Gustafson Erika L, Moses Jacqueline O, Pimentel Eliana, Lakind Davielle, Uribe Viviana, Thorpe Dillon, Bobadilla Gabriella, Caglianone Lily, Dickinson Grayson J, Smith Dale, Westrick Jennifer, Sánchez-Johnsen Lisa
Institute for Juvenile Research, Department of Psychiatry, College of Medicine, University of Illinois Chicago, Chicago, USA.
Department of Clinical Psychology, College of Health Professions, Mercer University, Macon, USA.
Adm Policy Ment Health. 2025 Jul 21. doi: 10.1007/s10488-025-01459-6.
The United States (US) faces a mental health crisis characterized by persistent unmet mental health needs, provider shortages, and pronounced mental health inequities for systematically marginalized communities, including the Latine population. Integrating community health workers (CHWs) into mental healthcare delivery via task-shifting is one promising approach to address longstanding inequities in treatment access. Yet, most studies of CHW mental health models have been conducted outside of the US, necessitating an evaluation of the evidence base for these models domestically, and in particular, their use with Latines living in the US. This systematic review examines the evidence for CHW-delivered mental health interventions for US-based Latines. In total, 27 articles (25 trials) met the eligibility criteria. The majority of interventions were delivered in Spanish to immigrant populations. The most common mental health targets included depression, stress, and parenting or the parent-child relationship. Common intervention components included psychoeducation, general coping skills, behavior management, case management, communication skills, relaxation, and problem solving. The majority of studies found that CHW-delivered interventions led to significant mental health symptom improvements. However, there was a high risk of bias across studies. Thus, there is promising preliminary evidence supporting CHW-delivered mental health interventions for US Latines, but more rigorous evaluation of these models is needed.
美国面临着一场心理健康危机，其特点是心理健康需求长期未得到满足、医疗服务提供者短缺，以及包括拉丁裔群体在内的系统性边缘化社区存在明显的心理健康不平等现象。通过任务转移将社区卫生工作者（CHW）纳入精神卫生保健服务是解决长期存在的治疗可及性不平等问题的一种有前景的方法。然而，大多数关于社区卫生工作者心理健康模式的研究是在美国以外进行的，因此有必要在国内评估这些模式的证据基础，特别是它们在美国拉丁裔人群中的应用。本系统评价考察了针对美国拉丁裔人群由社区卫生工作者提供的心理健康干预措施的证据。共有27篇文章（25项试验）符合纳入标准。大多数干预措施以西班牙语提供给移民人群。最常见的心理健康目标包括抑郁、压力以及育儿或亲子关系。常见的干预组成部分包括心理教育、一般应对技能、行为管理、病例管理、沟通技能、放松和问题解决。大多数研究发现，由社区卫生工作者提供的干预措施能显著改善心理健康症状。然而，各研究存在较高的偏倚风险。因此，有初步证据支持针对美国拉丁裔人群由社区卫生工作者提供的心理健康干预措施，但需要对这些模式进行更严格的评估。
