Abstract
Empirical engagement-promoting strategies in child and family mental health services have been identified largely within the context of clinic-based services delivered by mental health professionals. However, the magnitude of unmet youth mental health need necessitates expanding the scope of mental health services, and the associated engagement strategies, beyond traditional models and service providers. The present study aimed to extend our understanding of engagement strategies to a school-based mental health service model, using a community health worker (CHW) workforce implementing an early intervention program with parents and school-aged children (K-4) in high poverty urban communities. Qualitative semi-structured individual interviews were conducted with 16 CHWs to capture their descriptions of the engagement strategies they utilized with parents throughout program implementation. Transcripts were coded and themes were identified following procedures for thematic analysis. Thematic analyses revealed ten themes describing a range of engagement strategies falling into two overarching categories: (1) rapport building, and (2) responsive delivery. Themes within the rapport building category included non-judgmental supportive listening, increasing social proximity, praise, privacy and confidentiality, and leveraging relationships. Themes within the responsive delivery category included flexibility, consistency, advocacy, incentives, and meeting needs. Findings provide preliminary evidence regarding the ability of CHWs to identify and implement a range of engagement strategies with parents and families that parallel empirically-based engagement strategies in traditional services. These findings speak to the potential of this workforce to engage underserved families in mental health services, underscoring the important role for CHWs in reducing mental health disparities.
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Notes
In a separate analysis of these data, we found that social proximity was leveraged by CHWs to relate to parents, and this process of relating served to normalize parents’ challenges, create a sense of equality, and promote buy-in (Gustafson et al. 2018).
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We thank Francisco Padron for his contributions to data coding.
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This research was supported in part by the National Center for Advancing Translational Sciences, National Institutes of Health, through Grant UL1TR002003. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
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Gustafson, E.L., Lakind, D., Walden, A.L. et al. Engaging Parents in Mental Health Services: A Qualitative Study of Community Health Workers’ Strategies in High Poverty Urban Communities. Adm Policy Ment Health 48, 1019–1033 (2021). https://doi.org/10.1007/s10488-021-01124-8
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DOI: https://doi.org/10.1007/s10488-021-01124-8