•  
  •  
 

Abstract

Background: Mental health problems among older adults are a growing public health concern, particularly in urban areas. Mental health literacy can enhance problem recognition, self-help, and help-seeking. This study examined changes in mental health literacy and resilience among urban older adults following an integrated activity-based and tele-monitoring intervention.

Methods: A one-group quasi-experimental repeated-measures study was conducted among 30 adults aged 60 years and older in urban communities in Thailand. Participants received a structured 3-hour activity-based mental health literacy intervention followed by 1 month of tele-monitoring support. Data were collected at baseline, immediately after the intervention, and at 1-month follow-up. Changes in mental health literacy and resilience scores were analyzed using the Friedman test and Wilcoxon signed-rank test with Bonferroni correction.

Results: Mental health literacy scores increased significantly after the intervention and remained significantly higher at follow-up than at baseline (χ² = 29.29, p < 0.001, Kendall’s W = 0.49). Resilience scores also improved significantly across the three measurement points (χ² = 38.39, p < 0.001, Kendall’s W = 0.64). Although resilience scores declined at follow-up compared with immediately after the intervention, they remained higher than baseline.

Conclusion: The intervention was associated with improvements in mental health literacy and resilience among urban older adults in Thailand. This approach shows potential as a practical community-based model for mental health promotion in ageing populations; however, controlled studies with larger samples and longer follow-up are needed.

Keywords: Mental health literacy, Ageing, Older adults, Resilience, Tele-monitoring, Thailand

References

[1] Haque MN. Active ageing level of older persons: regional comparison in Thailand. J Aging Res 2016;2016:9093018. https://doi.org/10.1155/2016/9093018.

[2] He W, Goodkind D, Kowal P. An aging world: 2015. Washington (DC): U.S. Census Bureau; 2016 [cited 2026 Feb]. Available from: https://www.census.gov/library/publications/2016/demo/P95-16-1.html.

[3] World Health Organization [WHO]. Mental health of older adults. Geneva: WHO; 2026 [updated 2026 Jul 20; cited 2026 Sep]. Available from: https://www.who.int/news-room/fact-sheets/detail/mental-health-of-older-adults.

[4] Pengpid S, Peltzer K, Hajek A, Anantanasuwong D, Kaewchankha W. Determinants of depressive symptoms among persons 80 years and older: longitudinal national evidence from the Health, Aging, and Retirement Study in Thailand, 2015-2022. BMC Geriatr 2024;24(1):880. https://doi.org/10.1186/s12877-024-05479-z.

[5] Ministry of Public Health [MOPH], Thailand. Mental Health Data Center: psychiatric service utilization data. Nonthaburi: MOPH; [cited 2026 Feb]. Available from: https://datacenter.dmh.go.th/.

[6] National Suicide Prevention Center, Thailand. The national data suicide rates of Thailand. Khon Kaen: Khon Kaen Rajanagarindra Psychiatric Hospital. [cited 2026 Feb]. Available from: https://suicide.dmh.go.th/report/suicide/english/stat_prov.asp?ndead=1.

[7] Chen H, Ma Z, Huang R, Liu Y, Li L, Zhou Z, et al. Factors associated with mental health literacy and demand for mental health services among older adults in China: a cross-sectional study. BMC Geriatr 2025;25(1):343. https://doi.org/10.1186/s12877-025-06003-7.

[8] Ding KR, Wang SB, Xu WQ, Lin LH, Liao DD, Chen HB, et al. Low mental health literacy and its association with depression, anxiety and poor sleep quality in Chinese elderly. Asia Pac Psychiatry 2022;14(4):e12520. https://doi.org/10.1111/appy.12520.

[9] Wong AKC, Liu T, Liu LZ, Bayuo J, Tao X, Wong FKY. Healthcare and social needs of older adults in underserved urban communities: insights from community health workers. J Urban Health 2025;102(5):1057—68. https://doi.org/10.1007/s11524-025-01011-9.

[10] Ariyanti O, Sampaio D, Bailey A. Barriers and facilitators to urban mobility for older adults in LMICs: a scoping review. J Transport Geogr 2025;127:104289. https://doi.org/10.1016/j.jtrangeo.2025.104289.

[11] Wongjongrungruaeng T, Supanya S. Service access among individuals with psychotic experiences in Bangkok: results from the 2023 Thai national mental health survey. J Somdet Chaopraya Inst Psychiatry 2025;19(2):18—45 [in Thai]. Available from: https://he01.tci-thaijo.org/index.php/journalsomdetchaopraya/article/view/276945.

[12] Koistinen N, Boonyamalik P, Amnatsatsue K. Mental health literacy among older adults in Bangkok. J Public Health Nurs 2025;39(2):54—67 [in Thai]. Available from: https://he01.tci-thaijo.org/index.php/phn/article/view/265571.

[13] Jorm AF. Mental health literacy: public knowledge and beliefs about mental disorders. Br J Psychiatry 2000;177:396—401. https://doi.org/10.1192/bjp.177.5.396.

[14] Thangkratok P, Palacheewa N, Trainattawan W, Boonpradit P. Mental health literacy: concept and application for mental health problem prevention in older adults. BSCM 2020;59(3):163—72 [in Thai]. Available from: https://he01.tci-thaijo.org/index.php/CMMJ-MedCMJ/article/view/241355.

