Primary Care Mental Health Sustained Capacity-Building for Depression and Suicidal Behaviour (PrimeDep)

Project facts

Project promoter:
EUTIMIA
Project Number:
PT06-0013
Target groups
Public and private organizations, including not-for-profit organizations and NGOs, responsible for the organization and delivery of education and training at local, regional and national levels
Status:
Completed
Initial project cost:
€552,958
Final project cost:
€460,485
From EEA Grants:
€ 352,271
The project is carried out in:
Portugal

Description

A core feature of the national strategy for improving mental health (MH) and preventing suicide is to enhance the primary health care (PC) capacity in diagnosing and treating depression and assessssing and managing the risk of suicide. The aim of PrimeDep is to respond to the existing need, in Portugal, of new initiatives in the prevention of mental ill-health and suicide through the implementation of a large-scale transfer of knowledge within the context of MH care delivery in PC. The aim will be achieved through the application of evidence-based principles, methods and materials, through training activities organized in a cascade mode (train the trainers) with four levels of increasing intensity, and using technological innovation. Several thousand PC professionals, 40 000 patients and a population of 2 million people in the intervention areas, users of 4 health regions and 12-16 groups of PC units, will potentially benefit from the project. The PrimeDep project will deliver the the following products throughout its duration: 1) a report on barriers for MH in PC; 2) training of 12 MH professionals Lead Trainers, 4300 PC trained professionals (900 Depression Experts); 3) a website to strengthen public awareness about depression and suicide risk; 4) an e-learning training resource; 5) a clinical mobile app; and 6) four peer-review papers on the outcomes of the various interventions of the project. NSSF, the Norwegian donor country partner will assist scientific coordination, provide expert advice and assist with the training of Lead Trainers. Other partnerships will guarantee the presence of PC professionals, technological resources and contents and monitoring.

Summary of project results

Family doctors diagnose less than a half the depression cases that present to PHC, exactly as their international counterparts. One in five clinical encounters occurs with a person affected by depression but the family doctors miss most of them. This means prevalence in primary care of more than 20%. The results of the survey on the prevalence of common mental illness in Portuguese adult suggests that Portugal is the country in Europe with the highest prevalence of common mental disorders among adults. PrimeDep, propose a model of mental health promotion and illness prevention in PHC which aims at encouraging early symptomatology identification, proper diagnosis and prescription, combined treatment, proactive monitoring and referral through the professionals differential training capacitation in order to improve the knowledge, attitudes and skills, and therefore the tasks each professional group is supposedly more able to perform: family doctors, family nurses, clinical psychologists and social workers. The Primedep trained technicians of care primary health for the treatment of depression and suicide prevention, based on principles, methods and intervention materials based on evidence. This project implemented its national program in four regions (Algarve, Alentejo, North and Lisbon) through about 50 training sessions for health professionals, having formed about 950 experts for detection depression. The PrimeDep project, also developed, among other tools, two applications of self-help for mobile devices, targeted separately for health professionals and another for patients. Another of the activities was the creation of an ebook "The promotion of mental health and the prevention of depression and suicide strategic focus on the integrating mental health into primary health care," and with the participation and contributions of 25 authors . The project has contributed to the Public Health Initiatives Programme but also the EEA Grants wider objectives since it has developed mental health literacy all over the country in different health centers and units, through intensive and thorough programmes, in hundreds of primary care providers, thus improving mental health services and care aiming the general population.

Summary of bilateral results

The strengthening of bilateral relations has been a constant goal throughout the project`s development. The involvement of the partner from the donors’ countries, in this case Prof. Lars Mehlum from NSSSF, University of Oslo, from Norway, in public events, in materials’ adaptation and review, and in the exchange of experiences and knowledge was crucial and enriched the project. Participation of LEVE’s representatives in meetings in Lisbon and in the closure event, the 19th april. The promoter participated in trainings and meetings in Oslo at the National Center for Suicide Research and Prevention (NSSSF) and at LEVE, an NGO for suicide survivors. At LEVE, the programme started in LEVE’s offices in St. Olavs Plass in Oslo, where LEVE’s secretary general Oddrun Bøhlerengen made a welcoming speech, followed by vice-president of LEVE, Kari Wille Rekdal, who spoke of how LEVE was founded and why among other things. Ida de Leon spoke of how LEVE works towards the young suicide bereaved and about communications both within LEVE and towards the Norwegian Society. Also present were members of LEVE’s regional departments in both Oslo and Akershus, and the leader of LEVE’s youth department, Christoffer Vestli. There were interesting discussions about peer-to-peer work, local support groups, how to deal with the press, getting funding for voluntary work, how to support the bereaved, and several other topics. In the course of these activities, potential partnerships in projects have emerged, in particular, at the suicide prevention and postvention level. Based on LEVE experience, essential points were discussed to establish a concatenated collaboration between Norway and Portugal. With NSSSF, the intention to build, in the scientific field, a collaboration with the research team was reinforced. The potential collaboration between EUTIMIA and NSSSF is a very important result of these activities in which shared networks, know-how and discussion the strengths and weaknesses of the different realities and the possibilities of creating synergies. These activities also resulted in the planning of a visit from UNGE LEVE President to Portugal for training journalists with regard to suicide. The activities carried out in dissemination and communication have been essential for the development of the project and its success.