Project

EAAD-Best: Improving Depression Care and Preventing Suicidal Behaviour in Europe

Goal: EAAD-Best, which aims to adapt and implement EAAD’s Best Practice Model to improve depression care and prevent suicidal behavior in Europe, is a consortium of 10 European partners, led by the European Alliance Against Depression (EAAD), funded within the 3rd EU Health Programme (HP-PJ-2020).

This project has two overarching goals:
• improving care for patients with depression; and
• preventing suicidal behaviour.

These goals will be achieved by:
• transferring the community-based 4-level intervention concept of EAAD to new regions and countries in Europe and
• promoting the international uptake of the iFightDepression®-tool, an internet-based self-management tool for patients with depression.

Date: 2 April 2021 - 31 March 2024

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Project log

Piotr Toczyski
added a research item
Abstract ex post by: https://www.inis.pl/aktualnosci/forum-iab-2022-podsumowanie "Anna Gumkowska of TVN Group Discovery and Piotr Toczyski of EAAD-Best.eu, who in their talk "Depression of the system. What covid has done to our heads." presented the systemic tools that have been set up to combat the most common civilisation disease of our time - depression, which has been further exacerbated by the pandemic and social isolation of recent years. The need for the scientific and marketing worlds to come together and work more closely for the wellbeing of society as a whole also resounded. A case study was analysed of the most effective and only EAAD-certified self-test for depression - ifightdepression.com - which, however, without effective promotion, is not sufficiently widespread to be effective on a global scale."
Piotr Toczyski
added a research item
Presentation for the workshop "Counteracting digital dis(mis)information and other cyber threats in the pandemic times: preventive and corrective actions towards strengthening civil society, protecting human rights and human well-being" conducted within the project "Preserving fundamental rights in the use of digital technologies for e-health services" (https://www.reinitialise.eu). Within the Horizon-funded project "Preserving fundamental rights in the use of digital technologies for e-health services" (https://www.reinitialise.eu) the aim is to strengthen and stimulate scientific excellence and the innovation capacity of the Maria Curie-Skłodowska University (Lublin, Poland) ○ in the design and use of digital technologies in the sector of health, ○ in a way that adheres to the ethical principles. ● This will be ensured by mutual exchange, knowledge transfer and interdisciplinary cooperation among three leading institutions: KU Leuven (Belgium), the University of Macerata (Italy) and Eurocentro (Italy). ● We are happy to add our insights from EAAD-Best.eu into this resource. ● Many online spaces include information on depression or only contain the word depression to increase the web traffic. Burst of websites and tools on depression led to increased competition, not always based on reliability. ● We search for such media and digital partnerships, which can add value to the Europe-wide intervention in the reliable information sphere.
Ulrich Hegerl
added a research item
The EAAD-Best project (2021-2024) funded by the European Union’s 3rd Health Programme has two aims: to improve care for patients with depression and to prevent suicidal behaviour in Europe by: § facilitating the implementation and transfer of the evidence- and community-based EAAD 4-level intervention concept Figure 1 § promoting iFightDepresion (iFD) tool to new regions and countries in Europe Figure 2. The 4-level intervention concept of the European Alliance Against Depression (EAAD) and the iFD tool have been implemented in 120 regions in 17 countries in and outside Europe. In recognition of their efficacy proven by controlled studies1,2,3, both the concept and the iFD tool were voted as the following: 2014 The 4-level intervention concept – “Best Practice” intervention programme in the WHO report on suicide prevention 2019 The concept and the iFD tool – “Mental Health Best Practices” by the representatives of the EU Member States at the European Commission’s Joint Research Centre
Ulrich Hegerl
added 2 research items
Supported by the German Alliance Against Depression, 82 regions in Germany launched their own community-based multi-level intervention programs targeting both depression and suicidal behavior prior to January 2016. Sixteen of these regions have implemented the full 4-level intervention program comprising 1) training of General Practitioners, 2) a public awareness campaign, 3) training of community facilitators and 4) support for depressed patients and their relatives for at least three years. The aim of the study was to examine possible suicide prevention effects in these sixteen 4-level intervention regions (comprising a population of 6,976,309) by 1) comparing the annual suicide rates during the 3-year intervention period to a 10-year baseline and 2) comparing these differences to corresponding trends in Germany after excluding all intervention regions (Germany-IR). Primary outcome was the annual rate of suicides. Analyses included negative binomial regression models. When examining differences between suicide rates during the intervention period compared to the baseline period, only a trend towards a significant reduction was found. This reduction of suicides in the sixteen 4-level intervention regions did not differ from that in Germany-IR as control. The interpretation of these findings has to take into account that the training of General Practitioners, police and other community facilitators might have improved the recognition of suicides, thus increasing detection rates. Furthermore, destigmatizing effects of the public awareness campaigns might have increased the number of suicides by lowering suicide threshold (“normalization”) for those at risk and by decreasing the rate of suicides deliberately hidden by suicide victims or their relatives.