[15] Raghavan V, Chandrasekaran S, Paul V, Pattabiraman R, Mohan G, Durairaj J, et al. Effectiveness of a mental health literacy module on stigma related mental health knowledge and behaviour among youth in two educational settings in Chennai, South India: a quasi-experimental study. Asian J Psychiatry 2024;98:104074. https://doi.org/10.1016/j.ajp.2024.104074.

[16] Grosselli L, Baumgärtel J, Böhm H, Hoyer J, Knappe S. When knowledge falls short: a systematic review on the correlation of mental health knowledge with stigma and help-seeking. Ment Health Sci 2025;3(2):e70022. https://doi.org/10.1002/mhs2.70022.

[17] Gere B, Salimi N. Mental health literacy, stigma, and help-seeking behavior among Black male college students in historically Black universities. Am J Mens Health 2025;19(1):15579883251318214. https://doi.org/10.1177/15579883251318214.

[18] Wang Y, Jia S, Wang A, Li H, Xu R, He X. Multilevel factors affecting mental health literacy among older adults: a qualitative study based on social ecological model. Front Public Health 2025;13:1656116. https://doi.org/10.3389/fpubh.2025.1656116.

[19] Xu R, Jing M, Zhang A, Zha L, Wang Y, Wang A, et al. Mental health literacy among older adults in Shanghai: a descriptive qualitative study. Front Psychol 2025;15:1470758. https://doi.org/10.3389/fpsyg.2024.1470758.

[20] Cosarderelioglu C, Walston JD, Abadir PM. From frailty to resilience: exploring adaptive capacity and reserve in older adults-a narrative review. Front Aging 2025;6:1520842. https://doi.org/10.3389/fragi.2025.1520842.

[21] Timalsina R, Subedi M, Maharjan N, Shah B, Adhikari P. Factors associated with psychological well-being among older adults attending daycare centers of Kathmandu, Nepal: a cross-sectional path-analytical study. BMC Geriatr 2025;25(1):973. https://doi.org/10.1186/s12877-025-06506-3.

[22] Qiu Y, Cong Z, Wang X, Li S. Potential factors associated with resilience among older adults in rural China: a multilevel analysis. BMC Geriatr 2023;23(1):844. https://doi.org/10.1186/s12877-023-04575-w.

[23] Jangasem N, Bundasak T, Yotkhamlue K, Prommarut A, Udonsat S. Effects of the mental health literacy enhancing program on psychological well-being and quality of life among elderly. J Royal Thai Army Nurs 2024;25(2):302—10 [in Thai]. Available from: https://he01.tci-thaijo.org/index.php/JRTAN/article/view/269660.

[24] Sripho S, Reungsri T, Noparoojjinda S, Srisodsaluk P. The effects of a mental health literacy enhancement program among older adults at Subdistrict Health Promotion Hospital, Mueang District, Suphan Buri Province. Health Nurs Res 2026;42(2):118—28 [in Thai]. Available at: https://he01.tci-thaijo.org/index.php/bcnbangkok/article/view/284065.

[25] Leung DKY, Wong NHL, Yau JHY, Wong FHC, Liu T, Kwok WW, et al. Hybrid-delivered community psychoeducation for people aged 50 and older: a mixed-method evaluation and lesson learned. Internet Interventions 2024;35:100699. https://doi.org/10.1016/j.invent.2023.100699.

[26] Wu M, Li C, Hu T, Zhao X, Qiao G, Gao X, et al. Effectiveness of telecare interventions on depression symptoms among older adults: systematic review and meta-analysis. JMIR mHealth uHealth 2024;12:e50787. https://doi.org/10.2196/50787.

[27] de Oliveira PBF, Dornelles TM, Gosmann NP, Camozzato A. Efficacy of telemedicine interventions for depression and anxiety in older people: a systematic review and meta-analysis. Int J Geriatr Psychiatr 2023;38(5):e5920. https://doi.org/10.1002/gps.5920.

[28] Grigoraș G, Ilie AC, Turcu AM, Albișteanu SM, Lungu ID, Ștefăniu R, et al. Resilience and intrinsic capacity in older adults: a review of recent literature. J Clin Med 2025;14(21):7729. https://doi.org/10.3390/jcm14217729.

[29] Posai V, Boonchoo R, Watradul D, Makkabphalanon K, Thangkratok P. Mental health literacy and quality of life among patients with stroke. Chiang Mai Medical J 2021;60(1):63—74. https://doi.org/10.12982/CMUMEDJ.2021.06 [in Thai].

[30] Inthasit S, Junkiri S, editors. Plian rai klai pen dee: Palang sukkhaphap chit RQ: Resilience Quotient [Turning adversity into opportunity: The power of mental health RQ: Resilience Quotient]. Bangkok: Bureau of Mental Health Academic Affairs, Department of Mental Health; 2020 [Internet], [cited 2026 Feb]. [in Thai]. Available from: https://dmh-elibrary.org/items/show/168.

[31] Chaosuansreecharoen KR, Chaosuansreecharoen P, Khongsanit S. Effectiveness of resilience-enhancing program in elderly residents at Ban Sritang Nursing Home. Nurs J Ministry Public Health 2019;29(1):32—47 [in Thai]. Available from: https://he02.tci-thaijo.org/index.php/tnaph/article/view/187174.

Download

Share

COinS