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Table 3 Arrangements of the over-arching categories, factors, and sub-factors

From: Middle-aged and older people with urgent, unaware, and unmet mental health care needs: Practitioners’ viewpoints from outside the formal mental health care system

Factors

Suggested solutions

Factors related to specific individuals

 Individual’s intrinsic factor

Difficulty in seeking help

Recognition of how older people may inadequately understand their health or be unaware of available services

Delusions

Building a therapeutic alliance

 Family factor

Discord between family members

Provision of particularly intensive care for families with family discord

Denial of engagement

To have intensive efforts at contact and early involvement after contact with health care services

Multiple cases in one family

Provision of particularly intensive care for families with multiple cases

Family’s difficulty in seeking help

Provision of particularly intensive care for families who face difficulties in seeking help

Factors related to systems

 Physical health system-related factors

Indifference of physical healthcare providers regarding mental health matters

Mental health education campaigns to enhance mental health knowledge among non-mental health professionals

Discontinuation of physical health conditions

 Mental health system-related factors

Irresponsive mental health care systems

Reforms to be more responsible, especially regarding emergency inpatient care

Uncomfortable experiences in previous visits to clinics

Promote listening without ageism in clinical practice

 Social service system-related factors

Lack of time to provide care

Expansion of social services regarding human resources, flexibility of use, and breadth of types of care provided

Social service was not allowed without diagnosis

No appropriate service in the community

Lack of integration between systems

Facilitate integration between the systems

Others

 Community people-related factors

Encouragement of the community residents to be involved in social security systems

 Factors related to inter-regional movements

Provision of particularly intensive care for people who have just moved in