The ‘European Alliance Against Depression (EAAD)’: A multifaceted, community-based action programme against depression and suicidality

Abstract

Action programmes fostering partnerships and bringing together regional and national authorities to promote the care of depressed patients are urgently needed. In 2001 the 'Nuremberg Alliance Against Depression' was initiated as a community-based model project within the large-scale 'German Research Network on Depression and Suicidality' (Kompetenznetz 'Depression, Suizidalität'). The 'Nuremberg Alliance Against Depression' was an action programme, conducted in the city of Nuremberg (500,000 inhabitants) in 2001/2002, addressing four intervention levels (Hegerl et al. Psychol Med 2006;36:1225). Based on the positive results of the Nuremberg project (a significant reduction of suicidal behaviour by more than 20%) 18 international partners representing 16 different European countries established the 'European Alliance Against Depression' (EAAD) in 2004. Based on the four-level approach of the Nuremberg project, all regional partners initiated respective regional intervention programmes addressing depression and suicidality. Evaluation of the activities takes place on regional and international levels. This paper gives a brief overview of the background for and experiences with the EAAD. It describes the components of the programme, provides the rationale for the intervention and outlines the current status of the project. The aim of the paper is to disseminate information about the programme's potential to reduce suicidal behaviour and to provide examples of how European community-based 'best practice' models for improving the care of depressed patients and suicidal persons can be implemented using a bottom-up approach. EAAD is mentioned by the European commission as a best practice example within the Green Paper 'Improving the mental health of the population: Towards a strategy on mental health for the European Union' (European Commission 2005).

Effectiveness of a telephone management programme for patients discharged from an emergency department after a suicide attempt: Controlled study in a Spanish population

“…This project includes a comprehensive multilevel intervention practically in the same experimental area and aimed at an early diagnosis and treatment of depression, which is the main psychiatric disorder associated with suicide (193;194). As pointed out by Hegerl et al, general population interventions entail many factors that cannot be controlled and may affect the results obtained (168). Yet a general intervention on depression seems unlikely to have a greater impact on further attempts than a specific intervention on patients with suicide attempts such as the one presented in this study.…”

Programas de prevención del suicidio adolescente en establecimientos escolares: una revisión de la literatura

“…Tras dos años de estudio, si bien no provocó un cambio en las muertes por suicidio, sí disminuyeron las conductas suicidas en comparación con la región control (19,4% en Nuremberg versus 24% en la región control) 56 . Actualmente, esta iniciativa se esta implementando en 18 países europeos 57 .…”

Suicide Intervention Skills in Health Professionals: A Multidisciplinary Comparison

“…Improving the skills of front-line professionals such as primary care physicians and nurses in the assessment of suicidal risk among their patients has been demonstrated to be an effective strategy for preventing suicidal behaviors (Appleby, Morris, Gask et al, 2000;Asarnow, Jaycox, Duan et al, 2005;Hegerl, Wittmann, Arensman et al, 2007;Morris, Gask, Webb et al, 2005;Rix, Paykel, Lelliott et al, 1999;Rutz, 2004;Szanto, Kalmar, Hendin et al, 2007). Patient suicide is a relatively rare event for GPs (e.g., occurring at a rate of 0.31 suicides per GP per year in Holland) (Diekstra & van Egmond, 1989), but one with tragic consequences.…”