Enhancing professional competencies to tackle depression and suicidal ideation: outcomes of the EAAD 4-level intervention across seven European countries

• Training improved perceived competencies and behavioural intentions. • Online training during COVID-19 still showed positive effects. • Participants had positive attitudes towards depression and suicide prevention. • Future efforts should engage harder-to-reach professionals to maximize impact. Training primary care workers, mental health professionals, and community facilitators is a common strategy to enhance their knowledge, attitudes, and confidence in managing depression and suicidality. This study evaluates the impact of two standardized training programs within the EAAD 4-level intervention on participants’ attitudes, perceived competence, and behavioural intentions across seven European countries. A single-group pre-post-test study was conducted as part of the EU-funded EAAD-Best project. A cohort of 696 primary care and mental healthcare professionals (Level 1) from five countries and 519 community workers (Level 3) from five countries participated in tailored training. A bespoke questionnaire based on the Theory of Planned Behaviour assessed attitudes, perceived competence, and behavioural intention before and immediately after training. Linear mixed models showed significant improvements in perceived competence (Level 1: +14.7%; Level 3: +26.7%) and behavioural intention (Level 1: +25.7%; Level 3: +53.9%). Attitudes were already positive at baseline but improved slightly (Level 1: +1.7%; Level 3: +2.2%). Positive effects were observed across multiple countries, regardless of group size and training delivery mode. In one country, where training was delivered online to large groups due to the COVID-19 lockdown, training effects were still observed. Our results suggest that the EAAD training program may enhance professionals’ competencies and intentions to apply learned skills. An online version of the training, which enabled training of large groups, also showed promising results, highlighting potential for scalability. Future initiatives should focus on engaging harder-to-reach professionals and considering more robust evaluation designs to better assess impact.