What Have Been Achieved

During Phase I, JC JoyAge developed an innovative service model incorporating collaborative stepped-care and peer support components, targeting older adults at risk of depression or experiencing mild to moderate levels of depressive symptoms. The main quasi-experimental study by the HKU research team showed that JC JoyAge participants had greater reduction in depressive symptoms, anxiety symptoms, and loneliness, compared with usual care. Subgroup analysis showed that the model was effective in both selective and indicated prevention. The model was also cost-effective, with an incremental cost-effectiveness ratio of US$8 per depression-free day and US$18,471 per quality-adjusted life-year (QALY) gained. Subsequent research from the Second Phase further confirmed the model’s positive impact, with over 90% of participants showing reduced depressive symptoms and over 80% reporting no depressive symptoms (PHQ-9 score ≤ 4) after the intervention (SMY Wong et al., 2024).

The Ambassador training showed to improve mental health literacy, reduce mental health stigma, foster a sense of meaning in life, and expand social networks (Zhang et al., 2025). The benefits of the training remain consistent whether delivered in-person or via teleconferencing (Leung et al., 2024), suggesting the potential for wider dissemination of the program using digital platforms.

The Peer Supporter training showed strong potential for enhancing social capital at the community level, fostering relational resilience and protective networks buffering against psychosocial risks associated with late-life mental health challenges. Qualitative inquiry revealed four themes related to Peer Supporters’ experience: (1) peerness in health and age-related lived experiences; (2) companionship, social and emotional ties beyond formal support; (3) meaningful roles to facilitate older people’s functional ability; and (4) hopes and actions against the undesirable outcomes of ageing (Tang et al., 2022). The research team also identified a core competency framework for mental health peer supporters, which helps minimise role confusion and refine training and practice guidelines (ELY Wong et al., 2024).

What Will Be Done

In the current phase, JC JoyAge expands the successful stepped-care model from social care to primary care settings. The Project collaborates with DHCs/DHCE to enhance community medical-social collaboration and introduces mental health support in primary care for individuals aged 45 or above. A new co-care model is introduced, with social workers working with Primary Care Physicians to offer a combination of timely psychological and pharmacological support to people with increased mental health needs. Moreover, a referral system between HA Clusters and the Project has been established to provide early intervention to individuals awaiting psychiatric services. To leverage the potential of Peer Supporters, the Project has also provided additional training for them to serve as Emotional Support Assistants, offering low-intensity group intervention for middle-aged and older adults with mild depressive symptoms.

The research team will focus on four key areas:

• To evaluate the effectiveness of the collaboration with DHCs/DHCE, including the co-care model, in preventing and reducing depressive symptoms
• To evaluate the effectiveness of the referral system with HA in preventing and reducing depressive symptoms
• To evaluate the effectiveness of Peer Supporter-led group interventions in preventing the progression of depressive symptoms among at-risk individuals and in strengthening social capital
• To evaluate the community-based participatory research (CBPR) model aimed at promoting mental health literacy and reducing mental health stigma among older adults in Hong Kong