RISE (Regional Implementation and Scale-up of Early Adolescent Skills for Emotions) (360G-Wellcome-341139_Z_25_Z)

We propose to scale-up WHO–UNICEF endorsed Early Adolescent Skills for Emotions-EASE programme across Pakistan’s four provincial tertiary child and adolescent mental health(CAMH) facilities. Building on strong efficacy evidence from two RCTs(Pakistan and Jordan), we will evaluate EASE’s real- world clinical, implementation and cost-effectiveness compared with Enhanced Treatment as Usual using a Hybrid-Type-I trial design. EASE will be delivered by supervised postgraduate psychiatry and psychology residents, enabling rapid CAMH workforce expansion by integration in established and structured training, supervision and delivery pathways. Alongside the trial, to ensure integration and scale-up, co-designed by our Lived-Experience (LE) experts we will a)nationally, establish a government-endorsed Hub of Excellence for CAMH to coordinate scale-up; b)regionally, host a Collaborative Learning Group and Regional Fellowship Programme in eight CAMHSAN countries (Afghanistan, Bangladesh, Bhutan, India, Maldives, Nepal, Pakistan, Sri Lanka); and c)globally, co-develop a digital learning and knowledge-exchange hub using The Global Health Network(TGHN)’s Pathway to Impact framework to facilitate scale- up of CAMH psychotherapies and build scalable, youth-centred implementation capacity. LE youth will be embedded and co-lead governance, evaluation, and implementation, ensuring RISE delivers scalable, sustainable early intervention systems across Pakistan and South Asia. Keywords: EASE, active ingredients, implementation, (cost)-effectiveness evaluation, LE experts, task-shifting, regional and global scaling.