ABSTRACT

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.

摘要

在美国（US），近一半符合精神健康障碍标准的儿童没有得到他们需要的治疗。不幸的是，历史上被边缘化的群体（包括低收入、种族和少数民族青年）无法获得和参与心理健康服务的比例更高。非专业卫生工作者 (LHW) 代表了一支宝贵的劳动力队伍，已被确定为解决心理健康差距的有希望的解决方案。LHW 是没有接受过正规心理健康培训的个人，他们经常与他们所服务的社区分享生活经验。越来越多的研究支持动员 LHW 解决全球服务差异问题；然而，在如何扩大和维持 LHW 护理模式方面仍存在挑战，在美国存在特定障碍 在本文中，我们描述了 LHW 在心理健康领域的不同角色和参与，以及围绕 LHW 实施的文献现状。我们将 RE-AIM 框架与 LHW 如何解决差异的概念模型相结合，以概述研究和实践的未来方向，以提高 LHW 护理模型和循证实践的范围、有效性、采用、实施和维护的公平性美国历史上被边缘化的社区