Three Nontraditional Approaches to Improving the Capacity, Accessibility, and Quality of Mental Health Services: An Overview

Abstract

To provide evidence for wider use of peer workers and other nonprofessionals, the authors examined three approaches to mental health service provision-peer support worker (PSW) programs, task shifting, and mental health first-aid and community advocacy organizations-summarizing their effectiveness, identifying similarities and differences, and highlighting opportunities for integration. Relevant articles obtained from PubMed, MEDLINE, and Google Scholar searches are discussed. Studies indicate that PSWs can achieve outcomes equal to or better than those achieved by nonpeer mental health professionals. PSWs can be particularly effective in reducing hospital admissions and inpatient days and engaging severely ill patients. When certain care tasks are given to individuals with less training than professionals (task shifting), these staff members can provide psychoeducation, engage service users in treatment, and help them achieve symptom reduction and manage risk of relapse. Mental health first-aid and community organizations can reduce stigma, increase awareness of mental health issues, and encourage help seeking. Most PSW programs have reported implementation challenges, whereas such challenges are fewer in task-shifting programs and minimal in mental health first-aid. Despite challenges in scaling and integrating these approaches into larger systems, they hold promise for improving access to and quality of care. Research is needed on how these approaches can be combined to expand a community's capacity to provide care. Because of the serious shortage of mental health providers globally and the rising prevalence of mental illness, utilizing nontraditional providers may be the only solution in both low- and high-resource settings, at least in the short term.

The Availability of Peer Support and Disparities in Outpatient Mental Health Service Use Among Minority Youth with Serious Mental Illness

“…Peer support services have the potential both to support youth engagement in general and reduce racial/ethnic disparities by providing culturally and developmentally appropriate supports that build on mutuality, empathy, and trust (Grant et al 2018 ; Simmons et al 2017 ; Solomon 2004 ). Conceptual frameworks have identified common determinants of engagement among youth, including beliefs about treatment, stigma, and trust (Lal and Malla 2015 ; Munson et al 2012 ; Tindall et al 2018 ).…”

Assessing the Social Impact of Mental Health Service Accessibility by a Nonprofit Social Enterprise: A Mixed--methods Case Study

“…While research has endeavoured to understand and measure mental health accessibility (Elliott & Hunsley, 2015), it also continues to grapple with the complexity of the concept itself (Grant, Simmons, & Davey, 2018;Knight & Winterbotham, 2019). One way researchers and practitioners alike can begin to disentangle this concept is by applying it directly to a service setting (Ganann et al, 2019).…”

Inculcating Dispositional Optimism for Prevention of Mental and Substance Use Disorders Throughout and After the Coronavirus Disease-19 Pandemic

“…48 There is, however, a critical scarcity of mental health providers globally, and with the ever-rising incidence of mental illnesses, utilizing nontraditional providers may be a solution. 69,70 Peer social workers (PSWs) can play a profound role in primary health care, 71 and research has supported that implementation through these roles also achieves good clinical outcomes. 69 Application of these programs through PSWs would also help to reduce the overall stigma of discussions and interventions related to mental health.…”

“…69,70 Peer social workers (PSWs) can play a profound role in primary health care, 71 and research has supported that implementation through these roles also achieves good clinical outcomes. 69 Application of these programs through PSWs would also help to reduce the overall stigma of discussions and interventions related to mental health. 72,73 Targeted interventions at workplaces, schools, and universities appear to be promising supplements to help employees and students inculcate adaptive stress-buffering and analytical decision-making skills adopted through dispositional optimism.…”