16-19 NOVEMBER, 2017 

João Manuel Castro Faria Salgado
ISMAI - Instituto Universitário da Maia
1 English
João Salgado. Psychologist and psychotherapist. He is the Director of the Laboratory of Psychotherapy Research at ISMAI - University Institute of Maia, Portugal - where he is also the Coordinator of the PhD Program in Clinical Psychology. A large part of his career has been devoted to outcome and change process research in psychotherapy, especially in the domain of psychotherapy. More recently, he has been leading research projects on routine practice of primary health care of depression, including the introduction and assessment of the introduction of internet-based treatments. He was previously trained in Emotion-Focused Therapy by Leslie S. Greenberg, and he still has a regular practice of this form of psychotherapy.

Treatment of depression
Treatment of depression is not available for everyone. Major depression is a highly prevalent and recurrent mental health disorder, associated with significant comorbidity with other psychological and medical disorders, an increased risk for diverse psychosocial problems and suicide, as well as significant functional deterioration and impairment. Depression originates significant direct and indirect costs for the communities, and at this moment, according to a recent WHO report, it has become the leading cause of disability worldwide. It is almost paradoxical that this current epidemic of Depression is happening while we have a great variety of empirically supported treatments to deal with this mental health problem. Ranging from antidepressant medication to psychological treatments (and not forgetting some other possible forms of interventions, such as physical activity), there is a great range of different treatment possibilities. Nevertheless, the numbers of depression are still growing, and different studies make it clear that giving access to proper treatments is one of the biggest challenges in this field. This presentation addresses this problem by proposing a general framework for developing an integrated approach pursuing to improve the health care for depression. Such approach implies several steps. First, we can distinguish different important aims, such as: (a) improving the access of adequate knowledge about depression and its different treatments; (b) improving the access to adequate tools of screening, diagnosis, and intervention, taking also into account its use in routine practice contexts, with its possible constraints; (c) improving the training and supervision of the health professionals. Second, for obtaining an integrated plan for improving health care in depression, those aims need to be formulated according to different targets, ranging from patients (e.g., giving them better knowledge about depression), to health professionals, political deciders, and the general population. Third, different forms and tools of intervention can be distinguished, varying from clinical interventions to political action. Finally, all these dimensions need to be adapted to the national and regional circumstances. All these steps can and should be informed by the best practices available and empirically tested. This global general approach will be illustrated with the Portuguese plan for Preventing Depression, based on a e-health stepped-care model.