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NIMH ALACRITY Center Grant Seeks to Change Depression Treatment Paradigm

Expansion of CBITs follows successful NUCATS Studio Consultation

Northwestern University’s Center for Behavioral Intervention Technologies (CBITs) has received a National Institute of Mental Health (NIMH) ALACRITY Center grant to advance digital mental health research and accelerate those research discoveries into clinical practice.

The grant will focus on the design, evaluation, and implementation of digital mental health services for depression within healthcare settings, using a multipronged strategy that involves three research proposals, as well as resources to develop digital mental health, including consultation and pilot grant funding. The overarching goal of CBITs is to create digital mental health services that can be sustainably implemented in real-world healthcare settings.

Led by David Mohr, PhD, CBITs Director, Professor of Preventive Medicine: Behavioral Medicine, Medical Social Sciences and Psychiatry and Behavioral Sciences, and Madhu Reddy, PhD, FACMI, Co-Director of CBITs, Professor of Communication Studies,  Preventive Medicine: Health and Biomedical Informatics and a faculty member in the Center for Communication and Health, the grant will lead to digital mental health services designed to treat depression in three distinct care settings: family medicine, obstetrics and a geriatrics service. The Center will also develop research methods that integrate human-computer interaction methods, clinical science and implementation science, to provide substantial and enduring contributions to research methodology and the quality of science.

“The use of digital applications for patients coupled with support from a care coordinator have consistently been shown through randomized controlled trials to be effective at treating depression,” says Mohr, who has studied the remote treatment of mental health for most of his career. “Yet in spite of the overwhelming evidence of effectiveness from research studies, attempts to implement these services in real-world healthcare settings have failed. Patients don’t use the digital tools we have created, and these services do not fit into the workflows in healthcare settings.”

In spite of the overwhelming evidence of effectiveness from research studies, attempts to implement these services in real-world healthcare settings have failed. Patients don’t use the digital tools we have created, and these services do not fit into the workflows in healthcare settings.”

David Mohr, PhD, CBITs Director, Professor of Preventive Medicine: Behavioral Medicine, Medical Social Sciences and Psychiatry and Behavioral Sciences

Mohr and Reddy see the research-to-practice gap as caused, in part, by the approach taken in many studies, which have tended to design digital tools based on what clinical researchers believe patients need. Instead, this ALACRITY Center grant will be used to design processes that give voice to the needs and preferences of patients and clinicians, not only to improve patient engagement and outcomes, but also to make the work of clinicians easier.

“One of the strengths of this project is that we are very deliberately working with clinical and research leadership within each proposal,” says Reddy, whose primary interests are in understanding how health information technologies can be better designed and implemented to improve communication and collaboration in clinical settings. “The goal in doing so is to increase the likelihood of implementation and to enhance the capacity to expand these efforts for use in other settings.”

The four-year, $6-million NIMH grant (P50 MH119029) followed a successful NUCATS Research Studio consultation, which provides investigators with dedicated time and space to receive multidisciplinary guidance from clinical, translational and design science experts and leverage existing NIH-supported infrastructure through NUCATS in order to be more competitive for federal funding.

“The Studio helped us identify the many resources that we could leverage, which were than outlined in a supporting letter from the NUCATS director,” Mohr says. “Center grants are often interdisciplinary endeavors and having a better understanding of the resources we have access to at Northwestern is a critical component to a successful application.”

One of the strengths of this project is that we are very deliberately working with clinical and research leadership within each proposal. The goal in doing so is to increase the likelihood of implementation and to enhance the capacity to expand these efforts for use in other settings.”

Madhu Reddy, PhD, FACMI, Co-Director of CBITs, Professor of Communication Studies,  Preventive Medicine: Health and Biomedical Informatics and a faculty member in the Center for Communication and Health

Mohr and Reddy began collaborating shortly after Reddy’s arrival at the University five years ago. In 2018, the pair received an NIMH T32 training program grant, which established the first postdoctoral training program to jointly train fellows in clinical science and human-computer interaction focused on digital mental health. 

“This P50 grant is an extension of our efforts to better integrate user engagement with clinical science in a way that leads to positive health outcomes,” Reddy says.

CBITs will also make a number of pilot grants available to develop innovative research in digital mental health that can lead to R-level NIH grant submissions. Consultation services are available to support research and grant submissions in this area. 

Multidisciplinary Research Projects Funded by NIMH ALACRTIY Center Grant

Digital Mental Health Services in Primary Care and Family Medicine

  • Colleen Stiles-Shields, PhD, Assistant Professor, Department of Psychiatry and Behavioral Sciences at Rush Medical College 
  • David C. Mohr, PhD, Director of the Center for Behavioral Intervention Technologies, Professor of Preventive Medicine (Behavioral Medicine) at Northwestern University Feinberg School of Medicine

A Technology-Enabled Solution to Support Collaborative Care for Perinatal Depression

  • Emily S Miller, MD, MPH, Assistant Professor of Obstetrics and Gynecology in the Division of Maternal Fetal Medicine at Northwestern University Feinberg School of Medicine
  • Madhu C. Reddy PhD, FACMI, Co-Director of the Center for Behavioral Intervention Technologies, Professor, at Northwestern University School of Communication

Tailoring an Intelligent Virtual Assistant for Homebound Older Adults with Depression

  • Lee A. Lindquist, MD, MPH, MBA, Section Chief of Geriatrics, Associate Professor of Medicine, James R. Webster Distinguished Physician in Geriatrics at Northwestern University Feinberg School of Medicine
  • Maia Jacobs, PhD, a postdoctoral fellow at Harvard who is joining Northwestern in January as an Assistant Professor with a joint appointment in Computer Science and Preventive Medicine.

“About 20 percent of the Americans experience a mental health disorder in a given year, and most are unable to access adequate treatment” Mohr says.  “Since COVID-19, tele-mental health has been adopted rapidly, reducing access barriers for many. But tele-mental health does little to address costs and the chronic shortage of mental health professionals. Digital mental health, which is effective and cost-efficient, can, if properly designed and implemented, play a critical role in extending mental health care to larger numbers of patients.” 

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