In conclusion: Quality of life is an essential aim of a developing country

and is one of the national public health 20 years’ plans. Quality of life is an important criterion
used to evaluate health care systems and health care outcomes globally. In this study, the researcher
adopted the behavior model Anderson’s behavioral model especially
Andersen in the fifth phase (Andersen 2008). That determine quality of life as the presentation of
evaluation mental health care system. The quality of life can be affected on contextual
characteristics, and this study focus on an organization or use of mental health service delivery
system. Based on the literature review, no study directly focusses on variable in the context of
mental health service delivery system that is related to mental health service use and quality of
life. However, some literature review concluded that hospital level has served differentiated
resource allocation, service delivery, and competency of care. Therefore hospital level, nurse
competency, nurse-patient ratio, depression treatment, and appointment reminder could imply
effects on mental health service use and quality of life.
Besides, most of the evidence concluded that individual characteristics
including demographic (Age, sex), marital status, and income could affect mental health service
use and quality of life. It is found that attitude toward depression and social support can affect
quality of life and mental health, moreover elderly with comorbidity and severity have been found
to affect quality of life.
However, based on evidenced-based research, it was found that depression
treatment results in better quality of the elderly especially the ongoing depression treatment,
therefore mental health service use among elderly who are diagnosed with depression with
continuously antidepressant. On the other hand, most of evidence-based studies found that there is
no continuity of treatment for the elderly. Therefore, continuity of treatment has become an
important role in mental health service delivery system in order to improve depressive symptoms
to optimize the quality of life. Without continutity of treatment will inevitably affect the quality of
life of older adults and can cause an endless cycle of illness. The health service unit should seek
urgent prevention measures, and make it an important role in mental health service delivery system
in order to improve depressive symptoms to optimize the quality of life.
The study of the predictor of effect on mental health service use and quality
of life for the elderly is essential. Mental health service delivery system for elderly with depression
requires nurses with specific competencies, high level of quality mental health service delivery
system, and the most important things are adherence and continuous use of mental health service
among elderly with depressive disorders. Results from literature revealed that there have several
factors predicting the use of mental health care and quality of life among elderly with depressive
symptoms, some were supporting factors while others were barriers. There is no study regarding
predicting factors of quality of life and the use of mental health care among the elderly with
depressive symptom in Thai contexts. Thailand is under the 30-baht coverage scheme as well as
the elderly are under full social security coverage for their treatment; however, the use of mental
health care among elderly with depressive disorders has no continuity of care. There were some
studies from other countries; however, their results could not answer all phenomena in Thailand.
Therefore, this study will enclose predicting factors of quality of life and the use of mental health
care among the elderly with depressive symptoms. The results can be used for development of a
health service system policy that provides specific mental health service appropriate for elderly
with depression disorders, thereby, to enhance quality of depressive disorder care and quality of
life of the elderly with depressive disorders.