Community-based participatory development of a community health worker mental health outreach role to extend collaborative care in post-Katrina New Orleans

The REACH NOLA Mental Health Infrastructure and Training Project (MHIT) aimed to reduce disparities in access to and quality of services for depression and posttraumatic stress disorder (PTSD) in post-Katrina New Orleans by developing a mental health outreach role for community health workers (CHWs) and case managers as a complement to the collaborative care model for depression treatment. Community agency leaders, academics, healthcare organizations, and CHWs engaged in a community participatory process to develop a CHW training program. A review of qualitative data including semi-structured interviews, project team conference calls, email strings, and meeting minutes was conducted to document CHW input into training and responses to implementation. CHW contributions resulted in a training program focused on community engagement, depression screening, education, referral assistance, collaboration with clinical teams, and self-care. CHWs reported use of screening tools, early client successes in spite of challenges with client engagement, increase in networking and collaboration with other community agencies and providers, and ongoing community hurricane recovery issues. This intervention development approach and model may be used to address post-disaster mental health disparities and as a complement to traditional implementation of collaborative care.