OBJECTIVES: To report health care and social service costs from a trial of nonpharmacologic depression support program in older African Americans, Beat the Blues (BTB).  METHODS: Two-group randomized design in which the BTB group received the program and the control group did not receive the program. BTB employed licensed senior center social workers to meet with participants (up to 10 sessions).  Components of BTB were depression education, care management, stress reduction, referrals and linkages, and behavioral activation.  Both groups were followed for 4 months. Service use and costs at each time point included health care use for depression (outpatient calls and visits to physician, emergency department visits, hospitalizations), medications, alternative approaches to managing depression (massage, acupuncture), paid caregiving (homemaker, home health aide, and visiting nurse), and social services (meals, transportation, and social worker support). RESULTS: A total of 129 subjects were randomized (68 BTB, 61 wait-list control); the average age was 68.3 years, most were female (77.9%), not married (90.4%), not employed (92%), and had an average of 6.4 health conditions (range 1-19). In both groups, costs for health care use for depression and alternative approaches to managing depression were similar at baseline.  Medication costs for BTB decreased from $210 at baseline to $159 at 4 months, whereas in the wait-list control group, medication costs remained roughly constant ($186 at baseline and $197 at 4 months).  Both groups experienced a decrease in paid caregiving costs ($69 in the BTB group vs. $39 in the wait-list control group).  The BTB group experienced an overall cost decrease of $112 versus $19 in the wait-list control group over the 4 months.  CONCLUSIONS:   Decreases in medication and caregiving costs resulted in a net lower cost in the BTB group during observation period.  Larger scale translational studies are needed to understand the extent to which BTB influences specific types of costs.