Alliance Against Depression

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The Alliance Against Depression tagline: Mental Health is Everyone's Business

Good mental health is fundamental to the wellbeing of individuals, families and communities.

The strong link between depression and suicide requires a focus on improving access to primary mental health care for all people. This can be achieved by raising awareness of depression, by increasing the number of people who seek treatment and by reducing stigma around depression and suicide.

The Alliance Against Depression (AAD) is an approach based on evaluated trials and is recognised as the world’s best practice for the care of people with depression and in the prevention of suicidal acts. The initial implementation of

Good mental health is fundamental to the wellbeing of individuals, families and communities.

The strong link between depression and suicide requires a focus on improving access to primary mental health care for all people. This can be achieved by raising awareness of depression, by increasing the number of people who seek treatment and by reducing stigma around depression and suicide.

The Alliance Against Depression (AAD) is an approach based on evaluated trials and is recognised as the world’s best practice for the care of people with depression and in the prevention of suicidal acts. The initial implementation of the framework in the trial region of Nuremberg (The Nuremberg Alliance Against Depression) resulted in a 24% reduction of suicidal acts within a two-year period.

The AAD Coordination Centre at WA Primary Health Alliances supports local Alliances with resources, tools, and case studies. These support materials are informed by the European Alliance Against Depression (EAAD) Coordination Centre in Germany and from other alliances globally.


The Alliance Against Depression Framework

Anyone can start an Alliance

All local Alliances start with a small number or people wanting to improve the mental health and well-being of their community. Those ‘initiators’ then follow three stages to work with networks across the community to prepare, plan and implement their local Alliance.


  • WA Primary Health Alliance's Health Planning team focus on depression.

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    25 Feb 2021
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    Depression in WA

    Depression affects around 8.8% of Western Australians, being more prevalent in women than men (11.9% compared with 5.7% respectively) (Radomiljac, Joyce & Powell, 2017). By 2030, The World Health Organisation estimates that depression will be the number one health concern in both developed and developing countries (Christodoulou, 2012). Depression can be caused by a multitude of factors including challenging and stressful circumstances, loss of a loved one, childhood experiences and trauma, loss of a job, or use of substances (alcohol, drugs) (Black Dog Institute).

    Symptoms

    • Irritable and sad mood
    • Poor concentration
    • Reduced energy
    • Loss of interest in pleasurable activities
    • Recurrent thoughts of death and suicide (Beyond Blue, 2020)

    https://www.beyondblue.org.au/the-facts/depression

    At risk individuals

    People most at risk of depression include (Black Dog Institute, 2020):

    • Older Australians (over 65 years old)
    • People with a family history of depression
    • Women
      • Experience depression twice as often as men
      • 1 in 7 new mums experiencing post-natal depression (PANDA, 2017)
    • Personality factors (self-critical, negative, worries a lot, a perfectionist)
    • Those experiencing challenging life experiences, abusive relationships, serious physical health problems and drug and alcohol use

    Treatment and managing the condition

    In WA there were 314 psychiatrists, 2,614 mental health nurses and 2,770 psychologists (Mental Health Commission). In 2017-18, $9.9 billion was spent on mental health (AIHW, 2020). Psychological treatments are especially important to keep patient’s anxiety and depression under control and reduce irrational worries. Cognitive behaviour therapy (CBT) is a form of treatment which allows the patient to identify thought and behaviour patterns that contribute to their anxiety and replace these with strategies to cope with triggers.

    By making lifestyle changes a health professional can develop personalised recommendations for treatment such as:

    • Psychological therapy
    • Interpersonal therapy
    • Mindfulness-based cognitive therapy
    • Anti-depressants
    • Self-help and support groups
    • E-therapies

    Prevalence of the population with depression doctor diagnosed within the past 12 months, HWSS, Adults 16+ years, 2013 to 2017

    https://ww2.health.wa.gov.au/Reports-and-publications/Population-surveys


    Western Australia Health and Wellbeing Surveillance System
    ww2.health.wa.gov.au

    The WA Health and Wellbeing Surveillance (HWSS) was established by the Department of Health in 2002 to monitor the health status of the general WA population.

