The document discusses World Health Organization's 2017 World Mental Health Day campaign on depression. The campaign's goals were to educate the public about depression, its causes and consequences like suicide, and available prevention and treatment options. It provides global statistics on depression's prevalence, burden and lack of resources. The document outlines diagnostic criteria, screening methods, at-risk groups, contributing factors, impacts of untreated depression, and current policies and programs to promote mental health worldwide and in India. Prevention strategies include healthy lifestyle habits while treatment involves counseling, medication or a combination.

1. “Depression: let’s talk”
Dr. Shaan Ahmed
PGT, Community Medicine
NMCH, Patna

2. Overview
• Introduction
• Goal
• Status
• Diagnosis and Screening
• Target
• Causes and Consequences
• Programs/Policies
• Prevention and treatment

3. Introduction
• “Depression–let’s talk” is the slogan for World
Health Day 2017.
• World Health Day 7 April.
• To highlight a priority area of public health.
• Provides an opportunity for individuals in
every community to get involved in activities
that can lead to better health.

4. Goal of campaign
To educate general public about
• depression,
• its causes and possible consequences, including
suicide, and
• what help is or can be available for prevention
and treatment.
To educate people with depression seek help; and
family, friends and colleagues of people living
with depression are able to provide support.

5. Global Status
• Leading cause of disability worldwide.
• Major contributor to overall global burden of
disease.
• 10% of years lived with disability globally.
• India and china account for 50 % of global
burden.
• In humanitarian emergency 1 in 5 people
affected.

7. Status in India
Burden of psychiatric disorder
• Globally maximum number of cases of
depression (Prevalence 4.5 %).
• Globally maximum number of suicide in India
most common cause of death in adult female
is suicide.
• Approximately 36% of Indians are
depressed(WHO).

8. Health manpower status:
• 4000 to 4500 trained Psychiatrist ( 2
Psychiatrist per 10 lakh population )
• Number of psychiatric beds is about 0.2 per 1
lakh population.
Not included in primary health care yet.

9. What is depression?
• Depression is an illness
characterized by
persistent sadness and
a loss of interest in
activities that you
normally enjoy,
accompanied by an
inability to carry out
daily activities, for at
least two weeks.

10. ICD-10 diagnostic criteria
The symptoms need to be present for minimum period
of at least 2 weeks.
Major symptoms:-
• Feeling sad or depressed most of the day,
nearly every day.
• Markedly reduced interest or pleasure in
almost all activities, most of the day nearly
every day.
• Loss of energy or fatigue nearly every day.

11. Minor symptoms:-
• Loss of self-confidence
or self-esteem.
• Unreasonable feelings
of guilt nearly every
day.
• Recurrent thoughts of
death or suicide, or
suicidal behavior.
• Diminished ability to
think or concentrate,
• Bodily agitation or
slowness.
• Disturbed sleep
(reduced or increased
sleepiness) nearly every
day.
• Gloomy and unhappy
views of the future,
• Increased or decreased
appetite and/or weight.

12. Screening
The following two questions may be used:-
1. During the past 4 weeks, have you often been
bothered by feeling down, depressed or
hopeless?
2. During the past 4 weeks, have you often been
bothered by having little interest or pleasure in
doing things?
Those who score 'YES' on both questions can be
further assessed for depression.

13. Who we are targeting?
World Health Organization, chosen to pay
particular attention to three groups that are
disproportionally affected:-
1. Adolescents and Young adults,
2. Women of childbearing age (particularly
following childbirth), and
3. Older adults (over 60s).

16. Causes
• Poverty
• Unemployment
• Life events such as death of a loved ones or a
relationship breakup
• Physical illness and
• Problems caused by alcohol and drug use.

17. Consequences
Non Communicable diseases
• Cancer
• Ischemic Heart Disease
• Diabetes
• Substance Use Disorders (Alcohol and Drugs)
• Nutritional Disorders (under-nutrition, over-
nutrition and obesity).
Chronic Communicable diseases like TB, HIV and
others.

18. If untreated
• Inability to carry out even simplest everyday
tasks.
• Prevent people from working and
participating in family and community life and
the ability to earn a living.
• Lead to suicide.

19. Programs/Policies
• Sustainable Development Goals and mental
health
• Mental Health Action Plan 2013-2020
• National Mental Health Care bill 2013
• National Mental Health Policy 2014

20. Sustainable Development Goals and
Mental health
• Goal 3 – Target 4: By 2030, reduce by one third
premature mortality from non communicable
diseases through prevention and treatment and
promote mental health and well-being.
• Goal 3 – Target 5: Strengthen the prevention and
treatment of substance abuse, including narcotic
drug abuse and harmful use of alcohol.
• Goal 5 – Target 2: Eliminate all forms of violence
against all women and girls in the public and
private spheres, including trafficking and sexual
and other types of exploitation.

21. Mental Health Action Plan 2013-2020
(WHO)
• Mental Health Action Plan 2013–2020, focuses on
the need for a comprehensive and coordinated
response towards mental health from health and
social sectors at the country level.
• To promote mental well-being, prevent mental
disorders, provide care, enhance recovery,
promote human rights and reduce the mortality,
morbidity and disability for persons with mental
disorders.

22. Global targets by 2020
• 80% of countries develop/update policy/plan for
mental health
• 80% of countries will have >/2 promotion/prevention
programs.
• 80% of countries collect/report indicator every two
years.
• 50% of countries develop/update law for mental
health.
• 20% increase in service coverage for severe mental
disorders.
• 10% reduction in rate of suicide in countries.

23. National Mental Health Policy 2014
Vision:
• Promote mental health
• Prevent mental illness
• Enable recovery from mental illness
• Ensure accessible and affordable quality
health and social care.

24. Goals:
• To reduce , distress, disability, exclusion
morbidity and premature mortality associated
with mental health disorder.
• To enhance understanding of mental health in
a country.
• To strength leadership in mental health at
district, state and national level.

25. Prevention and treatment
• Depression can be effectively prevented and
treated.
• Treatment usually involves either a talking
therapy or antidepressant medication or a
combination of these.
• The earlier treatment begins, the more
effective it is.

26. Prevention
• Healthy diet
• Regular exercise
• Taking time out for fun and relaxation
• Not overworking, and
• Time Management Skills
• Routine health checkup

27. Treatment
• If you think you have depression talk to someone you
trust (WHO).
Counseling includes: Anti-depressant Medications:
Cognitive behavioral therapy Selective serotonin reuptake inhibitors
(SSRI)
Interpersonal therapy Serotonin and norepinephrine reuptake
inhibitors (SNRI)
Problem-solving therapy Tricyclic antidepressants (TCA)
Monoamine oxidase inhibitors (MAOI )

28. • On World Mental Health Day 10 Oct 2017,
“Depression let’s talk” campaign ends.
• Close to 2 million people involved.
• More than 300 activities in 76 countries
registered on campaign app.

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