ADDRESSING MENTAL HEALTH VULNERABILITIES FROM ADOLESCENCE TO OLDER AGE: INNOVATING PREVENTION SCIENCE FOR TIMES OF CHANGE

Project Information

ADVANCE

Grant agreement ID: 101080323

DOI

10.3030/101080323

EC signature date 5 April 2023

Start date 1 July 2023

End date 30 June 2028

Funded under

• Health

Total cost

€ 6 999 987,50

EU contribution

€ 6 999 987,50

Coordinated by

KOBENHAVNS UNIVERSITET
Denmark

Periodic Reporting for period 1 - ADVANCE (ADDRESSING MENTAL HEALTH VULNERABILITIES FROM ADOLESCENCE TO OLDER AGE: INNOVATING PREVENTION SCIENCE FOR TIMES OF CHANGE)

Reporting period: 2023-07-01 to 2024-12-31

Summary of the context and overall objectives of the project

Mental health conditions affect 84 million people in the EU, costing 4% of GDP and accounting for 26% of Europe’s disease burden—figures worsened by COVID-19 and driven by socio-economic inequalities, climate distress, workplace digitalization, migration stress, and aging. Despite this, mental health care in Europe relies heavily on specialized clinical treatments, which face major challenges: a shortage of specialists, limited access, and inadequate support for marginalized populations. Clinical approaches also fail to address broader risk factors. To meet rising needs, Europe must rethink its approach and scale up cost-effective mental health promotion and prevention strategies in everyday settings, addressing stigma and systemic risks—especially for high-risk populations.

ADVANCE aims to develop, evaluate, and scale mental health promotion and prevention strategies using a social justice and human rights approach. Its three objectives are:

Document challenges and co-create scaling strategies, anticipating emerging risks, improving access, and reducing stigma.
Evaluate interventions, assessing both new approaches for novel populations and optimal implementation of existing evidence-based programs.
Support large-scale implementation of these strategies.
The project spans six countries, targeting diverse populations:

1. Lithuania (WP2) – Socio-economically disadvantaged youth through WHO’s STARS (Sija).
2. Germany (WP2) – Youth experiencing climate distress via EMICompass (CliMACT).
3. Netherlands (WP3) – Workers in digitalized workplaces using WHO’s DWM and ASCEND.
4. Italy (WP4) – Migrants facing stress, supported by WHO’s SH+ and online DWM.
5. Denmark (WP4) – Migrants aided through WHO’s SH+ in social integration programs.
6. Switzerland (WP5) – Older adults at risk of cognitive decline through a Cognitive Training Program and adapted SH+.

Through these initiatives, ADVANCE seeks to transform mental health interventions across Europe.

Work performed from the beginning of the project to the end of the period covered by the report and main results achieved so far

The ADVANCE project started with a problem analysis and co-creation phase (Year 1). In this phase, we delivered seven situational analyses and one European-level policy brief. These documents were developed through a rigorous co-creation process, involving the establishment of seven Society Advisory Groups (SAGs). The SAGs assisted in designing situational analyses and the development of intervention scenarios. In Year 2, we have adapted mental health promotion and prevention interventions to local contexts and populations. We have delivered thirteen deliverables in the first 18 months which includes a guideline on selection, facilitation, and the role of SAGs; 7 national situational analyses which served as basis for a European-level policy brief; intervention scenarios; WHO protocol for end-user and technological adaptation for digital mental health interventions. We have also submitted translated and adapted training and facilitation manuals for all interventions in the six country sites. In addition, we have submitted a Socratic dialogue manual for interdisciplinary mental health research.

Currently, we are conducting/ preparing to conduct feasibility studies to understand the acceptability and feasibility of our intervention and research procedures. In Years 3 and 4, we will conduct evaluations of promotion and prevention interventions in six different countries. These evaluations will include both quantitative and qualitative methodology. In Finland, we will develop a scaling strategy based on prior Horizon Europe-funded research (RESPOND). Following the completion of the six evaluation studies, we will work with the SAGs to develop scaling strategies, based on all research findings generated through ADVANCE.

Throughout the implementation of the ADVANCE project, we will engage in activities to facilitate bringing together the strands of knowledge generated across the different academic disciplines. Ultimately, the results of ADVANCE research activities will be incorporated in an outward-facing, user-friendly toolkit for policy makers and practitioners to facilitate the implementation and scaling up of cost-effective mental health promotion and prevention interventions for populations at-risk in a changing Europe.

Progress beyond the state of the art and expected potential impact (including the socio-economic impact and the wider societal implications of the project so far)

Our project aims to accelerate the transition of interventions from research to real-world application. To maximize impact, we selected interventions with the highest social readiness levels (SRL), covering both efficacy and implementation trials.

A key focus is scaling tested interventions in collaboration with SAGS, including a new site in Finland. We will also develop a practical toolkit for policymakers and implementers.

Among interventions, WHO’s Management Training (SRL 3) will undergo its first RCT, while a sequential workplace distress trial aims to elevate it to SRL 8. EMICompass (SRL 4) is being adapted for climate-affected adolescents, with a hybrid RCT targeting SRL 8. STARS, having shown positive feasibility results, awaits definitive trials in Jordan and Lithuania—if effective, WHO will make it openly accessible (SRL 8). SH+ for older adults will be evaluated in a 2x2 factorial hybrid trial to enhance efficacy and reach SRL 8.

At SRL 5, Online DWM will be tested in SME workplaces in the Netherlands, with a sequential RCT to advance it to SRL 8. Cognitive training, already well-validated, will be combined with a psychological distress intervention to reach SRL 8.

SH+ for migrants (SRL 6) has been widely tested, and our focus now shifts to implementation. In Italy, we will compare online vs. in-person delivery and assess booster sessions. In Denmark, we will explore integration within social housing. These efforts aim to move SH+ to SRL 9, ensuring broad, sustainable impact.

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