Department of Counseling, Clinical, & School Psychology, University of California, Santa Barbara, Santa Barbara, California 93106, USA; email:
Department of Psychology, University of California, Los Angeles, Los Angeles, California 90095, USA; email:
Annu Rev Clin Psychol. 2018 May 7;14:185-208. doi: 10.1146/annurev-clinpsy-050817-084825. Epub 2018 Jan 31.
Mobilizing lay health workers (LHWs) to deliver evidence-based treatments (EBTs) is a workforce strategy to address mental health disparities in underserved communities. LHWs can be leveraged to support access to EBTs in a variety of ways, from conducting outreach for EBTs delivered by professional providers to serving as the primary treatment providers. This critical review provides an overview of how LHW-supported or -delivered EBTs have been leveraged in low-, middle-, and high-income countries (HICs). We propose a conceptual model for LHWs to address drivers of service disparities, which relate to the overall supply of the EBTs provided and the demand for these treatments. The review provides illustrative case examples that demonstrate how LHWs have been leveraged globally and domestically to increase access to mental health services. It also discusses challenges and recommendations regarding implementing LHW-supported or -delivered EBTs.
动员非专业卫生工作者（LHWs）提供基于证据的治疗（EBTs）是解决服务不足社区心理健康差距的一种劳动力策略。可以通过多种方式利用 LHW 来支持获得 EBT，从为专业提供者提供的 EBT 进行外展到作为主要治疗提供者。本批判性评论概述了在低收入、中等收入和高收入国家（HICs）中如何利用 LHW 支持或提供的 EBT。我们提出了一个概念模型，用于解决服务差距的驱动因素，这些驱动因素与提供的 EBT 的总体供应和对这些治疗的需求有关。该评论提供了说明性的案例示例，展示了如何在全球和国内范围内利用 LHW 来增加获得心理健康服务的机会。它还讨论了实施 LHW 支持或提供的 EBT 所面临的挑战和建议。
