2 - (SYM 30) The Lone Star Depression Challenge: Scaling Digital Training and Task Sharing to Strengthen the Community Mental Health Workforce in Texas

Depression remains a leading cause of disability in the United States, with large treatment gaps in underserved regions such as Texas. Task-sharing models, which have been widely tested in low- and middle-income countries, offer a promising strategy to expand access by training non-specialist providers to deliver brief, evidence-based psychological interventions. This study supported the development and statewide implementation of a digital platform to train non-specialist providers across Texas to deliver behavioral activation for depression in community settings, referred to as the EMPOWER program. Through a multi-year, multi-stakeholder collaboration, we designed and deployed a fully digital training curriculum for frontline providers without prior mental health specialization. The curriculum was developed in English and adapted into Spanish using a structured cultural adaptation process. Content was reviewed by licensed clinical psychologists and behavioral activation experts to ensure fidelity to the evidence-based intervention protocols. This project initially focused on community health workers but was expanded to include additional community organizations positioned to reach individuals with unmet mental health needs. The EMPOWER training was implemented across diverse community settings, including county and city health departments, faith-based and veteran-serving organizations, YWCA, health systems, and other community and academic partners. Over four years, we developed, tested, and deployed the platform statewide, training approximately 400 providers across more than 60 cities spanning all regions of Texas. This initiative demonstrates the feasibility of adapting and scaling global task-sharing approaches to address depression in a high-income U.S. context. Next steps include strengthening implementation supports, ensuring sustainability, integrating trained providers into community care pathways, and tracking outcomes to assess fidelity and impact.