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13/01/2026 - General information

World Day for the Fight Against Depression: new evidence of the need to address depression through a multidisciplinary programme

The journal Nature Mental Health has published a landmark scientific article on the prevention of depression and suicidal behaviour through an evidence-based programme designed to reduce depression and suicidal behaviour: the 4-Level Community Intervention, developed by the European Alliance Against Depression (EAAD).

The EAAD approach offers a sustainable model of community-based mental health care that can be effectively adapted to a wide range of contexts, including current and future public health emergencies.

Researchers from the National Suicide Research Foundation and the School of Public Health at University College Cork led the publication, with contributions from co-authors from the European Alliance Against Depression. These include Dr Víctor Pérez, psychiatrist at Hospital del Mar and researcher at the Hospital del Mar Research Institute and the CIBER Mental Health area (CIBERSAM), and Dr. Azucena Justicia, mental health specialist nurse and researcher at HMRIB.

The study indicates that addressing depression and suicidal behaviour simultaneously through interventions at four levels (primary care, the general population, community facilitators and affected individuals) produces incremental effects. For example, public awareness campaigns reduce stigma, which in turn facilitates the diagnosis of depression by physicians.

The EAAD 4-Level Community Intervention has been adopted by more than 150 regions across Europe and other parts of the world. It has been shown to be easily adaptable to different cultures and healthcare systems. A systematic review identified this programme as the best community-based approach for suicide prevention (Linskens et al., 2022).

The EAAD 4-Level Community Intervention

The EAAD 4-Level Community Intervention provides a structured, multicomponent response to the combined challenges of depression and suicidal behaviour. The four levels include:

1. Training sessions and practice support, primarily aimed at primary care physicians and mental health professionals.

2. Public awareness activities, launch events and media campaigns.

3. Training sessions for community facilitators and key agents in contact with people experiencing depression and suicidal behaviour in the community (for example, geriatric caregivers, clergy, pharmacists, healthcare staff, police officers and journalists), as well as cooperation with journalists based on media guidelines aimed at reducing contagion and suicide clusters.

4. Support for patients with depression and suicidal risk, as well as for their families. A digital self-management tool, the iFightDepression Tool, has been developed, which requires only minimal guidance from a healthcare professional. Reducing access to lethal means as a suicide prevention measure is integrated into intervention levels 1 and 3.

Since the early 2000s, the EAAD 4-Level Community Intervention has been evaluated in controlled trials in different countries. Several of these studies have demonstrated preventive effects on suicidal behaviour.

This 4-Level Intervention has been identified by the EU as a European good practice in mental health:
https://eaad.net/how-eaad-helps/community-based-4-level-intervention

Reference article

Arensman, E., Sadath, A., Callanan, A. et al. The European Alliance Against Depression approach: an evidence-based program to reduce depression and suicidal behavior. Nature Mental Health, 4, 42-51 (2026). https://doi.org/10.1038/s44220-025-00562-9

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