In the context of the rapidly increasing number of elderly people worldwide, this has started to appear as a social challenge. According to United Nations estimates, by 2050, the number of people aged 60 and over will reach 2.1 billion in the world, which will account for 21 percent of the total population.

In 2024, the share of the population above 65 years was 10.3 percent . From 2019 to 2050, the share of the elderly population is expected to double in four regions in particular - North Africa and Western Asia, Central and South Asia, Latin America and the Caribbean, and East and South-East Asia. With this type of demographic change, adopting a comprehensive and robust strategy for promoting the health and psychological well-being of the elderly is becoming an inevitable necessity.

Due to changes in the population structure in Nepal, the number of senior citizens is continuously increasing. According to the 2078 national census of Nepal, the population of the age group of 60 years or more is about 10.21 percent i.e. 29 lakh 70 thousand. In addition to this, the challenges of social security, health care and mental health of senior citizens have also increased together . In order to address this problem, the government of Nepal has introduced the 'Senior Citizens Act' in 2063 to set the basis for their rights, rights and protection, and is conducting various policies and programs to promote mental health .

Through the Senior Citizens Act, the government declared citizens over 60 years of age as 'senior citizens' and laid the foundation for their housing, health services, social security and dignified living. This act has provided the children with the legal obligation to care and nurture their elderly parents as part of the family obligation, and arrangements have been made to provide old age homes, health services, social security and other facilities. In addition to this, the act of harming the reputation and self-esteem of senior citizens is considered punishable by this act. However, there are still many challenges in the effective implementation of the Act.

It is necessary to adopt a comprehensive strategy for the effective implementation of the Senior Citizens Act in Nepal, in which, first of all, local government bodies (municipalities and rural municipalities) should be made transparent and facilitated by providing sufficient rights, responsibilities and resources. Secondly, mobile clinics, telemedicine services and regular health camps should be organized while expanding access to health services in rural areas, and thirdly, information about the rights, respect and services of senior citizens should be disseminated through social awareness campaigns with the active participation of families, communities and the media. In addition, adopting measures such as appointing expert counselors with special priority to mental health services, providing special training on mental health to community health workers and establishing community support centers will help to significantly improve the quality of life of Nepal's senior citizens .

Some countries in the world are famous for adopting cutting-edge and inclusive policies for senior citizens. Like: Sweden is considered to be the best country in terms of social security and welfare services. There is a universal pension system that ensures minimum income to all senior citizens. Health care is free, including nursing home care. There is a strict legal system to protect the rights of senior citizens. Japan is considered to be one of the best countries in the effective management of its aging population. There, the government has introduced a subsidized long-term care insurance system. Partial employment opportunities are offered to senior citizens and public transport and infrastructure are age-friendly. In the context of Nepal, the 'Senior Citizen Act' has ensured the rights of the elderly, but its implementation is very weak compared to other countries. It is necessary to learn this from Japan and Sweden.

Although the Senior Citizens Act provides a legal basis for the rights and protection of the elderly, mental health issues are still not adequately addressed. The narrow social perception of mental problems as a shame is still widespread, which has promoted the tendency to consider the elderly as a family and social burden. 

Access to mental health services in rural and remote areas is low, health institutions that provide services are not age-friendly and there is a shortage of qualified psychiatrists and trained human resources . Another challenge is isolation due to family breakdown . Many elderly people are forced to live alone when their children are abroad and there seems to be a lack of emotional closeness even in old age homes.

Solving these challenges requires a multifaceted effort. First, it is necessary to ensure the rights, treatment and protection of the elderly by including special provisions on mental health in the Senior Citizens Act. It should not be delayed now to expand mental health services at the community level and provide consultation and treatment facilities through local health institutions. Special training should be given to doctors and health workers to learn and follow age-friendly behavior. It is necessary to provide training on geriatric mental health to health workers, social workers and volunteers, and it is equally important to include this subject in the educational curriculum of health and social sciences .