    Mental health conditions require effective management, including targeted and sustainable community-based mental health care which can utilise a combination of therapies and medications to prevent mental health deterioration.

    Mental health is a significant burden to the health system. The current best-practice guidelines for the prevention, diagnosis and management of depression have been created for health practitioners by researchers and medical experts. To support general practitioners and their teams to provide high-quality management, Beyond Blue have developed guidelines to give evidence-based, up-to-date information tailored for specific health professionals (Beyond Blue, 2020). Guidelines are available here: https://www.beyondblue.org.au/health-professionals/clinical-practice-guidelines

    References

    Australian Institute of Health and Welfare. (2020). Mental health services in Australia. Retrieved from https://www.aihw.gov.au/reports/mental-health-services/mental-health-services-in-australia

    Beyond Blue. Statistics. Retrieved from https://www.beyondblue.org.au/media/statistics

    Beyond Blue. Clinical Practice Guidelines. Retrieved from https://www.beyondblue.org.au/health-professionals/clinical-practice-guidelines

    Black Dog Institute. Facts & figures about mental health. Retrieved from https://www.blackdoginstitute.org.au/wp-content/uploads/2020/04/1-facts_figures.pdf

    Department of Health Western Australia, WA Health and Wellbeing Surveillance System 2013-2017

    Department of Health (2012). Postnatal anxiety and depression. What Dads and Mums need to know. Retrieved from http://www.health.wa.gov.au/docreg/Education/Population/womens_health/HP3073_pnatal_depression.pdf

    PANDA (2017). After Birth. Retrieved from https://www.panda.org.au/info-support/after-birth

    Radomiljac A, Joyce S and Powell A 2017. Health and Wellbeing of Adults in Western Australia 2016, Overview and Trends. Department of Health, Western Australia

  • AAD recognised as a system-based model in the WA Suicide Prevention Framework 2021-2025

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    07 Jan 2021
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    In October 2020 the Mental Health Commission launched their new Suicide Prevention Framework for 2021-2025 (The Framework) . It sets the direction for future action to reduce deaths by suicide in Western Australia and is very much in line with the aims of Alliance Against Depression. The Framework references contemporary research that supports implementing a system-based approach and recognises Alliance Against Depression as one of the supporting models. There are four streams identified in The Framework:

    • Prevention/ early intervention;
    • Support/ Aftercare;
    • Postvention and;
    • Aboriginal people.

    All activities to support the priority areas within these streams are underpinned by 11 guiding principles:

    A whole of community approach is evident and a humble reminder of the important work each local Alliance is doing. Read the Framework here.


  • Inaugural AAD Workshop 2020

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    26 Nov 2020
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    On Tuesday 24 November, local WA Alliance Against Depression coordinators heard from President of the European Alliance Against Depression, Professor Ulrich Hegerl, at the first virtual AAD Workshop. It was a unique opportunity for local Alliance coordinators to connect with each other as well as the EAAD team, who were all in attendance. Prof Hegerl presented ‘Community based 4-level interventions targeting depression and suicidal behaviour: lessons learnt’. This was followed by robust conversation and the opportunity for Alliance coordinators to draw on the wisdom and experience from the EAAD team. Professor Hegerl has been committed to better research and education about depression and suicide prevention for more than 30 years and the presentation was a welcome reminder as to why we focus on depression.

    This was followed by an introduction to My Community Directory's Network Feature. My Community Directory is a free for health, social and community services and free for users to find services and events. Alliances Against Depression are encouraged to use My Community Directory as part of their service mapping, identifying gaps and promoting use within their community to improve access to services.

