# ESSENCE (Enabling translation of Science to Service to ENhance Depression CarE) Scale-Up

> **NIH NIH U19** · HARVARD MEDICAL SCHOOL · 2021 · $463,076

## Abstract

PROJECT ABSTRACT (SCALE UP COMPONENT)
Depression is the leading mental health cause of the Global Burden of Disease and accounts for 37% of
the mental health related Disability Adjusted Life Years (DALYs) in India. However, despite the
knowledge of evidence-based clinical treatments and delivery models, treatment gaps exceed 90% in rural
areas. In order to address this science to service gap, our aim is to generate knowledge on the most
effective and cost-effective approaches to sustainably scale up the ESSENCE `package' (collaborative
stepped care delivery of two evidence-based clinical treatments for moderate to severe depression in
primary care attenders) to four districts (population of approximately 5.3 million) in the state of Madhya
Pradesh with delivery entirely carried out by existing health workers funded by the government.
ESSENCE consists of two complementary, sequential randomized control trials, conducted over five
years to address following specific aims: a) the development and evaluation of the effectiveness and cost-
effectiveness of On-Line Training (OLT) interventions (with and without guidance) compared with Face-
to-Face (F2F) training on the competence of Accredited Social Health Activists (ASHA workers),
community health workers deployed in India's National Health Mission, to deliver the Healthy Activity
Program (HAP), an evidence-based brief psychological treatment for depression in primary care
attenders; and b) the development and evaluation of the effectiveness and cost-effectiveness of two levels
of implementation support interventions to address the key barriers to the collaborative stepped care
delivery of evidence-based clinical treatments for depression (the HAP and antidepressant medication)
compared with the current strategy of training alone, on outcomes in patients with moderate to severe
depression in primary care.
ESSENCE builds on a substantial body of evidence in the study country, led by the program PIs, to
capitalize on the unique and timely opportunity offered by the strong engagement of our research program
with the Ministry of Health, Government of Madhya Pradesh to address the critical knowledge gaps
regarding the training and implementation support strategies necessary to scale-up evidence-based
treatments for depression in a low resource setting. The most innovative aspect of research is the use of
technology platforms for delivery of both the training and implementation support interventions to
enhance the likelihood of future scaling up of these interventions. The knowledge gained will be the first
from any low or middle income country for such training and implementation interventions and could
thus be instrumental in influencing the mental health policy agenda beyond the study country.

## Key facts

- **NIH application ID:** 10168618
- **Project number:** 5U19MH113211-05
- **Recipient organization:** HARVARD MEDICAL SCHOOL
- **Principal Investigator:** Vikram H Patel
- **Activity code:** U19 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $463,076
- **Award type:** 5
- **Project period:** 2017-07-01 → 2024-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10168618

## Citation

> US National Institutes of Health, RePORTER application 10168618, ESSENCE (Enabling translation of Science to Service to ENhance Depression CarE) Scale-Up (5U19MH113211-05). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10168618. Licensed CC0.

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