Studies in Germany,55 the United Kingdom,57 Australia,56 and New Zealand58 suggest modest effects of public education campaigns on attitudes regarding the causes and treatment of depression. Such public education and awareness campaigns, largely about depression, have no detectable effect on primary outcomes of decreasing suicidal acts or on intermediate measures, such as more treatment seeking or increased antidepressant use.57,58,113 The German study showed an 18% decrease in suicide attempts in an intervention region after 9 months of a depression awareness campaign.59 However, the decline in suicide attempts occurred without a greater improvement in attitudes in the intervention region compared with the control region.55