Department of Counseling, University of California Santa Barbara.
Department of Pediatrics, University of Massachusetts Medical School.
J Clin Child Adolesc Psychol. 2021 Nov-Dec;50(6):966-978. doi: 10.1080/15374416.2021.1969655. Epub 2021 Sep 23.
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 evidence-based practices for historically marginalized communities within the U.S.
在美国，近一半符合心理健康障碍标准的儿童没有得到他们所需的治疗。不幸的是，包括低收入、种族和少数民族青年在内的历史上被边缘化的群体，甚至更难以获得和参与心理健康服务。非专业卫生工作者（LHWs）是一支有价值的劳动力，他们被认为是解决心理健康差距的一个有前途的解决方案。LHWs 是指没有接受过正式心理健康培训的人，他们通常与自己所服务的社区有着共同的生活经历。越来越多的研究支持动员 LHWs 来解决全球各地的服务差距问题；然而，如何扩大和维持 LHW 护理模式仍然存在挑战，在美国尤其存在具体障碍。在本文中，我们描述了 LHWs 在心理健康领域的不同角色和参与情况，以及围绕 LHW 实施的文献现状。我们将 RE-AIM 框架与 LHWs 如何解决差距的概念模型相结合，为如何在研究和实践中确定未来的方向提供了指导，以提高美国历史上边缘化社区的 LHW 护理模式和循证实践在覆盖范围、效果、采用、实施和维持方面的公平性。
