Policy recommendations related to the prevention of depression | Knowledge for policy

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Policy recommendations related to the prevention of depression

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World Health Organization 2013 , 2016
‘As the ultimate guardian of a population's mental health, governments have the lead responsibility to put in place appropriate institutional, legal, financing and service arrangements to ensure that needs are met and the mental health of the whole population is promoted’ ‘Broad strategies for mental health promotion and the prevention of mental disorders across the life course may focus on: antidiscrimination laws and information campaigns that redress the stigmatization and human rights violations all too commonly associated with mental disorders; promotion of the rights, opportunities and care of individuals with mental disorders; the nurturing of core individual attributes in the formative stages of life (such as early childhood programmes, life skills and sexuality education, programmes to support the development of safe, stable and nurturing relationships between children, their parents and carers); early intervention through identification, prevention and treatment of emotional or behavioural problems, especially in childhood and adolescence; provision of healthy living and working conditions (including work organizational improvements and evidence-based stress management schemes in the public as well as the private sector); protection programmes or community protection networks that tackle child abuse as well as other violence at domestic and community levels and social protection for the poor’ ‘Among the key factors for developing effective policies and plans addressing mental health are strong leadership and commitment by governments, involvement of relevant stakeholders, clear elaboration of areas for action, formulation of financially-informed and evidence-based actions, explicit attention to equity, respect for the inherent dignity and human rights of people with mental disorders and psychosocial disabilities, and the protection of vulnerable and marginalized groups’ ‘New e-health and m-health technologies offer many advantages, such as scalability, low cost, privacy, less stigma and ease of use. Both e-health and m-health interventions can be made interactive and engaging’
European Commission 2017, EU 2016
Policy makers should be encouraged to establish a legal framework that includes e-mental health and self-management tools (e.g. iFightDepression) for the prevention and early detection of depression. Internet-based mental health trainings are an innovative way to help people with high levels of stress or mental health problems. Support the dissemination and local adaptation of evidence-based e-mental health tools that encourage self-management or behaviour change to prevent the onset of depression (e.g. guided computerised online cognitive behavioural therapy) and promote resilience. Fostering self-management skills among people with comorbid depression is essential. One good practice is to train health-care professionals in primary care, such as nurses, in cognitive-behavioural or motivational approaches, that have been shown to have a beneficial effect in reducing symptoms of depression among people with long-term conditions. Employing psychosocial interventions such as problem-solving therapy, in which behavioural activation is an important component, has been shown to be an effective strategy for depression prevention in older adults. Depression prevention in the workplace can be facilitated through universal programmes that incorporate healthy lifestyle behaviour change elements, and psychological and motivational approaches to reduce and manage stress. A stepped-care prevention approach in primary care and residential homes for older people with sub-threshold depressive symptoms have been demonstrated to be particularly effective in reducing the incidence of depression. Such interventions comprise problem-solving therapy and guided self-help.
NHS Adult Improving Access to Psychological Therapies programme
Improving Access to Psychological Therapies (IAPT) is ‘widely-recognised as the most ambitious programme of talking therapies in the world and in the past year alone more than one million people accessed IAPT services for help to overcome their depression and anxiety, and better manage their mental health’. IAPT services are characterized by three things: ‘Evidenced-based psychological therapies: with the therapy delivered by fully trained and accredited practitioners, matched to the mental health problem and its intensity and duration designed to optimize outcomes’. ‘Routine outcome monitoring: so that the person having therapy and the clinician offering it have up-to-date information on an individual’s progress. This supports the development of a positive and shared approach to the goals of therapy and as this data is anonymised and published this promotes transparency in service performance encouraging improvement’. ‘Regular and outcomes focused supervision so practitioners are supported to continuously improve and deliver high quality care’.

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EU 2008 (pdf)
Policy makers and stakeholders are invited to take action on the prevention of depression including the following: Improve the training of health professionals and key actors within the social sector of mental health. Take measures to raise mental health awareness in the general public, health professionals and other relevant sectors.
Commonwealth of Australia 2009 (pdf)
Work with schools, workplaces and communities to deliver programmes to improve mental health literacy and enhance resilience. Promotion activities can be run at a local level or delivered through mass media campaigns. The media could be of great help in the effort of improving mental health literacy of the general population. Workplaces are also important settings for building resilience and fostering coping strategies.
Mental Health Commission Canada 2012 (pdf)
Train front-line service providers of all kinds to identify mental health problems and illnesses early, promote mental health, and prevent mental illness and suicide wherever possible.

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