Table 3 Organizational codes, themes and initial codes in this study

(1) Policy and legislative framework

Slow progress in the political agenda setting

- National discourse on mental health in older age

- Attitudes and knowledge of policy-makers

- Political space and priorities/recognition of mental health in older age

- Policy directions (strategies, programmes, legislation)/formulation of legislative framework

- Coordinated policy-making

- Voice and participatory policy-making

Strengthening public health governance for old-age mental healthcare

- Stewardship by the government

- Accountability, responsibility of the public health system

- Monitoring of governance for old-age mental healthcare

- Budget/allocation of resources to mental health for older people

- Implementation of policies

Development assistance: an opportunity or burden?

- Cross-country learning

- Influence of international organizations on domestic policy directions

- Dependence of India of international (development) organizations

- Agenda setting of international organizations

(2) Mental health in primary care

Primary healthcare (PHC): too weak to implement the vision of age-inclusive PMHC?

- Relevance of PHC for old-age mental healthcare

- Capacities of the PHC level

- Coordination between PHC level and secondary and tertiary care

- Integration of mental health (in older age) at the PHC level

Family- and community-oriented care as an opportunity

- Role of informal care in old-age mental healthcare

- Role of community health workers (CHWs) and mid-level care providers

- Interplay between informal and formal care

Integration of traditional health services as part of PMHC

- Role and relevance of Ayurveda, Yoga, Naturopathy, Unani, Siddha, Sowa-Rigpa and Homeopathy (AYUSH) in old-age mental healthcare

- Quality of AYUSH practices

(3) Mental health services

Needs-based, comprehensive and collaborative care for older persons: a difficult-to-implement vision

- Needs-based and person-centred care

- Comprehensive care

- Collaborative and interdisciplinary care

- Curative versus preventive care, guiding models of health

- Organization of PHC

Private and public mental health services

- Role of the private sector in old-age mental healthcare

- Agenda of the private sector

- Emphasis of the private sector on PHC

- Role of civil society organization in old-age mental healthcare

- Quality of care in the public PHC sector

- Collaborative approaches to care between the public and private sector

Integrating specialized mental health services for older persons into primary healthcare

- Institutional care

- Specialized services (e.g., psychotherapy, pharmacotherapy)

(4) Human resources

Shortage of skilled and motivated health workers for old-age-inclusive PMHC

- Skilled human resources

- Motivation of human resources

- Brain drain and retention factors

Providing age- and mental health-inclusive education to health professionals

- Specific knowledge of mental healthcare for older persons

- Age-inclusive mental health education

- Faculties of psychiatry and geriatrics

(5) Public information and links with other sectors

Greater public awareness of mental health in old age is required

- Public awareness of mental health in old age

- Awareness-raising programmes

The social protection sector is important to strengthen old-age mental healthcare and empower older persons

- Social security and protection of older persons

- Social welfare programmes

- Role of pensions in old-age mental healthcare

- Public health insurances for older persons

(6) Monitoring and research

Lack of research on old-age mental healthcare that can translate into practice

- Research on old-age mental health(care)

- Monitoring and evaluation of mental healthcare for older people

- Data-informed policy development, planning and implementation

- Attention to existing research