Future Directions in Lay Health Worker Involvement in Children’s Mental Health Services in the U.S.

Abstract

Nearly half of children meeting criteria for a mental health disorder in the United States (U.S.) do not receive the treatment they need. Unfortunately, lack of access to and engagement in mental health services can be seen at even higher rates for historically marginalized groups, including low-income, racial, and ethnic minority youth. Lay Health Workers (LHWs) represent a valuable workforce that has been identified as a promising solution to address mental health disparities. LHWs are individuals without formal mental health training who oftentimes share lived experiences with the communities that they serve. A growing body of research has supported the mobilization of LHWs to address service disparities around the globe; however, challenges persist in how to scale-up and sustain LHW models of care, with specific barriers in the U.S. In this paper, we describe LHWs' different roles and involvement in the mental health field as well as the current state of the literature around LHW implementation. We integrate the RE-AIM Framework with a conceptual model of how LHWs address disparities to outline future directions in research and practice to enhance equity in the reach, effectiveness, adoption, implementation, and maintenance of LHW models of care and evidencebased practices for historically marginalized communities within the U.S.

An exploration of the Indonesian lay mental health workers’ (cadres) experiences in performing their roles in community mental health services: a qualitative study

“…In carrying out their roles, cadres have routine tasks such as home visits, early detection of mental problems, supporting health education, and supporting patients and families, which were delayed due to COVID-19. COVID-19 has consequences for cadres in carrying out their roles, including outreach, auxiliary care, and prevention of mental problems in the community and for people with mental illness, which decreased the utilisation of access to mental health services [ 62 , 63 ]. This can be overcome by training and developing the skills of health cadres [ 63 ], which was in line with the key findings in this research about the importance of monitoring and supervising mental health professionals and the importance of training mental health cadres to optimise their roles.…”

An exploration of the Roles of Lay Mental Health Workers (Cadres) in Community Mental Health Services in Indonesia: A Qualitative Study

“…In carrying out their roles, cadres have routine tasks such as home visits, early detection of mental health problems, supporting health education, and supporting patients and families, which were delayed due to COVID-19. COVID-19 has consequences for cadres in carrying out their roles, including outreach, auxiliary care, and prevention of mental health problems in the community and for people with mental health problems, namely, reduced utilisation of access to mental health services [50,51]. This can be overcome by training and developing the skills of health cadres [51], which was in line with the key ndings in this research about the importance of monitoring and supervising mental health professionals and the importance of training mental health cadres to optimise their roles.…”

Addressing Social Determinants of Mental Health in Pediatrics During the Coronavirus Disease 2019 Pandemic

“…With increasing recognition of the social determinants of child mental health, the next question is whether addressing SDOH in pediatric primary care can prevent or improve mental health symptoms. Lay health worker-led interventions can improve access to needed mental health care, 7 but in general the evidence for SDOH interventions reducing mental health symptoms in youth is sparse. To improve mental health, primary care based SDOH interventions may need to be tailored to specific populations of children, and more attention is needed on implementation strategies to ensure they apply across practice settings, mitigate double loss (i.e., families disclosing needs but not having them addressed), and do not unintentionally worsen health disparities.…”