The aging population is a well-documented global phenomenon. It was estimated that by 2050, 1.5 billion people worldwide will be older than 65, equivalent to one in six people (1). As individuals age, mental health disorders become increasingly prevalent. It was demonstrated that one in three adults (aged 65 to 84 years) in Europe experienced a mental health disorder within the previous year (2), with depression ranking as fourth leading cause of disability in individuals aged 60 and over (3).

Mental health disorders significantly impact well-being of older adults and their families, with complex, multifaceted causes more common than not (4). Factors such as socioeconomic status, physical health, and loneliness often contribute to the onset and persistence of these conditions (5–7). People experiencing mental health problems often struggle to form and maintain social connections, resulting in smaller and less diverse social networks, typically involving only peers, family members, and healthcare professionals (8). Interventions aimed at increasing physical activity or reducing loneliness have shown to improve well-being, aid in the prevention and recovery from psychiatric disorders, and benefit all ages (9–16). Despite the effectiveness of interventions promoting social interaction, older psychiatric patients often face stigmatization (public stigma, i.e., negative attitudes or prejudices held by others), which hamper formation of new social connections crucial for mental health (17).

While prevalence of mental health disorders among older adults and the challenges in addressing their needs are already significant, this is further compounded by the substantial gap between the global demand for mental health care and its supply (18, 19), highlighting the urgent need for innovative solutions. The World Health Organization emphasizes that healthy ageing and long-term care require partnerships between governments, families, communities, health care providers and companies (20). Since the 1990’s, Corporate Social Responsibility (CSR) has emerged as a strategic approach for companies to create social impact and strengthen ties with stakeholders, including the wider community, which is often realized through corporate volunteering (21, 22). Such CSR initiatives most commonly focus on education, environment, health and welfare, and services for youth and senior citizens (21). In this context, corporate volunteering may offer a valuable way to mobilize additional resources and tap into volunteer potential for mental health care, reaching beyond peers and existing healthcare professionals or volunteers. Recent research indicates that corporate volunteering, particularly when centered on contributing to others, can enhance employees’ sense of meaningfulness in their daily work (23). It also fosters employees’ positive emotions, work engagement, social connections, and self-esteem (24). Promising results were also shown in initiatives such as buddy projects, which pair volunteers with individuals from various populations to enhance mental and physical well-being, benefiting both the populations – by reducing loneliness, strengthening self-reliance, and improving well-being - and the volunteers, who gain meaningful, enjoyable, and skill-building experiences (8, 25, 26).

Despite these promising results, we found no empirical research examining the intersection of corporate employees, social interaction interventions, and older adults with mental illness. While literature on corporate volunteering is extensive (27), the role of companies in geriatric mental health care remains underexplored (28, 29), with little understanding of the barriers and facilitators to participation in social interventions. This study therefore aims to explore factors associated with company employee participation in a walking project developed for psychiatric outpatients aged 60 and older. Our findings may contribute to improving the collaboration between companies and mental health care providers, potentially strengthening informal care networks, improving patient well-being, reducing loneliness, and combating stigma.

A total of 13 out of 250 contacted companies responded (5% response rate). These companies were contacted by telephone (n=6), online contact form (n=5), or email (n=2). Next, 17 respondents from these 13 companies consented to semi-structured interviews, including: three chief executive officers, seven managers (from HR, vitality and office departments), three advisors (in HR and vitality), and four employees. A detailed overview of companies involved in the interviews is provided in Table 1. Additional data was collected from 66 companies that declined to participate in an interview and the project, mainly via e-mail and short telephone conversations, and in few cases via an introductory meeting at the respondent’s location or a Microsoft Teams meeting. Reasons for declining are specified in Table 2.

Table 3 provides an overview of the findings after thematic analysis of both the interviews and additional data (see also paragraphs 3.1 to 3.3). Deeper interpretation of data will be addressed in the discussion.

This study aimed to explore factors associated with company employee participation in a waking project involving older psychiatric outpatients. Our exploratory method allowed us to uncover these factors, which we can now interpret in the light of existing theory on public stigma and CSR. Respondents generally viewed the project positively, emphasizing benefits for both employee well-being and patient support. This favorable outlook highlights the potential of targeted interventions in elderly mental health care.

However, significant barriers to structural volunteer engagement within companies were identified, complementing literature on the complexity of implementing volunteer work (28). The low (5%) response rate from contacted companies reflects a significant challenge of securing company engagement for ongoing volunteer efforts. This reluctance may reflect broader issues around stigma and discomfort with mental illness, as identified in the interviews. Franjić (34) noted that stigma, rooted in ignorance and fear, hinders social inclusion and engagement of people with mental illness.

Respondents expressed walking with psychiatric patients may evoke discomfort. Companies might hesitate to support initiatives requiring sustained interaction with this group. As respondents highlighted, media portrayals often exaggerate negative aspects of mental illness, creating a skewed perception that may deter employees from engaging with patients. This reflects research on the unjustified perception of individuals with mental illness, often stereotyped as dangerous (34, 35). Respondents with personal or professional experience with mental illness or disabilities showed greater openness towards patients. Recent study found healthcare professionals with close ties to mental illness, exhibited lower levels of stigma (36). Interestingly, health- and social care companies were somewhat reluctant to participate, as respondents expected employees to prefer walking without clients.

A potential barrier lies in respondents’ expectation that patients will demonstrate enjoyment. In a recent study, volunteers assumed that patients would exhibit enthusiasm during project involvement (37). Yet, older patients may experience symptoms such as anhedonia, limiting social engagement and potentially impacting project success (38). Although research shows mental health patients are often genuinely motivated to join physical activities, psychiatric barriers may limit actual participation (39–41). Nevertheless, respondents believed the project could gradually shift employee perspectives and reduce stigma, fostering greater empathy for individuals with mental health issues. They stressed the importance of providing a clear profile of the target demographic in advance, supporting findings from a study in which volunteer training covered communication, confidentiality, boundaries, risk assessment and emergencies to prepare volunteers for working with psychiatric patients (37).

Practical and organizational barriers included difficulties integrating the project into workflows, limited senior management support, and corporate focus on output over social engagement. Participation also should not conflict with work responsibilities, which makes companies reluctant to allocate resources to non-core activities. This points to the need for strategies to increase corporate buy-in, such as aligning volunteer projects with CSR objectives and clearly communicating mutual benefits for employees and organizations.

Leadership proved pivotal in enabling social initiatives: one CEO endorses the initiative, linking it to broader societal concerns. CSR research among executives (42) confirms such decisions often stem from personal beliefs and priorities.

This study explored factors influencing employee participation in a walking initiative for older, psychiatric outpatients. While the study highlights the positive impact of mental health volunteer initiatives on both employees and patients, it also emphasizes the need for greater company involvement in such initiatives. By addressing barriers like stigma and discomfort, and creating a supportive environment that encourages employee participation, companies can play a pivotal role in enhancing both employee well-being and patient care, ultimately contributing to a more inclusive and compassionate society.