Can Hospital-Community Integration Facilitate Timely Access to Mental Health Service and Improve Mental Health Outcomes in Older Adults? An Observational Analysis.

OBJECTIVES

To examine waiting time and mental health outcomes following a hospital-community service-bridging mechanism among older adults with mild-to-moderately-severe depressive symptoms.

METHODS

This retrospective cohort study (November 2023-June 2025) evaluated a mechanism linking public hospitals with JoyAge, a community-based stepped-care program for late-life depression. Healthcare professionals referred older adults in outpatient care with suspected depressive symptoms to JoyAge, where social workers confirmed eligibility. Primary outcomes included referral-to-assessment waiting time and depressive symptoms. Secondary outcomes included anxiety, loneliness, and health-related quality of life.

RESULTS

Of 239 referrals, 159 (median age 73; 75% females) enrolled in JoyAge. Median waiting time was 1 week, significantly shorter than the 40-week median for psychiatric outpatient services reported in public records (p < 0.001). Among those discharged, 93% achieved a clinically meaningful reduction in depressive symptoms, with significant improvements in secondary outcomes (ps < 0.001).

CONCLUSIONS

The service-bridging mechanism was associated with improved access and outcomes.