    All 6 local Alliances in WA were represented as well as the Mental Health Commission Suicide Prevention Coordinators. There were plenty of ideas shared, and what was apparent, is the enhanced connection to community and place after what has been a tough year for many and the increased need for a collaborative community-led initiative such as Alliance Against Depression. Next steps for the local Alliances are agreement to continue to foster the WA network and stay connected, so watch this space. Thank you to all those who made the first workshop such a success and we can't wait to see what the next year brings



  • Kalamunda AAD first community meeting

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    27 Oct 2020
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    Over 25 people came together in the middle of October to meet the people behind Kalamunda AAD and view a presentation on the AAD framework delivered by the coordination team at WA Primary Health Alliance. The conversation was organic and meaningful, highlighting the community passion and commitment to each other. It was agreed to maintain momentum and meet again in a fortnight to start stakeholder mapping and identify priority groups. We cannot wait to hear about their progress.

  • Busselton Dunsborough AAD celebrate World Mental Health Day with a local Arts Festival

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    26 Oct 2020
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    Mental health consumers, carers and staff from a number of local mental health service providers contributed to an art exhibition of decorated mannequin heads celebrating the mental health week theme “Strengthen our Community – Live, Learn, Work and Play”. The completed mannequins were on display daily the week starting Monday 12 October 2020 at Railway House in Busselton. Members of the public were encouraged to visit and vote for their favourite decorated mannequin head in The People’s Choice award and join City of Busselton Mayor Grant Henley for the presentations of awards on Sunday 18 October. There was also awards for Most Creative Head, Best Reflection of the Mental Health Week Theme and Encouragement. The event was supported by Lotterywest and City of Busselton.

  • Imagined Futures AAD drumming up awareness for World Mental Health Day

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    20 Oct 2020
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    Pictured: Councillor Tomas Fitzgerald (City of Melville), Mayor Brad Pettit (City of Fremantle) and Mayor Logan Howlett (City of Cockburn)

    With one in five Australians aged 16-85 suffering from depression, anxiety or substance abuse every year, safeguarding the mental health of Australians is a collective challenge that continues to be a top priority for the healthcare and communities sectors—particularly as the COVID-19 pandemic exacerbates psychological stress.

    As part of their ongoing efforts to promote social inclusion and wellbeing through community partnerships, Imagined Futures AAD commemorated World Mental Health Day on Saturday 10th October with a free event at The Esplanade in Fremantle.

    Leigh Sinclair, Executive Officer of Imagined Futures commented, “While there is an increasing instance of mental health issues in our communities, many people don’t seek help due to the stigma attached to having a mental illness.”

    “By running community mental health events such as this, Imagined Futures hopes to not only destigmatise mental health but to raise awareness, to start conversations and to work across boundaries, so we are all better able to work toward tackling some of the complex issues that are facing our community.”

    More than 200 people descended on the park in the heart of Fremantle on Saturday, enjoying live music, yoga, drumbeat sessions and exploring 24 stalls manned by mental health and wellbeing services agencies in the Fremantle, Cockburn and Melville areas.

    Noongar Elder Marie Taylor performed a stirring Welcome to Country, and Kaine Grigg, Chair of the Imagined Futures Alliance Against Depression and Executive Officer of Fremantle Mind spoke about his mission to identify gaps in existing community mental health systems and subsequently develop and deliver services to fill these areas of service need.

    Mayor Brad Pettit, Mayor Logan Howlett and Councillor Tomas Fitzgerald spoke about their Council’s efforts to combat the mental health crisis that has intensified during the pandemic and the importance of working together across government, health and community organisations to forge better mental health outcomes.

    Founded in 2014, Imagined Futures is a collective impact partnership auspiced by St Pat’s Community Support Centre. The partnership brings together human service agencies, businesses, philanthropists and community members to tackle complex social issues across the south west metropolitan region.

  • Meet Dr Daniel Rock, Principal Advisor and Research Director at WA Primary Health Alliance

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    22 Sep 2020
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    I had been studying and working on suicide for years and had obtained rather generous recurrent funding to establish a translational research centre. The obvious question was given all that we know, what interventions work outside of trials? So, I undertook a review and it turns out there are very few studies in real world settings and contexts with unselected participants and this remains the case today. This is not to discount social determinants at all. Indeed, these are foundational, but largely out of scope for health services and often misinterpreted as well. Of course, I knew about Ulrich Hegerl's work, President of the EAAD, but I had not examined it in any detail. I was quite skeptical about some of the reported claims, but over the course of the review it became increasingly clear it had the strongest evidence for real world applicability at scale.

