Abstract
Although depression is one of the main public health challenges of our time, the uptake of interventions aimed at the prevention and treatment is low to modest. New approaches are needed to reduce the disease burden of depression. Indirect prevention and treatment may be one method to increase uptake of services. Indirect interventions aim at problems related to depression but with lower stigma and prevent or treat depression indirectly. This paper describes the approach, the empirical support and limitations. A growing number of studies focus on indirect prevention and treatment. Several studies have examining the possibilities to prevent and treat depression through interventions aimed at insomnia. Several other studies focus on indirect interventions aimed at for example stress and perfectionism. Digital 'suites' of interventions may focus on daily problems of for example students or the workplace and offer a broad range of indirect interventions in specific settings. Indirect prevention and treatment may be a new approach to increase uptake and reduce the disease burden of depression.
Highlights
Depression is one of the main public health challenges of our time, the uptake of interventions aimed at the prevention and treatment is low to modest
An intervention aimed at insomnia for this person could be considered as indicated prevention and has the potential to prevent the onset of depressive disorders in an indirect way
This study found that the intervention significantly reduced perfectionism, and path analyses demonstrated a significant indirect effect of the intervention on depression and anxiety
Summary
Conventional methods to increase help-seeking rates include universal mental health awareness campaigns (Salerno, 2016; Yamaguchi et al, 2013), gatekeeper training (Lipson et al, 2014) and specific interventions aimed at improving help-seeking behaviours (Ebert et al, 2019). The basic idea of these “indirect” interventions is that they focus on problems related to depression, but not directly on depression itself. At the same time the participants learn techniques which directly affect the problem, and have an effect on depression or may prevent future depressive symptoms or disorders. Insomnia is less stigmatising than depression to talk about or to seek treatment for, and if the inter vention aimed at insomnia is effective in reducing depression, the participant is still successfully “treated” for depression in an indirect way. An intervention aimed at insomnia for this person could be considered as indicated prevention and has the potential to prevent the onset of depressive disorders in an indirect way. Participation in an intervention on insomnia is probably less stigmatising as an intervention to prevent a depressive disorder
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