This study delves into the global mental health challenges confronting the elderly within Thailand’s Buddhist context. It explores seniors’ perspectives on mental health distress, factors, and interventions, alongside monks’ viewpoints on traditional Buddhist approaches and their role in addressing these challenges. Our thematic analysis of qualitative research engaged 36 participants, comprising health volunteer monks and seniors from Northern Thailand, to identify primary themes and sub-themes. The perspectives on senior mental health scenarios highlight seniors’ experiences of stress, anxiety, sadness, and loneliness, influenced by factors like age, health, family, finances, and social isolation. Interventions encompass health care, religious practices, and community support. Monks advocate for integrating Buddhism into daily life, encouraging active participation, and addressing senior mental health issues, emphasizing their pivotal role, the embodiment of monastic ideals, and the challenges hindering their involvement. The research highlights the significance of empowering monastic involvement, acknowledging monks as representatives of monastic principles, even in the face of obstacles limiting their participation. This study uncovers a trend in Thai Buddhist communities where physical health and religious aspects take precedence over the mental well-being of seniors. It advocates for a comprehensive approach that integrates religious and mental health strategies, highlighting Buddhism’s impact on seniors’ mental wellness. The implications span spirituality, religious studies, mental health, and elderly care policy, emphasizing the crucial role of Buddhist practices and monks in enhancing the mental well-being of the elderly.