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Co-creation of proposals to improve prevention and treatment of anxiety and depression in Spain

Miguel VIEIRA and Maria Teresa SILVA

In Europe, recent reports highlight a sustained rise in mental health problems, particularly depression and anxiety, over the past decade, driven by social, economic, and cultural factors such as job insecurity, inequality and loneliness. In Spain healthcare services cannot always meet the growing demand for mental health care with adequate speed or depth. This situation underscores the need for preventive, community-based, and intersectoral strategies in order to identify barriers, needs, and opportunities that are not visible in epidemiological data.This study aims to contribute to the co-creation of strategies that improve the prevention, early detection, and treatment of depression and anxiety in Aragón by generating context-specific knowledge to guide healthcare, educational, social, and community institutions. The general objective is to identify and analyze intervention proposals from health and education professionals, people with current or past diagnoses of depression and/or anxiety, and their families.An exploratory qualitative study was conducted to gather the perspectives of key informants regarding potential strategies for the prevention and treatment of these conditions in Aragón. 25 participants from varied sectors (patients, family members, psychiatrists, psychologists, social workers, family doctors, nurses, educators among others)  were recruited across three provinces through purposive sampling.  Data was collected through semi-structured interviews on the following topics; 1) perceived differences in incidence, causation and treatment by gender, age, and social determinants of health,  2) perceived needs; 3) prevention; 4) treatment and care; 5) implementation of proposed interventions. An inductive thematic content analysis informed by grounded theory will be used and resulting intervention proposals will be assessed through a SWOT analysis.Preliminary analyses indicate recurrent concerns, including insufficient resources, limited time, and understaffing in primary care. Participants also highlighted the strong influence of social and economic determinants on mental health outcomes and on the feasibility of effective prevention and treatment strategies.Improving mental health in Aragón requires both better-resourced services and policies addressing structural social and economic vulnerabilities.Active participation from intersectoral actors in designing intervention proposals allows for more relevant, feasible, and effective prevention and treatment of depression and anxiety in specific territories, facilitating the intersectoral coordination required for implementation.