Transforming Primary Mental Health Care for Ageing Populations: The THIKA Model for Community-Based Integrative Intervention

Thika Marliana; Budi Anna Keliat; Novy H.C Daulima; Tri Budi W Rahardjo

doi:10.55927/fjas.v5i5.57

Authors

Thika Marliana Universitas Respati Indonesia
Budi Anna Keliat Universitas Indonesia
Novy H.C Daulima Universitas Indonesia
Tri Budi W Rahardjo Universitas Respati Indonesia

DOI:

https://doi.org/10.55927/fjas.v5i5.57

Keywords:

THIKA Model, Older Adults, Depression, Community-Based Intervention, Mental Health

Abstract

This study aimed to develop a community-based holistic integrative mental health intervention model (THIKA) for older adults with depression. A sequential explanatory mixed-method design was applied, involving quantitative identification of depression risk factors among older adults and qualitative exploration of psychosocial needs, followed by expert validation. The model integrates biological, psychological, social, and cultural approaches through five intervention components: self-disclosure, physical activity, social skills, positive behavior cultivation, and mental resilience. The study involved older adults with depression over a 15-week observation period. The results indicate that the THIKA model improves psychosocial development and happiness while reducing depression levels. This model offers a practical framework for strengthening primary mental health care for ageing populations.

References

Aihara, Y., Minai, J., Aoyama, A., & Shimanouchi, S. (2011). Depressive symptoms and past lifestyle among Japanese elderly people. Community Mental Health Journal, 47(2), 186–193. https://doi.org/10.1007/s10597-010-9317-1.

Alexander, R., Aragón, O. R., Bookwala, J., Cherbuin, N., Gatt, J. M., Kahrilas, I. J., Kästner, N., Lawrence, A., Lowe, L., Morrison, R. G., Mueller, S. C., Nusslock, R., Papadelis, C., Polnaszek, K. L., Richter, S. H., Silton, R. L., & Styliadis, C. (2021). The neuroscience of positive emotions and affect. Neuroscience and Biobehavioral Reviews, 121, 220–249.

Badan Pusat Statistik. (2017). Statistik penduduk lanjut usia Indonesia. Badan Pusat Statistik.

Beard, J. R., Officer, A., de Carvalho, I. A., Sadana, R., Pot, A. M., Michel, J. P., Lloyd-Sherlock, P., Epping-Jordan, J. E., Peeters, G., Mahanani, W. R., Thiyagarajan, J. A., & Chatterji, S. (2016). The World report on ageing and health. The Lancet, 387(10033), 2145–2154. https://doi.org/10.1016/S0140-6736(15)00516-4

Braun, V., & Clarke, V. (2021). Thematic analysis: A practical guide. SAGE Publications.

Briggs, A. M., Valentijn, P. P., Thiyagarajan, J. A., & Araujo de Carvalho, I. (2020). Elements of integrated care approaches for older people. BMJ, 368, m256. https://doi.org/10.1136/bmj.m256.

Brown, C., & Lowis, M. J. (2003). Psychosocial development in the elderly. Journal of Aging Studies, 17(4), 415–426.

Creswell, J. W., & Creswell, J. D. (2023). Research design: Qualitative, quantitative, and mixed methods approaches (6th ed.). SAGE Publications.

De Craen, A. J. M., et al. (2020). Accuracy of the abbreviated mental test. Age and Ageing, 49(3), 393–398. https://doi.org/10.1093/ageing/afz177.

Diener, E., Oishi, S., & Tay, L. (2020). Advances in subjective well-being research. Nature Human Behaviour, 4, 124–135. https://doi.org/10.1038/s41562-020-00900-8.

Etikan, I., & Bala, K. (2020). Sampling and sampling methods. Biometrics & Biostatistics International Journal, 9(3), 215–217.

Feng, L., Li, P., Wang, X., & Liu, Y. (2021). Functional disability and depression in older adults. BMC Geriatrics, 21, 1–10. https://doi.org/10.1186/s12877-021-02115-2.

Fetters, M. D., & Molina-Azorin, J. F. (2020). The Journal of Mixed Methods Research: Achievements and future directions. Journal of Mixed Methods Research, 14(2), 131–134.

Field, A. (2020). Discovering statistics using IBM SPSS statistics (5th ed.). SAGE Publications.

Harjana, N. P. A., Januraga, P. P., Indrayathi, P. A., Gesesew, H. A., & Ward, P. R. (2021). Prevalence of depression during COVID-19. Frontiers in Public Health, 9, 1–8.

Hennink, M., & Kaiser, B. N. (2022). Sample sizes for saturation in qualitative research. Qualitative Health Research, 32(2), 1–12.

