ESSENCE

Enabling translation of Science to Service to ENhance Depression CarE

 

Visit our website for more information: Essence | Sangath 

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 strengthen an existing collaborative network of institutions in South Asia by 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 resulting in reduction of treatment gap for mental disorders.

Project Period: 1st July 2017 to 31st May 2022

Funder: National Institute of Mental Health 

Objectives

1) Evolving the existing administrative infrastructure of SHARE Hub (the South Asian Hub for Advocacy, Research and Education on mental health) for International Mental Health Research, to provide overall coordination for the ESSENCE components and building on the existing research partnerships to establish a South Asian Mental Health Implementation Science Hub comprising of the ESSENCE partners which include governmental, non-governmental, academic, and implementing agencies in the region.

2) Carrying out implementation research to assess the comparative effectiveness of technology-enabled interventions to train non-specialist health workers and provide them implementation support to address the key barriers to the coordinated delivery of evidence-based clinical treatments for depression (Healthy Activity Program and Antidepressant Therapy) at the primary health care level.

3) Developing and offering a range of opportunities, including fellowships and online courses tailored for the region, to build the capacity of the researchers to generate knowledge, of the media professionals and service user representatives to disseminate that knowledge, and of policy makers and program, managers to ensure uptake of the knowledge.

Study Design

ESSENCE (Enabling translation of Science to Service to ENhance Depression CarE) is an implementation research project with a broader goal of bridging the science-to-service gap by identifying the most effective and cost-effective strategies for scaling up evidence-based clinical treatments for depression (i.e., the Healthy Activity Program, a brief psychological treatment delivered by Non-Specialist Health Workers) in primary care facilities in Madhya Pradesh, India.

ESSENCE consists of two complementary, sequential randomized controlled trials: 1) the ‘Training Trial’ to compare two forms of digital training (i.e., low-intensity and high-intensity) with traditional Face-to-Face training (F2F) of non-specialist health workers to deliver the Healthy Activity Program (HAP); and 2) the ‘Implementation Trial’ to compare different remote implementation support strategies on achieving fidelity of implementation of evidence-based clinical treatments for depression in primary care facilities and to assess impact on patient outcomes.

Background

In India, depression accounts for 37% of the mental health-related Disability Adjusted Life Years (DALYs) and significantly contributes to the burden attributed to suicide and ischemic heart disease thus making it a critical public health priority. However, despite the knowledge of evidence-based clinical treatments (EBT) treatment gaps exceed 90% in rural areas. ESSENCE will address the critical knowledge gap regarding the training and implementation support strategies necessary to scale-up evidence-based delivery strategies for treatments for depression in a low resource setting. The innovations in the study are focused on developing and testing strategies for effective delivery of evidence-based treatments in low-income settings.

Project Leadership

Principal Investigator: 
Vikram Patel, MD, PhD 
The Pershing Square Profess of Global Health 
Wellcome Trust Principal Research Fellow 
Department of Global Health and Social Medicine 
Harvard Medical School 
 
Site Principal Investigator: 
Dr. Anant Bhan, MHSc, MBBS 
Site PI, ESSENCE, Sangath, Bhopal, Madhya Pradesh, India. 
PResident of international association of bio-ethics 
 
Project Lead at Harvard Medical School: 
John A. Naslund, PhD 
Instructor in Global Health and Social Medicine 
Department of Global Health and Social Medicine 
Harvard Medical School 
 
Project Lead at Sangath: 
Deepak Tugnawat, MSW, PGDPHM, BPT, 
Project Director, ESSENCE,  
Sangath, Bhopal, Madhya Pradesh, India. 
 
NIMH Program Officer: 
Holly Campbell-Rosen, Ph.D. 
Center for Global Mental Health Research 
Division of AIDS Research 
National Institute of Mental Health/ NIH 
 

Key Collaborators (in alphabetical order)

Zafra Cooper, PhD 
Professor, Department of Psychiatry 
Yale University, USA 
 
Sona Dimidjian, PhD 
Professor, Department of Psychology 
University of Colorado Boulder, USA 
 
Christopher Fairburn, MD 
Emeritus Professor, Department of Psychiatry 
Oxford University, UK 
 
Steven Hollon, PhD 
Professor, Department of Psychology and Human Development 
Vanderbilt University, USA 
 
Chunling Lu, PhD 
Assistant Professor, Department of Medicine 
Brigham and Women’s Hospital and Harvard Medical School 
 
Abhijit Nadkarni, MD 
Associate Professor, Department of Population Health 
London School of Hygiene and Tropical Medicine, UK 
 
Rohit Ramaswamy, PhD 
Professor, Department of Maternal and Child Health 
Gillings School of Public Health, University of North Carolina, USA 
 
Daisy Singla, PhD 
Assistant Professor, Department of Psychiatry 
University of Toronto, Canada 
 
Donna Spiegelman, ScD 
Professor, Department of Biostatistics 
Yale School of Public Health, Yale University, USA 
 
 

Research Team (in alphabetical order):

 

Aditya Anand, MSc

Data Manager

Sangath, India

aditya.a@sangath.in

 

Shivangi Choubey

Research Fellow

Sangath, India 

shivangi.choubey@sangath.in

 

Dinesh Chandke, MPhil

Research Coordinator

Sangath, India

Dinesh.chandake@sangath.in

 

Pooja Dhurve, BVA

Intervention Assistant

Sangath, India

Pooja.dhurve@sangath.in

 

Udita Joshi, MPH

Research Fellow

Sangath, India

udita.joshi@sangath.in

 

Azaz Khan, MA, MSW

Intervention Coordinator

Sangath, India

Azaz.khan@sangath.in

 

Lauren Mitchell, MD Candidate,

Research Fellow

Harvard Medical School, USA

lauren_mitchell@hms.harvard.edu

 

Shital Muke, PhD

Research Coordinator

Sangath, India

shital.muke@sangath.in

 

Juliana Restivo, MPH

Research Assistant

Department of Global Health and Social Medicine, Harvard Medical School, USA

juliana_restivo@hms.harvard.edu

 

Kamlesh Sharma, MSW

Researcher

Sangath, India

kamalesh.sharma@sangath.in

 

Ritu Shrivastava, PG Diploma in Public Health Management

Researcher

Sangath, India

ritu.shrivastava@sangath.in

 

Abhishek Singh, MA

Research Coordinator

Sangath, India

abhishek.singh@sangath.in

 

Narendra Verma, MSW

Researcher

Sangath, India

Narendra.verma@sangath.in