The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #60847

Melanie M. Biggs, PhD¹, Shannon Lee, BA², and Mark J. DeHaven, PhD². (1) Department of Psychiatry, University of Texas Southwestern Medical School at Dallas, 5323 Harry Hines Blvd., Dallas, TX 75390-9086, 214-648-4613, Melanie.Biggs@utsouthwestern.edu, (2) Dept. of Family Practice and Community Medicine, UT Southwestern Medical School at Dallas, 6263 Harry Hines Blvd., Dallas, TX 75390

"Project Access: Caring for the Uninsured," (PA) is a CDC sponsored participatory research project providing access to care for the uninsured in Dallas, Texas. The project's mental health aim is to train and assess the effectiveness of Community Health Workers’ (CHWs) ability to provide mental health screening, referral and access to mental healthcare services and improve mental health status. The mental health-training program was developed by a clinical psychologist and included four 2-hour sessions utilizing didactics, case vignettes, video demonstrations, handouts, and role-plays. The sessions address mental disorders, screening procedures, and research procedures. A designated Mental Health CHW (CMHW) received specialized training since all patients screened with a mental disorder are assigned to them. The additional training included: depressive disorders, crisis intervention skills, procedures for accessing mental health services, and research procedures for mental health specific outcomes. All CHWs were evaluated on screening and research procedures, and were provided with additional training when necessary. Program outcomes are assessed at enrollment into PA and at six-month intervals using the SF-8 and the Quick Inventory of Depressive Symptomatology (QIDS; for patients with depressive symptoms at enrollment). Patient adherence to mental healthcare appointment keeping is also evaluated and examined for its association with patient's SF-8 and QIDS scores. The PA model encourages socialization of patients to medical care by treating mental and physical diseases simultaneously to improve patient outcomes.

Learning Objectives:

• Describe the methods used to train Community Health Workers (CHWs) to provide mental health screening, referral and access to mental healthcare services.
• Explain the Community Mental Health Workers (CMHWs) specialized training program and how the CMHWs assist individuals with mental disorders, particularly depression, to improve patients’ mental health status.
• Apply the CHWs training model and outcome measures to public health programs and mobilize the communities to address their mental healthcare needs.

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.