Keliat, B. A., Hamid, A. Y. S., Putri, Y. S. E., Daulima, N. H. C., Wardani, I. Y., Susanti, H., et al. (2019). Asuhan keperawatan jiwa. EGC.

Luo, Y., Li, Y., Xie, J., Duan, Y., Gan, G., Zhou, Y., Luo, X., Wang, J., Chen, Z., Zhang, Q., & Cheng, A. S. K. (2022). Symptoms of depression are related to sedentary behavior and sleep duration in elderly individuals. Journal of Affective Disorders, 308, 407–412. https://doi.org/10.1016/j.jad.2022.04.102.

Marliana, T., Keliat, B. A., Daulima, N. H. C., & Rahardjo, T. B. W. (2020). A concept analysis: Aloneness in elderly with depression. Enfermería Clínica, 30, 6–9. https://doi.org/10.1016/j.enfcli.2020.01.003.

Marliana, T., Keliat, B. A., Daulima, N. H. C., & Rahardjo, T. B. W. (2021). Factors related to happiness and quality of life in elderly depression. Open Access Macedonian Journal of Medical Sciences, 9(T5), 1–8. https://doi.org/10.3889/oamjms.2021.7847.

Marliana, T., Keliat, B. A., & Kurniawan, K. (2022). Mental health and psychosocial support online-based services. Malaysian Journal of Medicine and Health Sciences, 18, 1–6.

Nugroho, A., Fitriani, N., & Prasetyo, Y. (2022). Community-based mental health services for elderly in Indonesia. Jurnal Kesehatan Masyarakat Nasional, 17(2), 85–92.

Patel, V., Saxena, S., Lund, C., Thornicroft, G., Baingana, F., Bolton, P., Chisholm, D., Collins, P. Y., Cooper, J. L., Eaton, J., Herrman, H., Herzallah, M. M., Huang, Y., Jordans, M. J. D., Kleinman, A., Medina-Mora, M. E., Morgan, E., Niaz, U., Omigbodun, O., ... Unützer, J. (2022). The Lancet Commission on global mental health. The Lancet, 392(10157), 1553–1598.

Plano Clark, V. L., & Ivankova, N. V. (2021). Mixed methods research: A guide to the field. SAGE Publications.

Putri, D. A., Rahman, F., & Hidayati, N. (2022). Hubungan kesepian dengan depresi pada lansia. Jurnal Keperawatan Indonesia, 25(1), 45–52..

Rahmawati, I., Suryani, S., & Widodo, A. (2022). Happiness and depression among elderly. Jurnal Psikologi, 49(2), 120–130.

Rekawati, E., Hamid, A. Y. S., Sahar, J., Widyatuti, W., & Sari, N. L. P. D. Y. (2019). Model keperawatan keluarga santun lansia. Jurnal Penelitian Kesehatan, 10(3), 173–180.

Sadock, B. J. (2018). Kaplan & Sadock’s synopsis of psychiatry (11th ed.). Wolters Kluwer.

Santini, Z. I., Jose, P. E., York Cornwell, E., Koyanagi, A., Nielsen, L., Hinrichsen, C., Meilstrup, C., Madsen, K. R., & Koushede, V. (2020). Social disconnectedness, perceived isolation, and mental health. The Lancet Public Health, 5(1), e62–e70.

Sari, R., Kusuma, H., & Dewi, N. (2023). Quality of life among elderly with chronic disease. Jurnal Kesehatan, 14(1), 10–18.

Steptoe, A. (2021). Happiness and health. Annual Review of Public Health, 42, 1–20.

Sum, G., Lau, L. K., Jabbar, K. A., Lun, P., George, P. P., Munro, Y. L., & Ding, Y. Y. (2023). The WHO ICOPE framework. International Journal of Environmental Research and Public Health, 20(1).

Ulfa, L., Kusharipeni, Dewi, R. K., Rahardjo, T. B. W., et al. (2020). Analisis perubahan status gizi terhadap status fungsional pada lansia. Universitas Indonesia.

Wahyuni, S., Kurniawati, D., & Lestari, P. (2023). Family support and mental health outcomes in elderly. Jurnal Keperawatan Jiwa, 11(2), 200–210.

World Health Organization. (2020). Global health estimates. WHO.

World Health Organization. (2021). Depression.

Yesavage, J. A., et al. (1983). Development and validation of a geriatric depression screening scale. Journal of Psychiatric Research, 17(1), 37–49.

Zhang, D., Chan, D. C. C., Niu, L., Liu, H., Zou, D., Chan, A. T. Y., Gao, T. T., Zhong, B., Sit, R. W. S., & Wong, S. Y. S. (2018). Meaning and its association with happiness, health, and healthcare utilization. Journal of Affective Disorders, 227, 795–802. https://doi.org/10.1016/j.jad.2017.11.082.