Thought Leadership

The “JC JoyAge – Jockey Club Holistic Support Project for Elderly Mental Wellness” (JC JoyAge) has achieved a 92% success rate in improving elderly mental health.

When Professor Terry Yat Sang Lum, Henry G. Leong Professor in Social Work and Social Administration, returned to Hong Kong in 2011 from the United States, he was troubled by the state of Hong Kong’s elderly people.  Life expectancy in Hong Kong is 88 years for women and 82 years for men – among the highest in the world – yet many of Hong Kong’s elderly were struggling with mental health difficulties caused by stress, chronic health conditions and social isolation, resulting in depression rates of about 10 per cent.

Professor Lum, who has worked in elderly care for his entire career, was deeply concerned.

“If people live a long life but the quality of life is not good, what’s the point of this long life?” he mused.

A Mission to Improve the Quality of Elderly Lives

In addition to his ongoing social policy work, Professor Lum also started investigating practical ways to improve elderly mental health.

“Mental health suffering significantly adversely affects the quality of life.  So I asked myself, what can we do to really enhance the mental well-being of older people?”  The answer, it turns out, was a lot.

Professor Lum’s research identified two major gaps in the system.  One was the lack of provision of mental health care outside the specialist system.  The other was the lack of education about mental health for the very group that are most affected by it: the less educated elderly.  He and his team set up “JC JoyAge – Jockey Club Holistic Support Project for Elderly Mental Wellness” (JC JoyAge), funded by the Hong Kong Jockey Club Charities Trust, to respond to both of these needs.

JC JoyAge: A Dual-pronged Approach Embedded in Community Care

JC JoyAge takes a two-pronged approach.  First, it makes trained, community-based psychotherapeutic care available in every Hong Kong district for any elderly person who needs it.

“If you feel unwell mentally, you can walk into an elderly community centre in your neighbourhood, and there are social workers who are specialised in mental health care,” explains Professor Lum.  “That means the older people no longer need to go to hospital for care – they can receive care within their own community.”

That leaves Hong Kong’s specialist system – which counts only around 1,000 psychiatrists and psychologists for a population of 7 million – free to focus on the most critical cases, which are referred to them as necessary by the social workers and GPs working directly with the elderly.

Second, the project implements a wide-ranging mental health literacy programme that targets the often illiterate or poorly educated elderly people who cannot access government-run literacy programmes.

Reversing the Elderly Suicide Trend

To date, the programme has helped more than 10,000 people, of whom 92 percent report a very significant improvement in their mental health state, including lower levels of anxiety and loneliness.

Strikingly, since 2022, when the programme had expanded to all 18 districts, the elderly suicide rate started to drop, from 21 suicides per 10,000 people to just over 19.  This is particularly noteworthy as the suicide rate of every other age group has continued to rise.

In light of the evident need, Professor Lum began a pilot project in 2024 targeting people aged 45 and above, who face different life challenges, such as parenting and relationship issues.  He is confident that the same approach, with adjusted clinical protocols, will achieve positive results.

Strength through Community

The strength of the JC JoyAge project lies in its embeddedness in the community.  Evidence shows that provision of both specialist mental health care and community care produces the best results, as it enables both mild and serious cases to receive effective attention.

“We believe that we need to really trust the people, put the resources in the hands of the community and allow the community to develop their own strategy to promote mental health literacy,” says Professor Lum.

As of September 2024, JC JoyAge had enlisted 6,620 Ambassadors – elderly volunteers who have recovered from mental health problems themselves.  Ambassadors receive mental health assessment training to help them identify mental health problems among their own families and neighbours.  They bring those affected to community centres for further assessment and appropriate treatment.

Almost 1,000 Ambassadors with good communication skills have received intensive training to become Peer Supporters who work alongside social workers to provide one-to-one support and companionship to people with mental health challenges.

Other Ambassadors design specific mental wellness activities for their own community.  “They know the characteristics of their neighbours,” says Professor Lum.  “If they can work together with the social worker, they can develop mental health literacy promotion from the bottom up.  Then those messages will be able to come across easier than a top-down approach.”

The aim is to treat mental problems as soon as possible after the symptoms become apparent, he explains.

“If we can somehow help people when they have mild to moderate levels of mental disorder, then we can cut down the number of people who have severe mental disorder.”

Professor Terry Yat Sang Lum of the Department of Social Work and Social Administration and his team received the University’s Knowledge Exchange Excellence Award 2024 for the project “JC JoyAge – Jockey Club Holistic Support Project for Elderly Mental Wellness”.

Contributing Writer: Liana Cafolla