a major inhibitive force in facilitating their social connectedness. Most videoconferencing/ communication platforms have not been developed with the older adult in mind, leading to low rates of uptake.

We now find ourselves in a catch-22 situation where the negative mental health implications of social isolation and loneliness amongst older adults could perhaps be mitigated by digital solutions, but only if they have the knowledge, desire, and access to use these technologies. Further, without the capacity to interact in person, it can be challenging to provide guidance, an issue further compounded by physiological challenges such as reduced visual acuity, manual dexterity, and cognitive impairment). 

Moving forward, there is a need for a major shift in research culture away from a researcher and technology-driven agenda to one that focuses on real-world problems and solutions.

The prevalence of isolated and unsupported older persons - defined as Older Adults Without Advocates - is expected to grow in the coming decade, placing significant demands on Canada’s formal care systems.

The PMH team is conducting a qualitative study to gain insight about the challenges experienced by older adults with limited access to family-based support in accessing health and social care services and navigating care systems, with the aim to illustrate disparities and health-related inequities experienced by this vulnerable segment of Canada’s aging population.

Interviews will be conducted with older adults and health and social care providers to attain in-depth, relevant, and diverse perspectives on this issue, and to identify what may be done to improve access to services for this population. Recruitment and knowledge translation activities will be undertaken in collaboration with a network of 25+ seniors-serving organizations.

In partnership with Emily Carr University of Art and Design's Health Design Lab (HDL), PMH seeks to identify and understand the mental health priorities of older adults living in the community.

Through reflection, on-line connection, and co-design workshops on subjects including the meaning of aging and mental health, and factors that motivate them to engage in activities that benefit their mental health, the Health Design Lab works with senior participants to gain insight and understanding.

A synthesis of the conversations led to the seven distinct themes below, completing the project’s first phase in March, 2022.

During the second phase of this project, the HDL-SFU collaboration will continue with more older adult participants to better understand when and where possible interventions could be offered to support and maintain good mental health for our community-dwelling older adults.

PhD Candidate Indiri Riadi is utilising qualitative, community-based research methods for her doctoral project on digital mental health interventions for community-dwelling older adults in Vancouver, British Columbia. This project aims to:
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1. Identify existing digital mental health interventions for older adults.
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2. Identify the factors that affect mental health and the mental health priorities of the diverse population of community-dwelling older adults.
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3. Create guidelines to develop future services/interventions to improve the mental wellbeing of older adults.

‍Summary:
‍One in five older adults experience symptoms of depression and anxiety. Digital mental health interventions are promising in their ability to provide researchers, mental health professionals, clinicians, and patients with personalised tools for assessing their behaviour and seeking consultation, treatment, and peer support. This systematic review looks at existing randomised controlled trial studies on digital mental health interventions for older adults. Four factors have been found that contributed to the success of digital mental health interventions: 
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1. Ease of use
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2. Opportunities for social interactions
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3. Having human support
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4.Having the digital mental health interventions tailored to the participants' needs

Read the publications here:
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PubMed
Digital Interventions for Depression and Anxiety in Older Adults: Protocol for a Systematic Review - PubMed

The Lancet Healthy Longevity
Digital interventions for depression and anxiety in older adults: a systematic review of randomised controlled trials