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

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FORMOSA NEWS - Jakarta - New Community-Based Care Model Successfully Reduces Depression and Boosts Happiness in Older Adults. A groundbreaking community health framework successfully reduces depression levels, improves psychosocial development, and increases overall happiness among ageing populations. Thika Marliana, Budi Anna Keliat, Novy H.C Daulima, Tri Budi W Rahardjo from Universitas Respati Indonesia and Universitas Indonesia, the newly unveiled "THIKA Model" integrates biological, psychological, social, and cultural approaches into a unified primary care intervention. Published in May 2026 in the Formosa Journal of Applied Sciences, the study introduces a practical, scalable solution to the global challenge of managing late-life mental disorders.

The Growing Crisis in Elderly Mental Health
Population ageing has become a major global phenomenon, presenting severe operational challenges for modern healthcare infrastructure. In Indonesia, a rapid demographic transition is underway, with the elderly population projected to comprise 23% of the total population by 2050. This demographic shift coincides with a mounting mental health burden. Globally, depression affects approximately 5.7% of older adults, but in Indonesia, the prevalence rate sits noticeably higher at 7.7%. Late-life depression is frequently worsened by chronic physical illnesses, declining functional abilities, and severe psychosocial stressors. Left unaddressed, it drastically reduces quality of life and escalates suicide risks. Despite this growing crisis, primary mental health services remain heavily fragmented. Existing community health programs, such as local Posyandu clinics, disproportionately prioritize physical health while leaving complex psychosocial and emotional needs unmet.

Designing the Holistic THIKA Framework
To address these systemic gaps, researchers designed the THIKA Model using a comprehensive, sequential mixed-method approach. They initially surveyed 452 older adults experiencing depressive symptoms to map out core risk factors, followed by qualitative focus groups with 27 stakeholders including depressed individuals, caregivers, healthcare professionals, and community policymakers to uncover deep-seated psychosocial needs. The empirical findings confirmed that late-life depression cannot be treated via single-dimension clinical therapies alone. Loneliness, emotional withdrawal, empty nest syndrome, and unaddressed life regrets function as dominant mechanisms that aggressively accelerate depressive conditions. Conversely, subjective happiness acts as a vital protective mechanism that enhances psychological resilience. The resulting THIKA framework operationalizes care through five core intervention components delivered over a structured 15-week period:

• Self-Disclosure Practice: Encourages older adults to openly express suppressed thoughts and emotional distress, actively counteracting the impacts of isolation.
• Physical Activity Management: Improves biological markers and physical functioning, directly mitigating fatigue and lethargy.
• Social Skills Training: Rebuilds communication competence through group activities, helping participants construct supportive peer networks.
• Cultivating Positive Aspects: Focuses on structured gratitude, positive thinking, and finding personal meaning in later life stages.
• Mental Resilience Strengthening: Teaches adaptive coping mechanisms to help older individuals navigate life transitions and health uncertainties smoothly.

Transforming Outcomes and Primary Care Architecture
The 15-week implementation study demonstrated that the THIKA Model yields measurable, transformative improvements across five distinct psychosocial and clinical dimensions. A critical element behind the framework's success is its collaborative ecosystem. Rather than relying solely on hospital-based specialists, the THIKA model distributes care across professional health workers, family caregivers, and local community mental health cadres. Healthcare professionals maintain clinical standards, community cadres provide continuous localized monitoring, and caregivers reinforce positive behavioral changes within the home. By successfully shifting primary care from a disease-centered model to an integrated, person-centered support network, the THIKA framework offers a scalable blueprint to optimize geriatric mental health services worldwide.

Broad Implications for Primary Healthcare Policy

This research, led by Respati Indonesia University and the University of Indonesia, has strategic implications for public policy reform and geriatric nursing education. The THIKA model demonstrates that shifting from disease-centered to person-centered care can sustainably reduce the national burden of depression. For the government and public sector, this model offers a blueprint for efficient and cost-effective elderly-friendly programs, as it maximizes the potential of existing community cadres. Going forward, integrating this model with digital health platforms could further expand the reach and sustainability of elderly care in various regions.

Researcher Profile

Thika Marliana, S.Kep., Ners., M.Kep., Sp.Kep.J. – Principal researcher and expert in mental health nursing from the Faculty of Health Sciences, Universitas Respati Indonesia. Focuses on developing community-based mental health intervention models and gerontology.

Prof. Dr. Budi Anna Keliat, S.Kp., M.App.Sc. – Professor and senior expert in mental health nursing from the Faculty of Nursing, Universitas Indonesia. Widely recognized for her contributions to the development of community mental health nursing care in Indonesia.

Dr. Novy H.C. Daulima, S.Kp., M.Sc. – Lecturer and senior researcher at the Faculty of Nursing, Universitas Indonesia, with special expertise in mental health nursing service management and psychosocial support.

Prof. Dr. Tri Budi W. Rahardjo, drg., MS – Professor in gerontology from Universitas Respati Indonesia, with extensive experience in research on elderly well-being, functional status, and active aging policies.

Source
Thika Marliana, Budi Anna Keliat, Novy H.C Daulima, Tri Budi W Rahardjo (2026).Transforming Primary Mental Health Care for Ageing Populations: The THIKA Model for Community-Based Integrative Intervention. Formosa Journal of Applied Sciences (FJAS), Vol. 5, No. 5 2026: 1211-1226
DOI: https://doi.org/10.55927/fjas.v5i5.57
URL: https://journalfjas.my.id/index.php/fjas