From cost to value – Mental health among the elderly as an investment

Investing in the mental health of older adults 

Loneliness and mental illness among older adults are significant societal challenges. Municipalities, regions, and civil society organisations are already implementing numerous initiatives to promote health and social connection. However, these entities often operate with differing mandates, budgets, and objectives. This can hinder coordination and make it difficult to track the actual impact these initiatives have on older adults. Another challenge is that preventive work is often viewed as a cost rather than an investment. Initiatives that reduce loneliness and strengthen mental health can improve people's quality of life and, in the long term, reduce the need for health and social care services. Yet, these benefits are rarely highlighted in the documentation used for decision-making and resource allocation. The project "From Cost to Value: Older Adults' Mental Health as an Investment" aims to explore how this situation can be changed. 

A new model for collaboration and governance 

The project aims to develop and pilot a model in which municipalities, regions, civil society, and older adults work together to identify needs, formulate shared goals, and monitor the outcomes of preventive initiatives. The model is based on "outcome-based governance." This shifts the focus from the number of activities carried out or the resources utilised to the actual changes achieved for the individuals involved. A key component is the development of a social outcome contract. This is an agreement in which the relevant stakeholders agree on the desired outcomes, the organisation of responsibilities and funding, and the methods for monitoring results. The project aims to test how such an approach can be adapted to the Swedish welfare context. 

Three test environments in Blekinge 

The project is being carried out in three so-called testbeds, where new working methods are developed and tested in practice. Two testbeds focus on activities that strengthen the social participation, mental health, and quality of life of older people. These activities are designed in collaboration with older people to ensure they are based on their needs, experiences, and wishes. The third testbed focuses on improving collaboration between the municipality, the region, and civil society. The goal is to identify older people experiencing involuntary loneliness at an earlier stage and to create better opportunities for offering coordinated support. By monitoring all three testbeds, the project examines both the changes experienced by the participants and how the collaboration between the organisations functions. 

Highlighting human and economic values 

RISE uses the Social Return on Investment (SROI) analysis method to examine the value created by these initiatives. The method makes it possible to highlight social values—such as improved mental health, a greater sense of community, and a higher quality of life—and to estimate their economic significance. The analysis will also examine potential long-term effects, such as reduced future costs for health and social care. In this way, the project can provide a better basis for decision-making regarding investments in preventive work. 

From Blekinge to national benefit 

The project builds upon the regional development initiative "Mission: Mental Health Among the Elderly" and is being carried out by Karlshamn Municipality (the project coordinator), Region Blekinge, RISE, NetPort Science Park, and Schvung AB. The project is funded through SustainGov—part of the "Impact Innovation" initiative supported by the Swedish Energy Agency, Vinnova, and Formas—and runs from October 2026 to September 2028. It aligns with the program’s focus area, "The Future Social Contract," which aims to develop the relationship between residents and the public sector. The ambition is to develop a model that can also be used in other municipalities and regions. In the long term, the results could contribute to new ways of organising, financing, and monitoring preventive measures across other areas of the welfare sector as well.