This review first highlights the public health impact of major depression. To this end, increased collaboration between mental health disciplines and public health is recommended to enact a multilevel approach to the prevention of depression (see Figure 1).

Moreover, although the recent success of indicated and selective prevention programs in clinical psychology is encouraging, substantial progress must be made to develop preventive interventions that are sustainable and accessible to larger segments of the population. Although the contribution of depression to disability in the population is recognized as an important public health concern (e.g., Murray & Lopez, 2002), depression has been largely ignored as a target of public health intervention. Recent efforts to develop preventive interventions for depression have been successful (e.g., Gillham et al., 1995 Clarke et al., 2001) and suggest that depression is amenable to a public health approach to disease prevention. To date, mental health interventions for depression have focused almost exclusively on an individual treatment approach. Department of Health and Human Services, 1999). This growing problem has been identified by numerous organizations as among the largest health-care priorities in the country (Healthy People 2010, 2000 U.S. Major depression is a prevalent and disabling condition that constitutes an important public health problem in the United States. Increased interdisciplinary collaboration between mental health disciplines and public health is recommended to develop, enact, and evaluate multi-level preventive interventions aimed at reducing the population health burden of major depression. To this end, a research agenda incorporating the perspectives of both mental health disciplines and public health is proposed as a guide for future depression prevention research.

The development of sustainable preventive interventions that have the potential to impact population health represents a critical goal for the field.

Although effective preventive interventions targeting high-risk groups have been developed, they have thus far had poor reach and sustainability in the community. Depression has long been recognized as an important target of intervention in psychology and psychiatry, but these fields have focused efforts primarily on treatment rather than prevention. Major depression is a consequential public health problem in the United States.

Back to Life by Kathy McLaughlin