Building a Workforce of Care in NYC
Adam Brown, Ari Holman Fey & Sophia Ryder
Who are we?
Ari Holman Fey Professor & Director
CGMH
PhD Student & Education Specialist
CGMH Research Associate
CGMH
Sophia Ryder
Adam Brown
Global Mental Health & Capacity Building
Non-specialist providers can safely and effectively deliver low intensity MH interventions.
The World Health Organization has developed a series of MHPSS task-sharing interventions
This approach also targets:
Cultural relevance
These can be culturally and contextually adapted.
Stepped Models
Capacity building are different levels of care promotes prevention, appropriate intervention and referral processes.
Community-delivered support has shown to increase engagement & access to care.
Growing body of research demonstrates that non-specialists (people without formal clinical training) may be trained to effectively deliver evidence-based psychological interventions, something called task-sharing (Singla et al., 2017)
Singla et al., 2017
Task-Sharing
● Holds promise for improving mental health care delivery.
● Training and education of non-specialists to provide basic and brief forms of psychosocial care.
● Opportunities for providers to integrate psychosocial work into their broader range of responsibilities
● Numerous randomized control trials have demonstrated the efficacy of task-sharing for reducing distress, stigma, and improving quality of life
● Important in contexts in which there is low trust in traditional forms of mental health care
Our Work
Stepped Care Models
Scalability + Stigma Reduction
Cultural Context + Adaptability
Reach 02
Problem management plus (PM+) in NewYork City
“People who are un-lettered have been taking care of each other throughout time; the clinician is not the lead here, it’s the person who has the concern. An important shift in paradigm.” – PM+ Helper, NYC
• PM+ is 5 sessions and provides participants with a “toolkit” of skills they can use when facing stress and difficult situations, including: Deep Breathing, Problem Solving, Behavioral Activation, Accessing Social Support
• Many PM+ studies outside the US have shown PM+ to be effective in addressing stress that impacts day-to-day functioning
• Can be delivered by community members without a mental health background
• Helpers have been trained in PM+ and have been delivering the intervention in NYC since the start of the pandemic
Pillars of PFA
5. Hope
Promoting and instilling hopepromoting positivity after difficult experiences
4. Social Connectedness
Provide opportunities for knowledge, emotional support & social support activities
Psychosocial Support
(Hobfoll et al., 2007)
1. Safety
Promoting a psychological sense of safety
3. Self & Collective Efficacy
Promoting sense of self-efficacy by helping regain sense of competency and belief in one’s self
2. Calming
Promoting calming when individuals are feeling anxious
RECOUP-NY
Train Non-Profit Community Organization Staff PM+
Deliver PM+ to individuals in the community, assess symptoms before, during, and after delivery
Analyze symptoms in well-being (anxiety, depression, trauma, reducing tension)
Train more workforces
Community-Based Organizations
We currently have 39 different sites from 27 NYC community organizations participating in RECOUP–NY.
● Race groups: Black/African Americans, Hispanic/Latino, White, Asian
● Languages: English, Spanish, Chinese, French
● Populations: Elderly, immigrants, formerly incarcerated, new & expectant mothers, etc.
● Presenting concerns: housing instability, food insecurity, safety concerns, loneliness, loss of independence
TRINITY
Train Focusing on organizations localized in Lower Manhattan
Deliver PM+ is delivered to individuals who receive services at organizations in Lower Manhattan
Analyze Symptoms of depression and anxiety are measured before, during and after receiving PM+
Train Through capacity building of staff we can expand the mental health care workforce
Trinity Mental Health Network
Moving Forward 03
Biggest Issues NYers Face Today:
Finances
Financial Literacy, Resilience
Particularly among the Latinx community
Senior populations reported this Post-Pandemic, stress remains
Future Directions
Strengthen partnerships with government, private sector, and policy makers to make PM+ a sustainable model nationally
Scale in NYC with quality
Deepen local adaptation
Broaden the stepped-care ecosystem
Evaluate outcomes that matter to communities
