Enabling Translation of Science to Service to Enhance Depression Care (ESSENCE)

Leadership

Contact Principal Investigator: Vikram Patel, Ph.D.
Principal Investigator: Rahul Shidhaye, M.D.

Hub Activity Sites

India (Madhya Pradesh)
Nepal
Bangladesh
Afghanistan

Project Overview

The long-term goal of ESSENCE (Enabling translation of Science to Service to ENhance Depression CarE) is to bridge the science to service gap and to strengthen an existing collaborative network of institutions in South Asia bound together by the NIMH-supported SHARE Hub (the South Asian Hub for Advocacy, Research and Education on mental health) for International Mental Health Research. This involves generating knowledge on cost-effective implementation approaches for scaling up of evidence-based interventions for mental disorders, and building capacity in a range of key stakeholders to enhance the conduct of implementation research, the dissemination of its findings, and the uptake of this evidence in policy and programs. Ultimately, the aim of these efforts is to reduce the treatment gap for mental disorders.

Implementation Research Study

The ESSENCE scale-up component has two specific aims, each of which will be addressed by a separate, but complementary research strategy. These include:

1. To develop and evaluate the effectiveness and cost-effectiveness of Digital Training interventions (with and without guidance) compared with Face-to-Face training on the competence of Non-Specialist Health Workers (ASHAs – Accredited Social Health Activists, community health workers deployed in India’s National Health Mission). ESSENCE will also deliver the Healthy Activity Program, an evidence-based brief psychological treatment for depression in primary care attenders.
2. To develop and evaluate the effectiveness and cost-effectiveness of two progressively resource-intensive implementation support strategies to address key barriers to the collaborative stepped care delivery of evidence-based clinical treatments for depression. ESSENCE will also compare the current strategy of training alone, on the fidelity of implementation and outcomes, in patients with moderate to severe depression in primary care.

Research Capacity Building

The capacity-building component aims to strengthen the capacity in the four South Asian countries (India, Nepal, Bangladesh, Afghanistan) to conduct implementation research in mental health. It also aims to disseminate the findings to facilitate knowledge exchange, and promote the uptake of research findings to facilitate evidence-based mental health policy making and program planning. To achieve these objectives, ESSENCE will focus on four target groups in this component: (1) researchers, (2) service user representatives, (3) media professionals, and (4) policy makers and program managers, with the aim of building three aligned networks of stakeholders including implementation researchers who will generate knowledge, service users and media professionals who can facilitate exchange and diffusion of this knowledge, and policy makers and program managers who can utilize this knowledge in mental health policy and program design. Across these stakeholder groups, the scope of the networks will comprise both national and regional geographies. Ultimately, ESSENCE aspires to build a wider collaborative network of all these stakeholders, that is regionally led and coordinated by ESSENCE network partner institutions.