Due to the many different factors contributing to diagnostic and therapeutic deficits concerning depression and the risk of suicidal behaviour, community-based interventions combining different measures are considered the most efficient way to address these important areas of public health. The network of the European Alliance Against Depression has implemented in more than 120 regions within and outside of Europe community-based 4-level-interventions that combine activities at four levels: (i) primary care, (ii) general public, (iii) community facilitators and gatekeepers (e.g., police, journalists, caregivers, pharmacists, and teachers), and (iv) patients, individuals at high risk and their relatives. This review will discuss lessons learned from these broad implementation activities. These include targeting depression and suicidal behaviour within one approach; being simultaneously active on the four different levels; promoting bottom-up initiatives; and avoiding any cooperation with the pharmaceutical industry for reasons of credibility.
Ulrich Hegerl
added an update
EAAD-Best project
The EAAD-Best project funded within the Annual Work Programme 2020 of the 3rd EU Health Programme (HP-PJ-2020) began on 2nd April, 2021. It has the two overarching aims to improve care for patients with depression and to prevent suicidal behavior in Europe by: i) transferring the community-based 4-level intervention concept of EAAD to new regions and countries in Europe and ii) promoting the international uptake of the iFightDepression®-tool, an internet-based self-management tool for patients with depression. Both aims are particularly timely considering the exacerbation of mental health problems associated with the impacts of Covid-19. Additional objectives of EAAD-Best include reducing stigma, improving health literacy, and encouraging help-seeking behavior.
Targeting both depression and suicidal behaviour
EAAD-Best simultaneously targets depression and suicidal behaviour, two large and partly overlapping public health problems and disease burdens. According to the global burden of disease study (1), depression is the leading cause for disability in developed countries. This results from the fact that depression is prevalent, e.g. life time prevalence of 13% (2) and is associated with reduced life expectancy of ten years. In addition, depression is the most important cause for suicidal behavior. Around 800,000 completed suicides occur worldwide in each year and the number of attempted suicides is estimated to be about 20 times higher. Around 90 % of completed suicides occur in the context of psychiatric disorders, depression being by far the most significant one.
EAAD’s 4-level Intervention
The 4-level Intervention concept developed by the non-profit NGO “European Alliance against Depression” (www.EAAD.net) is a community based intervention involving cooperations and activities on the levels 1) primary care providers, 2) general public, 3) community facilitators and gate keepers (journalists, teacher, police, geriatric care givers, pharmacists) and 4) patients and their relatives (e.g. supporting self help) (3,4). This 4-level intervention concept was named as a Best Practice intervention programme concerning suicide prevention in the WHO report4 and the European Commission’s Green Paper on Mental Health. It is promoted worldwide by the EAAD and has in the meanwhile been implemented in more than 120 regions in 15 countries in and outside of Europe.
EAAD-Best: Collaboration of 10 high-ranked organizations from 10 European countries
EAAD-Best is coordinated by the EAAD coordination center (Head: Prof. Dr. Ulrich Hegerl) located in the Department of Psychiatry, Psychosomatics and Psychotherapy at the Goethe Universität, Frankfurt am Main. In so called “implementation countries” (Bulgaria, Estonia, Greece, Italy and Poland), EAAD’s 4-level intervention will be conducted for the first time in model regions and later transferred to additional regions. In “transfer countries” (Hungary, Ireland and Spain), the 4-level intervention concept has already been implemented in model regions. The aim is to transfer these interventions to new regions in the respective country. In concert, both implementation and transfer countries will promote and coordinate the nationwide implementation of the iFightDepression®-tool and awareness website.
References
(1). Murray 2020 : Lancet 396: 1204–22
(2). Kessler et al 2015: Epidemiol Psychiatr Sci. 24(3):210-26
(3). Hegerl et al 2019: PLoS One. 14(11):e0224602.
(4). Hegerl et al 2013: Neurosci Biobehav Rev 37:2404-9
This project has received funding from the European Union’s 3rd Health Programme - Annual Work Programme 2020 (HP-PJ-2020) under grant agreement No. 101018325.
 
