Description
STOP Depression meets one of the main recommendations of the National Plan of Mental Health-PNSM by implementing a pilot-study of stepped care and task-shifting for improving and expanding the treatment of depression and suicide prevention. It also aims to reduce inequalities between user groups by outreaching especially vulnerable, underprivileged, underdiagnosed and undertreated patients in the ACES of Western Oporto. It involves a comprehensive strategy: a staff development training program; a public campaign to outreach the main targets; systematic support in the implementation of new forms of interventions, including ICT tools; and outcome monitoring by means of a clinical trial. Main goals are to increase the treatment gap in depression, and to increase treatment effectiveness. Bilateral relations between Portugal and Norway are strengthened through knowledge transference and joint development of new technology focused on the treatment of depression.
Summary of project results
Depression is a highly prevalent and recurrent mental health disorder. It is associated with significant comorbidity with other psychological and medical disorders as well as with an increased risk for diverse psychosocial problems and suicide. A recent epidemiological report found, in a representative community sample of the Portuguese population, a 16,7% lifetime prevalence rate for major depression which places it amongst the highest reported in western countries. It also found that 81,2% and 33,6% of the individuals with moderate and severe depressive conditions respectively, received no treatment in the past 12 months and that, of the ones who received treatment, only 34,2% received an appropriate treatment. In this context this project: (1) implemented a stepped care model oriented towards the assessment and treatment of depression and suicidality with an strong component of innovative ICT tools, (2) assessed its efficacy and cost-effectiveness, (3) implemented a high quality training program for health care professionals on stepped care models of treatment delivery, and (4) conducted a comprehensive public awareness campaign in order to raise the population’s knowledge of depression symptoms and treatment possibilities and sensitize and enable community gatekeepers to provide adequate guidance to the population they serve. These actions and their outcomes contribute to improve primary care services capacity (trained about 225 health professionals) to obtain gains in the number of health care recipients adequately diagnosed and treated, in its ability to provide adequate and diversified treatment alternatives, and in its treatment efficacy. Primary care services are the main access point of the underprivileged population to health care. The capacity of the stepped-care model to improve the primary care services capacity to early diagnosis and deployment of evidence-based treatments enables the project to contribute to the programme´s objectives by reaching significantly more currently undiagnosed and untreated persons, currently no identified risk groups, and currently excluded groups of persons due to their socio-economic situation, gender or cultural background. The results of the project were highly disseminated in several actions, like seminars, running events, journal reports, radio Interviews, television Interviews and others. The project transmitted de knowledge and to ensure the sustainability in the future.
Summary of bilateral results
Arkimedes is a Norwegian company which develops ICT (Information and Comunication Technologies) tools within the domain of mental health. It was responsible, in collaboration with the team responsible for the project, for the development and implementation of the smartphone app that completes the group of ICT tools developed and used in this project. This app aggregates and makes available to patients adequate contents pertaining mental health problems diagnosis and treatment.