Understanding how “non-traditional” providers can support the early detection of mental health problems among older adults: a realist synthesis

Talk Code: 
Tom Kingstone
Kingstone T, Corp N, Chew-Graham CA
Author institutions: 
Keele University


Help-seeking for mental health problems by older adults (60+ years of age) may be delayed due to a lack of awareness, stigma, and limited access to acceptable services; meaning such problems remain hidden. NHS recommends wider public services, particularly those that are embedded within their local communities, could play an important role in health by facilitating engagement with healthcare services. For example, public health interventions for falls prevention led by the fire and rescue service have demonstrated acceptability and effectiveness among older adults. Evidence for interventions related to mental health within this population has not yet been synthesised. Moving forward, it is important to know how, when and in what contexts mental health interventions delivered by non-traditional organisations would work.

The approach

A realist synthesis to identify interventions that support detection of, and sign-posting for, mental health problems in older adults. We focus on interventions delivered by services that would not traditionally be involved in healthcare, such as fire and rescue, police, and library services. A PPIE group supported our initial evidence search strategy and definition of key terms. The review is registered with PROSPERO (CRD42020212498).


Systematic searches revealed a dearth of relevant evidence reporting mental health interventions delivered by non-traditional providers. The scope of our review has been adjusted to consider evidence for falls prevention and dementia; findings will be transposed to mental health contexts. Evidence has been coded to establish and refine context-mechanism-outcome configurations. These inform our programme theories and help make sense of existing interventions from multiple levels (receiver-, provider-, system-level). Findings are transposed to mental health contexts.


This synthesis will generate new understandings regarding the role of non-traditional providers in the management of mental health problems among older adults. Findings will inform a future study and implications related to sustainability will be discussed.

Statement of funding:

The RIDDLE study is funded by the National Institute for Health Research (NIHR) School for Primary Care Research Grant (ref: 472). The views expressed are those of the authors and not necessarily those of the NIHR or the Department of Health and Social Care.

Abstract dedicated to Katie Tempest.