Collaborative care models, stepped care interventions in primary care settings and an enhanced inter-professional approach to patient care in old age psychiatry is necessary to improve detection, treatment and ongoing care. Tele-mental health services may become important parts of the provision of mental health services and the effectiveness revealed for in-home tele-health problem solving therapy in old age depression may be an approach to make psychotherapy available to a large number of underserved elderly patients with mental illness.