Sharing results of Elderly Mental Wellness Telescreening Survey in Hong Kong 2022 and clinical observations by Professor Terry Lum, Dr. Bridget Liu and Ms. Wai Wai Kwok
Findings revealed a surge in the risk of depression, anxiety and lonelineliness in the past 2 years
Foreword
JC JoyAge: Jockey Club Holistic Support Project for Elderly Mental Wellness ("JC JoyAge") held a press conference today (October 10) to release the findings of "Elderly Mental Wellness Telescreening Survey in Hong Kong 2022". The Programme Director of the JC JoyAge Project Professor Terry Lum, Project Manager (Research) and Research Assistant Professor Dr. Bridget Liu, and Project Manager (Clinical) and Senior Clinical Psychologist Ms. Wai Wai Kwok explained the findings of the survey conducted with nearly 5,000 older adults in the second quarter of 2022.
Background
JC JoyAge is dedicated to promoting public awareness of older adults' mental health, especially the potential threat of depression to older people's physical and mental well-being. Depression is one of the common mental health problems, and surveys in the past have found that, on average, one in ten older adults suffer from depressive symptoms. The fifth wave of COVID-19 outbreak has caused unprecedented pressure on all in Hong Kong, and the elderly population is one of the high-risk groups. They are more prone to emotional issues such as depression, anxiety, and loneliness due to the lack of in-kind and social support during the pandemic. Given the situation, the JC JoyAge team at The University of Hong Kong worked with 29 JC JoyAge service units to conduct a telephone survey on elderly mental wellness in Hong Kong from April to June 2022. They successfully interviewed 4,921 people aged 60 or older and learned about their current mental well-being.
Telescreening survey results and data trends
The Telescreening covers the Patient Health Questionnaire-2 (PHQ-2; for measuring depressive symptoms), Generalised Anxiety Disorder-2 (GAD-2), Loneliness Scale (UCLA-3), COVID-19-related stressors, COVID-19 infection history (self-infection, families or friends infection), and some basic demographic information. Among the respondents, 66% of them aged 60-79, and the remaining 34% were 80 or over. 76% were women, and 24% were men. 37% lived alone, and 17% had experienced mental disturbances in the past. 35% had experiences with COVID-19 infection (self, families or both), and 65% had no COVID-19 infection experience. Among the responses to COVID-19 stressors, most respondents did not express excessive concern about the related stresses. The top stressor, as indicated by most respondents, was "They worry that they would burden their families if they were infected with COVID-19", with 26% showing at least a considerable level of worry. For questions regarding mental well-being, the total scores for PHQ-2 and GAD-2 are 6, and the total score for UCLA-3 is 9. Higher scores indicate more severe levels of depressive and anxiety symptoms and a higher level of loneliness, and 3 points or above indicate a significant level of depression, anxiety, or loneliness. The percentages of scores at 3 or above in the three questionnaires were 14% (PHQ-2), 12% (GAD-2), and 29% (UCLA-3). Based on the combined scores, 34% of the respondents scored 3 points or above in at least one of the three mental health measurements. In other words, about one-third of the elderly respondents suffered from at least one condition of depression, anxiety, or loneliness. During the second and third waves of COVID-19, older people with the risk of depression and anxiety were 8.4% and 7.4%, respectively. Compared to the telescreening interview results in the same quarter of 2020, there are significant gains in the proportion of older adults with a heightened risk of depression and anxiety. In the fifth wave of the pandemic, the results showed that older people who are female, live alone, have a history of mental health problems, a history of COVID-19 infection, and experience more stress due to the pandemic face a greater risk of mental health issues than other older adults. Therefore, we should pay more attention to this at-risk group.
Older adults become Mental Health Ambassadors to promote mental health in the community
Wendy, a Peer Supporter of JC JoyAge, participated in the Telescreening survey and made phone calls to the older adults. Through the dialogue with the respondents, Wendy learned more about the difficulties and physical and mental conditions faced by older people during the pandemic. "By asking about their daily life, we know more about elderly mental health. Some of them cherished the opportunity to talk to us and told us about their health condition and worries about the current situation. Some others showed more positive attitudes towards the pandemic and have maintained social connections." Wendy works as a 'JC JoyAge Peer Supporter' in Caritas Cheng Shing Fung District Elderly Centre (Shamshuipo). She assists the centre's social workers in providing support to adults aged 60 or above who are suffering from depression in the Sham Shui Po area. Two years ago, Wendy also experienced low moods due to the passing of a family member. Wendy's friend introduced her to JC JoyAge. After completing nearly 100 hours of training in mental health knowledge and community service practicum, Wendy became a JC JoyAge Peer Supporter. Wendy had learned not only to accept and manage negative emotions in the process, but she also understood the importance of listening patiently and showing empathy to others. As a result, she became more determined to use personal experience to help others overcome their difficulties.
