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  • Perspective
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The European Alliance Against Depression approach: an evidence-based program to reduce depression and suicidal behavior

Nature Mental Health volume 4, pages 42–51 (2026)Cite this article

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Abstract

The Global Burden of Disease studies have consistently highlighted the persisting burden of mental disorders worldwide. Public health emergencies such as the COVID-19 pandemic, war and conflict, and climate change have exacerbated many determinants of poor mental health, resulting in an increased prevalence of anxiety and depression worldwide. Despite substantial advancements in intervention and prevention programs, treatment gaps in depression and suicidal behavior persist. Addressing these gaps requires a multi-level approach involving both community and health services. This Perspective addresses the urgent need to strengthen mental health systems globally. The primary purpose of this Perspective is to discuss the four-level community-based approaches of the European Alliance Against Depression program, including evidence in support of its four-level intervention as a sustainable model for community-based mental health care that can be effectively adapted to various contexts, including current and future public health emergencies.

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Author information

Authors and Affiliations

  1. School of Public Health, University College Cork, Cork, Ireland

    Ella Arensman, Anvar Sadath, Aileen Callanan, Almas Khan, Mallorie Leduc, Grace Cully & Niall McTernan

  2. National Suicide Research Foundation, University College Cork, Cork, Ireland

    Ella Arensman, Anvar Sadath, Aileen Callanan, Almas Khan, Mallorie Leduc, Grace Cully & Niall McTernan

  3. EAAD-Best Consortium members, Warszawa, Poland

    Ella Arensman, Anvar Sadath, Aileen Callanan, Almas Khan, Mallorie Leduc, Grace Cully, Katharina Schnitzspahn, Kahar Abdulla, Simge Celik, Pia Hauck, Carolina Pina, Giancarlo Giupponi, Michela Roberti, Andreas Conca, Vargiu Nuhara, Marco Lazzeri, Serena Trentin, Manuela Tosti, Aurora Belfanti, Camilla Ferrara, Victor Perez Sola, Saiko Allende, Azucena Justicia Diaz, András Székely, Diana Ruzsa, Éva Zsák, András Székely Jr, Piotr Toczyski, Chantal Van Audenhove, Evelien Coppens, Giota Fexi, Panagiota Deredini, Nikoletta Konsta, Thanasis Arabatzis, Beky Pasho, Eleni Tsagaraki, Tsvety Naydenova, Albena Drobachka, Peeter Värnik, Agnes Sirg, Merike Sisask, Lenne Lillepuu, Rainer Mere & Ulrich Hegerl

  4. Australian Institute for Suicide Research and Prevention (AISRAP), Griffith University, Griffith, New South Wales, Australia

    Ella Arensman

  5. Grace Abbott School of Social Work, College of Public Affairs and Community Service, University of Nebraska, Omaha, NE, USA

    Anvar Sadath

  6. Clinic for Psychiatry, Psychosomatics and Psychotherapy, University Hospital Frankfurt, Frankfurt, Germany

    Katharina Schnitzspahn, Kahar Abdulla & Ulrich Hegerl

  7. SABES, Südtiroler Sanitätsbetrieb Bozen, Bozen, Italy

    Giancarlo Giupponi, Michela Roberti, Andreas Conca, Vargiu Nuhara, Marco Lazzeri, Serena Trentin, Manuela Tosti, Aurora Belfanti & Camilla Ferrara

  8. CIBER, Consorcio Centro De Investigacion Biomedica En Red, Madrid, Spain

    Victor Perez Sola, Saiko Allende & Azucena Justicia Diaz

  9. Végeken Egészséglélektani Alapítvány, Budapest, Hungary

    András Székely, Diana Ruzsa, Éva Zsák & András Székely Jr

  10. Department of Sociology of Media and Social Communication, Institute of Philosophy and Sociology, Maria Grzegorzewska University, Warszawa, Poland

    Piotr Toczyski

  11. LUCAS KU Leuven, Leuven, Belgium

    Chantal Van Audenhove & Evelien Coppens

  12. EPAPSY, Association for Regional Development and Mental Health, Athens, Greece

    Giota Fexi, Panagiota Deredini, Nikoletta Konsta, Thanasis Arabatzis, Beky Pasho & Eleni Tsagaraki

  13. SPOC, Sustainability of Progressive and Open Communication Association, Sofia, Bulgaria

    Tsvety Naydenova & Albena Drobachka

  14. Estonian-Swedish Mental Health and Suicidology Institute, Tallinn, Estonia

    Peeter Värnik, Agnes Sirg, Merike Sisask, Lenne Lillepuu & Rainer Mere

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  1. Ella Arensman
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  2. Anvar Sadath
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  22. Victor Perez Sola
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  23. Saiko Allende
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  24. Azucena Justicia Diaz
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  25. András Székely
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  26. Diana Ruzsa
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  27. Éva Zsák
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  28. András Székely Jr
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  29. Piotr Toczyski
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  30. Chantal Van Audenhove
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  31. Evelien Coppens
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  32. Giota Fexi
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  33. Panagiota Deredini
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  34. Nikoletta Konsta
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  39. Albena Drobachka
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  41. Agnes Sirg
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  42. Merike Sisask
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  43. Lenne Lillepuu
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  44. Rainer Mere
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  45. Ulrich Hegerl
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E.A., A. Sadath, A. Callanan, A.K., M.L., G.C., N.Mc., K.S., K.A., S.C., P.H., C.P., G.G., M.R., A. Conca, V.N., M.L., S.T., M.T., A.B., C.F., V.P.S., S.A., A.J.D., A. Székely, D.R., E.Z., A. Székely Jr, P.T., C.V.A., E.C., G.F., P.D., N.K., T.A., B.P., E.T., T.N., A.D., P.V., A. Sirg, M.S., L.L., R.M. and U.H. contributed to the conception and design. E.A., A. Sadath, A. Callanan and A.K. drafted the paper. U.H. and K.S. provided feedback on the paper.

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Correspondence to Aileen Callanan.

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

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