Global educational initiative for managing major depressive disorders in primary care: the MDD minds project

Depressive disorders are common and disabling, and a substantial treatment gap exists particularly in low-resource settings. Family doctors are well-placed to bridge this gap but often lack the confidence, knowledge and skill to do so. The World Organization of Family Doctors (WONCA) and its collaborators designed the MDD Minds project to improve care for major depressive disorders delivered by family doctors in Africa/Middle East (Kenya, Nigeria, and Saudi Arabia), Asia (Indonesia, Japan, and Sri Lanka) and Latin America (Brazil, Mexico, and Peru). The MDD Minds organizational structure included a steering committee, a design and measurement team and a group of master faculty composed of primary mental health care experts from participating countries. Project delivery was in three phases: MDD Minds 101, an online programme with seven modules; Train-the-Trainer, a group-based approach combining online and real-time elements and leading to delivery of in-country educational activities; and Performance- in-Practice, focused on enhanced depression screening for patients with diabetes. Recruitment was conducted by WONCA in collaboration with national primary care organizations. Project delivery began in October 2023 and was completed in December 2024. Enrollment and completion rates were tracked: 2,892 family doctors enrolled in MDD Minds 101; 581 (20%) completed the course. In Train-the-Trainer 210 scholars enrolled; 126 (60%) completed the program, delivering 143 educational sessions to 1,697 other healthcare professionals in their respective regions. Nine primary care teams in Brazil, Kenya, Japan and Nigeria participated in the Performance-in-Practice program; among 1,592 diabetes patients screened, 26.6% were diagnosed with depression and promptly managed. Strategic alignment between partnering organizations, in combination with world-wide expertise in mental health, ensured effective participation. Language and cultural adaptation were important to serving the diverse range of learners, as was ease of access to online platforms and enhanced use of social media. Our online course completion rate exceeded our expectations. The MDD Minds project demonstrates WONCA's ability to deliver high-quality educational programming at scale, as well as the benefits of localized frameworks that support family doctors, primary care teams, and patients in improving the care of those with major depressive disorder. It offers a replicable and sustainable approach to enhancing mental healthcare in diverse primary care settings.