Community health workers as an integral part of a collaborative care team to address depression and PTSD in post-disaster New Orleans

Hurricane Katrina had a prolonged and marked mental health impact on the population of New Orleans and challenged the mental health care delivery infrastructure. Coupled with the stigma of depression, many people are suffering from depression and/or PTSD. While the need for information and resources to address mental health needs has been great, there are few community-based mental health outreach models in the literature.

The REACH NOLA community-academic partnership, dedicated to supporting health recovery in New Orleans, initiated the Mental Health Infrastructure and Training Project (MHIT) to address the lack of capacity and challenges in access to care for depression and post-traumatic stress disorder. Community agency leaders, academics, health-care organizations and grass-roots community members collaborated to develop a new mental health outreach model and training and supervision program, designed to be compatible with the collaborative care model of chronic disease management as applied to depression and post-traumatic stress disorder. The approach features community engagement, screenings, education, and referral, behavioral management skills, and suggested strategies to facilitate entry into and coordinate care, and to track client services and progress. We evaluated feasibility and described outreach worker responses through minutes, field notes, surveys, and semi-structured interviews collected during several rounds of training of outreach workers in New Orleans. Our experience and data suggest that such comprehensive mental health outreach programs are feasible and fill an important gap in community capacity for vulnerable populations following a major disaster, by reducing stigma, offering tangible social support, and facilitating entry into care.