The community-based 4-level-intervention concept developed within the “European Alliance against Depression” (www.eaad.net/) combines two important aims: to improve the care and treatment of patients with depression and to prevent suicidal behavior. It has been shown to be effective concerning the prevention of suicidal behavior [1Hegerl, et al. Psychol Med 2006 ;  36 : 1225-1234 [cross-ref]

Cliquez ici pour aller à la section Références, 2Hegerl, et al. Eur Arch Psychiatry Clin Neurosci 2010 ;  260 : 401-406 [cross-ref]

Cliquez ici pour aller à la section Références, 3Székely, et al. PLOS One 2013 ; [in press].

Cliquez ici pour aller à la section Références, 4Hübner-Liebermann, et al. Gen Hosp Psychiatry 2010 ;  32 : 514-518 [inter-ref]

Cliquez ici pour aller à la section Références] and is worldwide the most broadly implemented community-based intervention targeting depression and suicidal behavior. The 4-level intervention concept comprises training and support of primary care providers (level 1), a professional public relation campaign (level 2), training of community facilitators (teacher, priests, geriatric caregivers, pharmacists, journalists) (level 3), and support for self-help of patients with depression and for their relatives (level 4). In order to deepen the understanding of factors influencing the effectiveness of the intervention, a systematic implementation research and process analysis was performed within the EU-funded study “Optimizing Suicide Prevention Programs and Their Implementation in Europe” (www.ospi-europe.com/; 7th Framework Programme) [5Hegerl, et al. Neurosci Biobehav Rev 2013 ; [pii: S0149-7634(13)00045].

Cliquez ici pour aller à la section Références]. These analyses were based on data from four intervention and four control regions from four European countries. In addition to intervention effects on suicidal behaviour, a variety of intermediate outcomes (e.g. changes in attitude or knowledge in different populations) were considered. Strong synergistic as well as catalytic effects were identified as a result of being active simultaneously at four different levels. Predictable and unpredictable obstacles to a successful implementation of such community-based programs will be discussed. Via the EAAD, the intervention concept and materials (available in eight different languages) are offered to interested region in and outside of Europe.