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European Alliance Against Depression: Person centered care for depression and prevention of suicidal behaviour

Ulrich Hegerl, Ella Arensman, Elisabeth Kohls


Background: Depression is a prevalent and severe disorder and a major cause for attempted and completed suicides in Europe.

Objectives: The community-based 4-level-intervention concept developed within the “European Alliance against Depression” (EAAD; combines two important objectives:  to improve the care and treatment of patients with depression and to prevent suicidal behavior.

Methods: The EAAD community-based 4-level intervention comprises training and support of primary care providers (level 1), a professional public awareness  campaign (level 2), training of community facilitators (teachers, priests, geriatric care givers, pharmacists, journalists) (level 3), and support for self-help of persons suffering from depression and for their relatives (level 4).

Results: Several studies evaluated different aspects of the 4-level community-based intervention concept over the past years and showed a significant reduction in suicidal behavior and various changes in intermediate outcomes (e.g. changes in attitude or knowledge in different populations). Systematic process evaluation was helpful to identify several predictable and unpredictable obstacles to a successful implementation of such community-based programs as well as synergistic and catalytic effects.

Conclusions: The EAAD community-based interventionhas been shown to be effective concerning the prevention of suicidal behavior and is the most broadly implemented community-based intervention targeting depression and suicidal behavior world-wide. Via the EAAD and partners from currently 22 countries from in- and outside of Europe, the intervention concept and materials (available in many different languages) are offered to interested regions.



depression; suicide prevention; community-based; multi-level interventions; self-management

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