ABSTRACT

The purpose of this study is to examine the multidimensional effects and underlying experiential meanings of the depression-focused intervention within the Specialized Service within the Individualized Support Services for Older Adults,-a community-based suicide prevention initiative-using a mixed-methods design. To this end, we conducted a secondary analysis of the 2022 evaluation dataset (quantitative data: N=2,645; qualitative data: N=19), employing a one-group pre-post comparison, effect size estimation, and qualitative content analysis. The quantitative results showed significant reductions in depression and suicidal ideation following service participation, along with improvements in positive psychological resources such as self-esteem, self-efficacy, and perceived social support. In contrast, loneliness did not exhibit statistically significant change; moreover, among long-term participants, loneliness increased over time, revealing an opposite pattern. The qualitative analysis provided empirical explanations for this asymmetry. Participants described the service relationship as a source of emotional comfort, yet the deep-rooted loneliness stemming from long-standing relational loss remained largely unresolved. Building on these findings, this study proposes that mental health policy for older adults should move beyond crisis-oriented symptom management and be restructured into a dual intervention framework that integrates both psychological and relational recovery. To this end, we highlight the need to develop a community-circulating care ecosystem, revise outcome indicators to include the restoration of social networks, and shift from a protection-centered model to a strengths-based empowerment approach. Beyond evaluating program effectiveness, this study offers important empirical evidence for redesigning suicide prevention policies for older adults and advancing an integrated mental health care system for high-risk older adults through strengthened community linkages.