Mental Health Task-Shifting in Community-Based Organizations: Implementation, Impact, and Cost &amp;mdash; Evaluation of the Connections to Care Program

Ayer, Lynsay; Schultz, Dana; Abbott, Michele; Barnes-Proby, Dionne; Chan, Wai Kin Victor; Dunbar, Michael Stephen; Hoch, Emily; Liu, Harry H.; Martineau, Monique; Ohana, Elie; Siconolfi, Daniel; Snoke, Joshua; Stevens, Clare; Towe, Vivian L.

doi:10.7249/rr3083

Cited by 3 publications

(1 citation statement)

References 153 publications

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“…Clear recommendations for the communities about better mental health service development methods must be developed and disseminated. It is recommended to include mental health needs assessment methodology (WHO, 2012), the WHO optimal mix of services model (WHO, 2009), guidance on the work of working\coordination groups, coordination of service provision and task-shifting approaches (Hoeft et al , 2018; Ayer and Schultz, 2020).…”

Section: Discussionmentioning

confidence: 99%

Decentralisation and community stakeholders’ engagement for better mental health services development in the conflict-affected regions of Ukraine

Klymchuk¹,

Vysotska²,

Gorbunova

2022

JPMH

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Purpose The purpose of this paper is to explore how conflict-affected communities in Ukraine (the Lugansk region) can develop sustainable mental health services in decentralised settings. The main interest focuses on community stakeholders’ perception of their problems and solutions that communities can create to achieve better mental health coverage. Design/methodology/approach A series of roundtables (RTs) (4 RTs, 62 participants overall), accompanied by interactive brainstorming techniques, were conducted with communities’ representatives/stakeholders from the East of Ukraine (Lugansk region, a government-controlled area) during the year 2021. Participants (health, mental health, social care workers and administration representatives) were provided with the opportunity to discuss mental health services’ development challenges and create affordable solutions for their communities. Results of discussions were submitted to qualitative analysis and offered for review by participants. Findings Decentralisation in Ukraine led to allocating funds alongside responsibilities for developing the services to communities. Most of the communities appear not to be ready to acknowledge the role of mental health services, entirely relying on the existing weak psychiatric hospital-based system. Awareness-raising interactive capacity-building activities for the community leaders and decision-makers effectively promote community-based mental health services development. Five clusters of challenges were identified: leadership, coordination and collaboration problems; infrastructure, physical accessibility and financial problems; mental health and primary health-care workforce shortage and lack of competencies; low awareness of mental health and available services and high stigma; war, crises and pandemic-related problems. Communities stakeholders foresaw seven domains of action: increasing the role of communities and service users in the initiatives of governmental bodies; establishing in the communities local coordination/working groups dedicated to mental health service development; developing the community-based spaces (hubs) for integrated services provision; embedding the mental health services in the existing services (social, administrative and health care); mental health advocacy and lobbying led by local leaders and service users; increasing capacity of communities in financial management, fundraising; developing services by combining efforts and budgets of neighbouring communities. Research limitations/implications The study has potential limitations. Participants of the roundtables were mostly appointed by local authorities, so some of them didn`t have a motivation for mental health services development. Service users were involved only from the facilitators` side, not from the side of communities; therefore, it was impossible to include their view of problems and solutions. Obtained data were limited to the opinion of local professionals, administration workers and other local stakeholders. The human rights aspect was not clearly articulated in the tasks of the roundtables. Originality/value To the best of the authors’ knowledge, the paper is original in terms of its topic (connecting decentralisation and local stakeholders’ engagement for understanding the challenges of mental health services development) and research strategy (engagement of Ukrainian communities, qualitative analysis of the discussion results and applying the best practices and international recommendations to the local context).

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Section: Discussionmentioning

confidence: 99%

Decentralisation and community stakeholders’ engagement for better mental health services development in the conflict-affected regions of Ukraine

Klymchuk¹,

Vysotska²,

Gorbunova

2022

JPMH

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Apply a Venture Investor Mindset to Improve Program Success

Liu,

Zhao

2024

Population Health Management

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Compassion-Based Resilience Training (CBRT) to protect and nurture community care providers

Tosatti,

Khamash

2024

JPMH

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Purpose This case study describes pilot implementation of Nalanda Institute’s Compassion-Based Resilience Training (CBRT) with community care providers in New York City (NYC) to protect them from stress and trauma impacts and nurture their capacity to deliver skillful, compassionate care. Design/methodology/approach The Academy for Community Behavioral Health in NYC offered CBRT at no cost to a diverse cohort of 28 nonprofit care providers. This virtual eight-week course met weekly for 2 hours over Zoom, with formal and informal meditation practice between sessions. A mixed methods pre/post survey assessed changes in meditation practice, work-related stress and mindfulness and compassion. A final survey invited participant feedback on course experiences and course outcomes. Findings This case study suggests that a virtual eight-week CBRT course can be both feasible and effective for community care providers, even in their demanding roles. Most participants who started the course completed it (77%). CBRT helped participants establish a regular meditation practice and led to improvements on indicators of work-related stress, mindfulness and compassion. Participants linked these changes to an increased sense of hopefulness, agency and resilience for navigating stress and trauma in their work. They also found valued peer support in the course. Originality/value This case study offers one model for sharing effective but underused contemplative healing tools with care providers who encounter significant stress and trauma. It can inform efforts by funders, organizational leaders, managers, direct care staff and researchers to better protect these critical helpers.

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Mental Health Task-Shifting in Community-Based Organizations: Implementation, Impact, and Cost — Evaluation of the Connections to Care Program

Cited by 3 publications

References 153 publications

Decentralisation and community stakeholders’ engagement for better mental health services development in the conflict-affected regions of Ukraine

Decentralisation and community stakeholders’ engagement for better mental health services development in the conflict-affected regions of Ukraine

Apply a Venture Investor Mindset to Improve Program Success

Compassion-Based Resilience Training (CBRT) to protect and nurture community care providers

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