Unexplored community mental health resources and medical-social collaboration for community mental health needs
In the past decade, the HKSAR Government has been allocating resources to develop mental health care in District Elderly Community Centres (DECCs) and Integrated Community Centres for Mental Wellness (ICCMWs) in all 18 districts of Hong Kong. The service of DECCs and ICCMWs gradually matured, providing various services and activities to meet older adults' physical and mental needs. However, there is still room for increasing service acceptance, popularity, and coverage of DECCs and ICCMWs.
Mr. Wong is a service beneficiary of the DECC. The JC JoyAge team in Caritas Cheng Shing Fung District Elderly Centre (Shamshuipo) posted mental wellness info packs to the older adults in the Sham Shui Po area during the fifth wave of the pandemic to raise older people's awareness of mental health self-care and needs so as to encourage them to seek professional help if needed. Mr. Wong's daughter found that the emotional distress described in the info pack was very similar to that she saw in her father's condition. She then called Caritas Cheng Shing Fung District Elderly Centre (Shamshuipo) and enquired about Mr. Wong's situation with a social worker in the JC JoyAge team. The social worker, Ms. Kwan, arranged to speak to Mr. Wong, assessed and realised the urgency of his situation, and sent Mr. Wong for emergency service and psychiatric treatment immediately. With the support from medical-social collaboration, Mr Wong's condition is now stabilised.
Active care from relatives, friends and the neighbourhood is a crucial protective factor, older people can also be important supporters in the community
Ms. Wai Wai Kwok believes that the data obtained from the telescreening interview is consistent with frontline social workers' clinical observations, indicating an increased number of older adults with emotional distress now than in the past. The ongoing development of the pandemic and its impact on community services has disrupted older people's lives and weakened social relationships, resulting in increased emotional distress and the number of people with emotional disturbances among the elderly population. However, many older adults and their families with mental health needs often do not know how they may seek help. There are many ways to manage the emotional stress experienced by older persons. Family members and members of the neighbourhood can actively care for and encourage older people to rebuild their daily routines and introduce meaningful activities into their lives. Active care from friends and neighbours can reduce older adults' feelings of loneliness and swiftly connect individuals in need with appropriate social services, serving as an essential protection for older persons in the community. In the process of establishing and maintaining such protection, the older adults are given an opportunity to develop their strengths. They have not only become essential members of the community in promoting mental health, but also formed vital support in clinical services. Elderly volunteers have overcome various challenges during the pandemic and actively participated in mental health-related training. While improving resilience for themselves, they also help and share social workers' duties in contacting older adults, understanding their needs, providing companionship to reduce loneliness, and promptly identifying older people in need and matching them with relevant services.
About JC JoyAge: Jockey Club Holistic Support Project for Elderly Mental Wellness
According to a study, about 10% of the elderly population in Hong Kong have depressive symptoms. Factors such as stress, health problems and a lack of social engagement usually contribute to the vulnerability of older people and increased risks of geriatric depression or other major illnesses. In response to this concern, The Hong Kong Jockey Club Charities Trust initiates the "JC JoyAge: Jockey Club Holistic Support Project for Elderly Mental Wellness". Through cross-sectoral collaborations, JC JoyAge provides a community-based supporting network for senior citizens to enhance their resilience in facing the challenges of ageing. The service model bridges DECC and ICCMW to establish a collaborative and integrated service model, which renders standardised prevention and timely intervention services for older persons at-risk of or with depressive symptoms, according to risk levels and symptoms severity.
JC JoyAge is now implemented in all 18 districts in Hong Kong. The project partners include The University of Hong Kong and 17 local NGOs operating DECCs and/or ICCMWs across the territory, with services currently running in 16 ICCMWs and 31 DECCs. For details of the programme, please visit http://www.jcjoyage.hk/.
Research results enquiries
Research Assistant Professor and Project Manager (Research), JC JoyAge, Department of Social Work and Social Administration, The University of Hong Kong
Dr. Bridget Liu