    It is important to understand it is not WAPHA who creates or determines value but the individuals who use the services we commission, live in the places where these are and systems we help develop, and this value is created (or lost) by the local teams (GPs and others) who deliver the care ,and nowhere else. EAAD unlocks the power that exists in local communities to improve the treatment and care of people with depression and, in doing so, prevent suicide. It is not a panacea. It is not an approach to tackle social determinants. It is about supporting communities to take effective action to make their system work better for them.

    Read the full Q&A here.

  • Meet Pauline from Busselton-Dunsborough AAD

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    26 Aug 2020
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    When I first read about the European Alliance Against Depression and Dr. Hegerl’s work in Nuremburg I was excited. I hadn’t previously read of any research that had resulted a significant reduction of suicidal behaviour by more than 20%. The important thing with this programme is that its evidence based and community-led and developed within a particular locality with its own special attributes and needs. When you look at the numbers, with 8 people dying every day by suicide and more young Australians (15 – 44) dying from suicide than any other cause, it’s distressing. When you know family or friends that have loss a loved one by suicide it’s a further compelling reason for being involved. That’s why the Alliance Against Depression is important to me. The EAAD is mentioned by the European commission as a best practice example within the Green Paper 'Improving the mental health of the population: Towards a strategy on mental health for the European Union' (European Commission 2005).

    in 2018 when I moved to Busselton and didn’t know anyone and could no longer be involved in the groups I was involved in in Perth, I decided to become a Mental Health First Aid Instructor. I am a retired Psychiatrist and previously worked in the general adult psychiatry area. I thought that with this background I may be able to contribute to the mental health field in promoting mental health awareness.

    Read the full Q&A here,

  • Meet Kelly from Waroona AAD (who also played an integral role in Murray AAD)

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    26 Aug 2020
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    My relationship with the WA Primary Health Alliance (WAPHA) started early 2017 when I was working at the Shire of Murray as the Senior Community Development Officer. The Shire of Murray was one of two Local Government areas selected by WAPHA to deliver community led suicide prevention intervention to improve mental health outcomes for young Aboriginal people living in the regions. The need for a specialised program and funding support was identified through the WA Primary Health Needs Assessment for the South Metropolitan area.

    The needs assessment identified that regional areas face additional barriers in accessing mental health supports, due to limited service provision, no public transport and limited training opportunities. In early 2017, the Shire of Murray in conjunction with the Bindjareb Reference Group, developed the ‘Completing the Circle’ program, a community led approach derived from the Aboriginal Medicine Wheel for holistic healing. The Shire of Waroona also developed community led initiatives targeting Aboriginal youth in their Local Government area. Late 2017, ‘Perth South’ was announced as one of 12 National Suicide Prevention Trial Sites and the only site with a youth focus.

    The Shires of Murray and Waroona became part of ‘Perth South’ trial site along with Mandurah, Rockingham and Kwinana. It was an easy transition for the two Shires to the Alliance Against Depression framework as the focus on youth aligned with work that had already commenced in respective communities. The Alliance Against Depression framework allowed Murray and Waroona to broaden their original project scope to a wider community approach around mental health and local service provision.

    Read the full Q&A here.

  • Meet Darren from Kalamunda AAD

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    26 Aug 2020
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    Having had over twenty years’ experience working in the Heavy, Construction and Fly In, Fly Out (FIFO) Mining industries, I have seen firsthand the impact Mental Health issues have; not only at work but in our personal lives and with our families. I also have a lived experience of depression and anxiety though at the time, like so many others, I could not see it for what was. I have since learnt that these feelings of anxiety or depression are not something to be ignored, pushed aside or self-medicated in unhealthy ways.


    Read the full Q&A here.