Ulrich Hegerl
added an update
The EAAD-Best project has successfully been launched on April 2, 2021 and the Online Kick-off Meeting was held on April 26, 2021.
EAAD-Best, which aims to adapt and implement EAAD’s Best Practice Model to improve depression care and prevent suicidal behavior in Europe, is a consortium of 10 European partners, led by the European Alliance Against Depression (EAAD), funded within the 3rd EU Health Programme (HP-PJ-2020).
EAAD-Best is led by the EAAD Coordination Centre (Head: Prof. Dr. Ulrich Hegerl). For more information, please send an email to dooyoung.kim@eaad.net.
Please follow on twitter: @EAAD_Best.
 
Ulrich Hegerl
added an update
The overarching aim of EAAD-Best is to improve care for patients with depression and to prevent suicidal behaviour in Europe by i) transferring the community-based 4-level intervention concept of the European Alliance Against Depression (EAAD) to new regions and countries in Europe and ii) promoting the uptake of the iFightDepression®-tool, an internet-based self-management tool for patients with depression. Implementation countries (Bulgaria, Estonia, Greece, Italy and Poland) are those countries where EAAD’s 4-level intervention concept has not yet been implemented. In these countries, model regions have been selected in which the 4-level intervention will be implemented and later transferred to other regions. Transfer countries (Hungary, Ireland and Spain) are those countries in which the 4-level intervention concept has already been implemented. These countries will focus on promoting and expanding these interventions to new regions. Both implementation and transfer countries will furthermore promote and coordinate the nationwide implementation of the iFightDepression®-tool and awareness website. EAAD-Best will contribute to reduce the huge diagnostic and therapeutic deficits concerning depression and to prevent suicidal behaviour in Europe, which is particularly timely considering the exacerbation of mental health problems associated with the impacts of Covid-19. Reducing stigma, improving health literacy and help-seeking behaviour are further objectives of EAAD-Best. EAAD-Best will start a long-term process of dissemination of both the 4-level intervention and the iFightDepression®-tool beyond the funding period. Experiences from EAAD member countries have demonstrated that other regions will be encouraged to adopt their own regional 4-level interventions as soon as culturally sensitive materials and support (e.g. by national coordination centre) are available. An explicit goal of EAAD-Best is to thus ensure long-term sustainability via this self-promoting process.
 
Ulrich Hegerl
added a project goal
EAAD-Best, which aims to adapt and implement EAAD’s Best Practice Model to improve depression care and prevent suicidal behavior in Europe, is a consortium of 10 European partners, led by the European Alliance Against Depression (EAAD), funded within the 3rd EU Health Programme (HP-PJ-2020).
This project has two overarching goals:
• improving care for patients with depression; and
• preventing suicidal behaviour.
These goals will be achieved by:
• transferring the community-based 4-level intervention concept of EAAD to new regions and countries in Europe and
• promoting the international uptake of the iFightDepression®-tool, an internet-based self-management tool for patients with depression.